Dermatica / Melasma Treatment
PERSONALISED FORMULA
The candidate pool is hydroquinone 4%, tretinoin 0.025–0.1% and fluocinolone acetonide 0.01% — the exact composition of the only melasma product the FDA has ever approved, published in numbers, for $29.95 a month. That product is licensed for eight weeks. This one is sold with a twelve-month prepay and no end date on the page.
Worth buying for a specific person with a specific problem. Read who.
ASSESSED ON 75% OF THE MODEL. 2 CRITERIA LEFT UNSCORED — SEE SCORING FOR WHY.
Ask at the outset how many weeks the fluocinolone runs for and what you step down to. The page will not raise it, and it is the single most important question here.
The verdict
Read the candidate pool and you are looking at the best-evidenced melasma regimen that exists. Hydroquinone 4%. Tretinoin, published at 0.025–0.1%, a range containing 0.05%. Fluocinolone acetonide 0.01%. That is the Kligman triple combination, and it is the exact composition of Tri-Luma — the only topical the FDA has ever approved for melasma. Dermatica publishes all three concentrations on the page, adds azelaic acid 4–20% and niacinamide 4% as alternatives, and charges $29.95 a month. On the pharmacology, this is the strongest thing in the register.
Tri-Luma is licensed for short-term use — up to eight weeks. The reason is the steroid: prolonged fluocinolone on facial skin causes atrophy, telangiectasia and perioral dermatitis, and the melasma it treats mostly returns afterwards, which is precisely why the temptation to keep going is the risk being guarded against.
This page states no duration limit anywhere. It states the opposite: 'start seeing results within 12 weeks' — a headline timeline that runs half again past the labelled maximum of the regimen it is selling. The pricing page's cheapest per-bottle tier is twelve months paid upfront. The word 'steroid' does not appear on the page at all; fluocinolone acetonide is listed as something that 'slows down the inflammatory process that leads to pigmentation', which is true and is not the sentence a buyer needs.
And then the part that is hardest to defend. Melasma is called the pregnancy mask on this very page. Pregnancy appears three times — as a cause of the condition, in the definition, in the FAQ, in a blog link. It appears zero times as a reason not to use the treatment, on a page whose pool contains topical tretinoin. The company writes that warning well elsewhere; on its own retinal serum it is bolded, explained and given alternatives. Here, on the one indication most tightly bound to pregnancy in all of dermatology, it is absent.
- The candidate pool reproduces the Kligman triple combination — the only regimen the FDA has approved for melasma.
- All five concentrations are published on the page you buy from, including the corticosteroid's.
- Hydroquinone is at 4%, the licensed concentration, not the 12% found elsewhere in this register.
- Naming fluocinolone acetonide 0.01% on the product page is better disclosure than the competitor who kept its hydrocortisone in support material.
- Azelaic acid at up to 20% is a genuinely evidenced alternative for anyone who should not take hydroquinone or a steroid.
- The 'what to expect' FAQ describes the irritation honestly and gives a real tolerance-building protocol.
- The page is honest that topical treatment may not be enough and that hormonal causes are worth investigating with a doctor.
- $29.95 a month for this composition is a serious price.
- A named consultant dermatologist is attached to the clinical claim.
- No treatment duration is stated anywhere, for a regimen whose reference product is licensed for eight weeks.
- 'Start seeing results within 12 weeks' sets an expectation half again beyond that licensed maximum.
- The word 'steroid' and the word 'corticosteroid' appear zero times on a page that prescribes one.
- Pregnancy is named three times as a cause of melasma and never as a contra-indication, on a page offering tretinoin.
- Sun protection — the foundation of melasma management — is one clause inside an FAQ headed 'What else can I do'.
- Hydroquinone and fluocinolone are the two actives with duration limits and the only two in the palette with no ingredient page; both URLs 404.
- The cheapest per-bottle tier is twelve months prepaid, which is the longest commitment attached to the shortest-course drug in the range.
- No fill size, and no INCI for the base, so neither cost per application nor the vehicle is knowable.
- The actives blurb is copied from the anti-ageing page and still promises to 'slow and reverse visible signs of aging' on a melasma treatment.
- Tranexamic acid is in the company's palette at 3–5% and named as a melasma treatment in its own index, but is absent from this pool.
Every active, assessed
- Hydroquinone4%
Tyrosinase inhibitor — blocks melanin synthesis
- BENCHMARK
- 4% is the conventional prescription strength and the Tri-Luma concentration
- ASSESSMENT
- The right drug at the right number for this indication, published on the page. Melasma is the textbook hydroquinone indication and this is the textbook dose. The duration question is the whole question: the company's own blog says cycles of three to four months, its support centre says a break at six, and the page says nothing.
- Fluocinolone Acetonide0.01%
Topical corticosteroid — suppresses the inflammatory component of melasma and offsets retinoid irritation
- BENCHMARK
- 0.01% is the Tri-Luma concentration, licensed for up to 8 weeks
- ASSESSMENT
- Pharmacologically correct and the reason triple combination outperforms hydroquinone alone. It is also the component that caps the regimen at eight weeks, and neither that cap nor the word 'corticosteroid' appears on the page. Named with its concentration, which is more than a competitor managed — with no stated stop, which is less.
- Tretinoin0.025%–0.1%
Retinoid — increases turnover, disperses pigment, improves penetration of the other two
- BENCHMARK
- 0.05% is the Tri-Luma concentration; the published range contains it
- ASSESSMENT
- The third leg of the triple combination, published as a range that brackets the licensed concentration. Correct. It is also the reason the missing pregnancy warning matters: this is a teratogen-class topical on a page about a condition that pregnancy causes.
- Azelaic Acid4%–20%
Tyrosinase inhibitor, selectively cytotoxic to hyperactive melanocytes
- BENCHMARK
- 20% has trial evidence in melasma comparable to hydroquinone 4%
- ASSESSMENT
- The genuinely good alternative in this pool, and the one to ask about. At 20% it has melasma evidence approaching hydroquinone's, carries no ochronosis risk and no duration ceiling, and is the option their own material calls suitable in pregnancy. At 4% it is a supporting player. The five-fold range decides which product you actually have.
- Niacinamide4%
Inhibits melanosome transfer to keratinocytes; anti-inflammatory
- BENCHMARK
- 2%–5% is the evidenced range
- ASSESSMENT
- A real dose of a genuinely useful melasma adjunct — it works on pigment transfer rather than synthesis, so it stacks with everything else here without adding irritation.
| ACTIVE | CONC. | BENCHMARK | ASSESSMENT |
|---|---|---|---|
| HydroquinoneTyrosinase inhibitor — blocks melanin synthesis | 4% | 4% is the conventional prescription strength and the Tri-Luma concentration | The right drug at the right number for this indication, published on the page. Melasma is the textbook hydroquinone indication and this is the textbook dose. The duration question is the whole question: the company's own blog says cycles of three to four months, its support centre says a break at six, and the page says nothing. |
| Fluocinolone AcetonideTopical corticosteroid — suppresses the inflammatory component of melasma and offsets retinoid irritation | 0.01% | 0.01% is the Tri-Luma concentration, licensed for up to 8 weeks | Pharmacologically correct and the reason triple combination outperforms hydroquinone alone. It is also the component that caps the regimen at eight weeks, and neither that cap nor the word 'corticosteroid' appears on the page. Named with its concentration, which is more than a competitor managed — with no stated stop, which is less. |
| TretinoinRetinoid — increases turnover, disperses pigment, improves penetration of the other two | 0.025%–0.1% | 0.05% is the Tri-Luma concentration; the published range contains it | The third leg of the triple combination, published as a range that brackets the licensed concentration. Correct. It is also the reason the missing pregnancy warning matters: this is a teratogen-class topical on a page about a condition that pregnancy causes. |
| Azelaic AcidTyrosinase inhibitor, selectively cytotoxic to hyperactive melanocytes | 4%–20% | 20% has trial evidence in melasma comparable to hydroquinone 4% | The genuinely good alternative in this pool, and the one to ask about. At 20% it has melasma evidence approaching hydroquinone's, carries no ochronosis risk and no duration ceiling, and is the option their own material calls suitable in pregnancy. At 4% it is a supporting player. The five-fold range decides which product you actually have. |
| NiacinamideInhibits melanosome transfer to keratinocytes; anti-inflammatory | 4% | 2%–5% is the evidenced range | A real dose of a genuinely useful melasma adjunct — it works on pigment transfer rather than synthesis, so it stacks with everything else here without adding irritation. |
Scoring
- EVIDENCE FOR THE ACTIVEWEIGHT 30%88/100
The strongest evidence position in the register. The candidate pool reproduces the only FDA-approved melasma treatment, at its licensed concentrations, published as numbers, with azelaic acid at up to 20% as a well-evidenced alternative and niacinamide at 4% as a sensible adjunct. Held back only by the absence of clinical data for the personalised formula itself, and by tranexamic acid — which the company's own ingredient index says treats melasma — not appearing in this pool at all.
- FORMULATION INTEGRITYWEIGHT 20%60/100
The regimen is right and the base is sensible. What is missing is a stop. Agency scores highest in this register on formulation because it built the cycle into the product — two to three months on hydroquinone, then a hydroquinone-free break formula, switched automatically. Here the same drugs, plus a corticosteroid, run on a formula that changes only if a check-in changes it. Also marked down for no published INCI on the product you apply nightly.
- DISCLOSUREWEIGHT 15%50/100
Better than the anti-ageing page in two respects — side effects are described and sun protection is at least mentioned — and worse in the ones that count here. No duration limit for an eight-week regimen. The word 'steroid' appears zero times. Pregnancy appears three times as a cause of the condition and never as a contra-indication, on a page whose pool contains tretinoin. Against that, real credit: all five concentrations are on the page, including the steroid's, which a competitor omitted entirely.
- TOLERANCE IN USEWEIGHT 15%NOT ASSESSED
Not assessed. Triple combination is more irritating than any single agent in it, and the retinisation guidance the page does give — build up slowly, moisturise before and after, take rest days — is sound. A panel would be most useful here on whether people stay on it long enough to work and stop before it costs them.
- TEXTURE & WEARWEIGHT 10%NOT ASSESSED
Not assessed. Requires the product in hand across the full course.
- COST PER APPLICATIONWEIGHT 10%60/100
$29.95 a month for the composition of a branded product that has historically cost several times that is real value, and the prescriber and adjustments are included. Held back because no fill size is published, so cost per application is still not computable — and because the per-bottle discount ladder rewards a twelve-month commitment to an eight-week regimen, which is the wrong incentive pointed at the wrong drug.
What it is
A compounded prescription night cream for melasma, prescribed after an online consultation, at $29.95 a month following a $4.99 first month. A provider selects from five published candidates — hydroquinone 4%, tretinoin 0.025–0.1%, fluocinolone acetonide 0.01%, azelaic acid 4–20% and niacinamide 4% — blended into the company's SmartBase. Two bottles ship every 56 days, and the plan runs until you stop it.
This is Tri-Luma, unbundled
Melasma has exactly one FDA-approved topical treatment. It is Tri-Luma, and it is three drugs in one cream: fluocinolone acetonide 0.01%, hydroquinone 4%, tretinoin 0.05%. The combination is Kligman's, it has been the reference regimen for decades, and it outperforms hydroquinone alone because the three agents attack pigment by different routes while the steroid holds down the irritation the other two cause.
Dermatica's melasma pool is those three drugs, at those concentrations, printed on the page with the numbers attached. Tretinoin is published as 0.025–0.1%, a range that brackets the licensed 0.05%. Hydroquinone is 4% exactly. Fluocinolone acetonide is 0.01% exactly.
We should be plain about how good that is. This register has spent nineteen reviews asking companies to say what is in the tube. Here is one publishing the composition of a branded prescription product, correctly, on the page where you buy, for $29.95 a month — and adding azelaic acid at up to 20%, which has melasma trial evidence approaching hydroquinone's and carries neither an ochronosis risk nor a steroid clock. On pharmacology alone this is the strongest entry in the register.
And Tri-Luma is licensed for eight weeks
The approved indication is the short-term treatment of moderate to severe melasma of the face. Short-term means up to eight weeks. It is not approved for maintenance, and the label is explicit that most patients relapse after treatment stops.
The eight weeks are there because of the steroid. Fluocinolone acetonide on facial skin, continued, produces cutaneous atrophy, telangiectasia, perioral dermatitis and tachyphylaxis — and because melasma characteristically returns when treatment stops, the pressure to simply keep applying it is built into the condition. The duration limit is the guard-rail against the most predictable behaviour a melasma patient has.
Every figure above except the first is Dermatica's own. The licensed maximum for the regimen is the shortest number on the chart, it is set by the steroid, and it is the only one that does not appear anywhere on the melasma page. The twelve-month plan is the cheapest per bottle.
Dermatica has published hydroquinone guidance twice — three to four months in its SkinLab article, six months in its support centre. Both are defensible for hydroquinone. Neither is about fluocinolone, whose ceiling is shorter than either, and no Dermatica document we found addresses how long the corticosteroid runs. The drug with the tightest limit in the pool is the one with no stated limit anywhere.
The fair mitigation, and we made the same one on the anti-ageing review: a Dermatica plan buys a prescribing relationship rather than a fixed formula. Providers review at check-ins and the formula does change. So twelve months paid does not mean twelve months of fluocinolone. It means the stop depends on a review happening and someone acting on it, rather than on the product.
We scored Agency's Dark Spot Formula at 65 and marked it down for keeping its hydrocortisone in support material instead of on the page. But Agency built the stop into the product: two to three months on the hydroquinone formula, then two months on a hydroquinone-free break formula, switched automatically without being asked. Dermatica names its steroid and its concentration on the page, which Agency did not. Agency ships the break, which Dermatica does not. Neither company has done both, and the two edits are trivial next to the formulation work each has already finished.
The word 'steroid' does not appear on the page
We searched the source. 'Steroid': zero occurrences. 'Corticosteroid': zero. 'Atrophy': zero. 'Eight weeks': zero.
What the page says instead is that fluocinolone acetonide 'slows down the inflammatory process that leads to pigmentation'. That is accurate, and it is a description of a mechanism rather than a description of a drug class. A buyer reading that line has no way to know they are being offered a topical corticosteroid, or that corticosteroids on facial skin are conventionally time-limited, or that this is why the branded version of the regimen carries an eight-week ceiling.
Name the class. Two words in the ingredient card — 'a mild topical corticosteroid' — would let a reader connect fluocinolone to everything they already know about steroid creams on faces. Dermatica writes that kind of sentence well everywhere else on its site.
Pregnancy is named three times, always as a cause
This page opens by explaining that melasma is 'also known as chloasma or the pregnancy mask'. Its FAQ says the underlying factors include 'hormonal changes from pregnancy or hormone treatment'. It links to a blog post titled 'Let's talk about: Pregnancy and Melasma'.
Three mentions of pregnancy, all of them explaining why you have the condition. Zero mentions of pregnancy as a reason not to use the treatment — on a page whose candidate pool contains topical tretinoin, for an indication defined by its association with pregnancy, sold to an audience the page itself says is typically aged thirty to forty.
On the anti-ageing page we flagged the same absence and noted that the company writes the warning properly on a $39.99 cosmetic — bolded, explained, with pregnancy-safe alternatives named, and a passing note that a pregnancy-safe personalised formula exists. Every one of those sentences is more necessary here than there. Melasma is the one dermatological indication where the prescriber can assume a meaningful share of readers are pregnant, recently pregnant, or on the hormonal contraception that triggers it. The page that most needs the warning is the page without it.
The remedy is already written and already stocked. Azelaic acid is in this pool, their own material calls it suitable in pregnancy, and at 20% it is a real melasma treatment rather than a consolation. One sentence pointing pregnant readers at it would turn the largest hole on this page into one of its strengths.
Sun protection is the treatment, filed under 'what else can I do'
Melasma is driven by ultraviolet and visible light. Photoprotection is not an adjunct to treating it; it is the part without which the rest does not hold, and the part that determines whether the result survives the summer.
On this page it appears once, as a clause, inside an FAQ headed 'What else can I do to help with melasma?': 'Avoiding direct sunlight and applying sun protection frequently will also help to improve the appearance.' The word 'also' is doing a lot of work there.
Their own blog is better and more specific — mineral or physical sunscreen, at least SPF 30, daily, whether or not the sun is out, which is the correct advice for this condition. It is the same pattern we found across the anti-ageing review: the right guidance exists, written by people who know it, one click from the page that needed it.
Two drugs with clocks, two pages that do not exist
Dermatica publishes full ingredient pages for adapalene, benzoyl peroxide and tretinoin — mechanism, strengths, FAQ, and a real bibliography. They are good pages.
Hydroquinone and fluocinolone acetonide have no pages. We checked both URLs; both return 404. Those are precisely the two actives in this pool that carry duration limits, and precisely the two whose limits are the thing a melasma patient most needs explained. The three actives with pages are the three that need them least.
One smaller sign of the same haste: the actives section on this melasma page still carries the anti-ageing page's blurb, promising ingredients that 'slow and reverse visible signs of aging'. It is a copy-paste, it is harmless, and it suggests the melasma page was assembled from the template rather than written for the indication. That would explain a good deal of what is missing from it.
If you are considering it
- Ask which actives you have been prescribed and at what strength. Azelaic acid alone spans 4% to 20% here.
- If fluocinolone is one of them, ask at the outset how many weeks it runs for and what you step down to. The licensed answer for this regimen is eight weeks. Put the date in your calendar yourself.
- If you are pregnant, breastfeeding or trying to conceive, say so unprompted. Ask for azelaic acid and no retinoid — the page will not raise any of this.
- Buy a mineral SPF 30 or higher and wear it daily, including indoors near windows and in winter. For melasma this is not optional and this page underplays it.
- Think hard before prepaying twelve months. The discount is real; nothing in this pool is a twelve-month drug.
- Expect management rather than cure, and expect relapse if photoprotection lapses. Their blog says this; their treatment page does not.
- Ask about tranexamic acid. Their own ingredient index lists it at 3–5% for melasma and it is the conventional substitute during a hydroquinone break, but it is not offered in this pool.
Where we stand
At 69 this is a review pulled hard in both directions. The pharmacology deserves better than 69 — it is the licensed melasma regimen, published in numbers, at a price that puts it within reach of people who would never have filled the branded prescription. Nobody else in this register has published a corticosteroid's concentration on the page you buy from. That is real, and the competitor we scored higher for its cycling protocol did not manage it.
The score is where it is because the one number this regimen depends on is the one number missing. Eight weeks is not a footnote; it is the difference between the best-evidenced melasma treatment there is and a topical steroid running indefinitely on a face. Selling it beside a twelve-month prepay and a promise of results at twelve weeks points every incentive the wrong way, and a check-in that may or may not catch it is not the same as a product that stops.
Four edits fix this, and Dermatica has already written three of them elsewhere on its own site. Put the eight weeks on the page. Call fluocinolone a corticosteroid. Add the pregnancy warning that the $39.99 serum already carries, and point pregnant readers at the azelaic acid in the pool. Move the mineral-SPF advice out of the blog and into the treatment. Do those and this is the product we recommend for melasma without qualification — and it would deserve to be.
Who this is for
- Someone with established melasma who wants the licensed regimen at a fraction of the branded price and will treat it as a course.
- Someone who will ask at the outset how many weeks the fluocinolone runs and what the step-down formula is.
- Someone who will wear a mineral SPF 30+ daily without being told to, because this page barely tells them.
- Someone who would rather ask for azelaic acid 20% and skip both the hydroquinone and the steroid entirely — a good option here, and it is in the pool.
- Someone who understands melasma recurs, and is choosing management rather than expecting a cure.
- You are pregnant, breastfeeding or trying to conceive. This pool contains tretinoin, and the page will not warn you — ask for a pregnancy-safe formula, which the company does run.
- You want to prepay twelve months. Nothing in this pool is a twelve-month drug and the steroid is an eight-week one.
- You will not use daily photoprotection. Without it this regimen is treating against a cause that is still running.
- You have had steroid-induced atrophy, telangiectasia or perioral dermatitis before.
- You want a cure. Melasma relapses, and their own blog says so more plainly than their treatment page does.
Ask at the outset how many weeks the fluocinolone runs for and what you step down to. The page will not raise it, and it is the single most important question here.
This is an editorial assessment of published information about a prescription product. It is not a diagnosis, not a prescription and not a substitute for your own prescriber. Hydroquinone and tretinoin are drugs. Decisions about them belong with a clinician who has seen your skin.
Sources
- S-01Dermatica — melasma treatment page The five published candidates and their concentrations including fluocinolone acetonide 0.01%, the 'results within 12 weeks' claim, the 'what to expect' side-effect FAQ, the single sun-protection clause, the three pregnancy-as-cause mentions, and the absence of any duration limit or use of the word steroid. Read 27 July 2026.
- S-02Dermatica — ingredients index Fluocinolone acetonide 0.01% and tranexamic acid 3–5% in the palette, the latter listed as treating melasma but absent from the melasma pool. Neither hydroquinone nor fluocinolone has an ingredient page; both URLs return 404.
- S-03FDA — TRI-LUMA cream prescribing information Fluocinolone acetonide 0.01% / hydroquinone 4% / tretinoin 0.05%, indicated for the short-term treatment of moderate to severe melasma — up to eight weeks — with relapse expected after treatment stops.
- S-04Galderma — Tri-Luma, the only FDA-approved treatment for melasma Confirms Tri-Luma's status as the sole FDA-approved melasma topical, which is what makes the composition of this pool notable.
- S-05Dermatica SkinLab — hydroquinone cream The company's published position that hydroquinone should run 'in cycles of three to four months, followed by a break', and its ochronosis risk.
- S-06Dermatica support centre — hydroquinone The dermatology team's stated position that a break is needed after six months. Neither this nor the SkinLab figure addresses the corticosteroid.
- S-07Dermatica SkinLab — how can I get rid of my melasma sun moustache The photoprotection advice the treatment page lacks — 'a mineral or physical sunscreen (at least SPF 30) daily whether the sun is shining or not' — and the acknowledgement that there is no cure for melasma.
- S-08Dermatica — pricing page The four payment plans: $29.95 monthly down to $22.42 a bottle on twelve months prepaid at $269, the largest discount attached to the longest commitment.
- S-09Ishack et al. — Exogenous ochronosis associated with hydroquinone: a systematic review (Int J Dermatol, 2022) The ochronosis literature behind the hydroquinone duration finding, applied here to the same 4% concentration on facial skin.