Derm Talk: Is Triluma Safe? Dr. Jeanine Downie dishes….
SO, I know what you are thinking, “Another post on melasma?”…Why? Because this annoying skin condition (pictured above) affects 1/3 of ALL women who take birth control pills or who are on HRT!!! Most common in dark skinned women ( and myself, thanks to my Latina roots..) it can be a frighteningly hard problem to solve. Why? Because A. everyone’s skin is different and responds to treatments uniquely and B. the potions and procedures to fight melasma can be pretty intense (not mention costly).
So you can imagine how pleased-as-punch I was to be able to sit down and interview (via Skype) Dr. Jeanine Downie. An amazingly accomplished dermatologist, Dr. Downie is a regular on The Today Show, has been quoted in “Oprah” and even wrote chapters on skincare for 2 of Bobbi Brown’s books ( I knew I liked her..lol)! Needless to say, I knew Dr. Downie would be able to increase my understanding of melasma and the various treatment options.
Why does Dr. Downie know so much about melasma? Because as a teenager she regularly fried her skin on the Jersey Shore as a lifeguard (the sun is the DEVIL when it comes to bringing out melasma). The resulting sun damage, coupled with her African American descent and she was ripe for developing melasma later in her life (as this condition tends to develop in women of child-bearing age and beyond)….Nothing quite like hearing advice directly from the horse’s mouth, I say!
So how does Dr. Downie treat melasma on herself and her patients? Well, her first line of fire is the prescription cream Triluma. You’ve heard me talk about it before because the combo of the bleaching agent hydroquinone, the exfoliating action of retinoid and the skin-calming effects of a steroid truly represent the gold-standard when it comes to fighting melasma. However, Triluma (and consequently it’s bleaching agent, hydroquinone) has not been without controversy when it comes to the side effects. Banned in Europe and Japan, hydroquinone was found to cause cancer in laboratory rats; however our American Academy of Dermatology stands by the safety of hydroquinone, saying that the study was flawed since these rats were fed an increasingly high dose of the drug over an extremely long time.
Does Dr. Downie think Triluma is safe? Most definitely. In fact, she has used the cream on her own melasma since 2002! Even though it’s not approved for long-term use, she says it’s fine to spot-treat after the first 8 weeks of treatment (due to the fact that the retinoid in Triluma negates the skin-thinning effects that a topical steroid can potentially cause). Dr. Downie also prescribes Triluma “off-label” for the annoying hyper-pigmentation that recent acne scars can leave you with ( …good times!). She even told me that the initial controversy (and a resulting move to ban the drug in the US in 2006) regarding hydroquinone was started by a competing company who stood to profit from the ban of the ingredient from cosmetic and/or prescription products (big shock there!…no, I’m not bitter).
What other weapons does Dr. Downie use to fight melasma? The Fraxel “Restore” laser (way too much info for me to go into here…I’m still on topicals) and a steady, daily dose of sunscreen. You can do everything to get rid of melasma, but the minute you go out in the sun unprotected it will come back. Melasma is definitely a condition that is “managed” and not “cured” (like so many things in life, *sigh*).
What’s MY personal opinion of Triluma? Well, as you know I’ve been spot-treating with it the last month or so on my upper-lip. I’ve had absolutely no side-effects there and am happy to say am “mustache-free” this summer (in fact, I haven’t even had a breakout…”knock on wood”)! However, I did try it on a few acne scars on my upper cheeks and it left a pretty nasty red mark for a few days (so I stopped using there)….Even so, I’ll continue to use with caution to keep the ’stache at bay this summer at least.
Bottom-line, I think (like any other prescription) Triluma should be used just like my pharmacy label states “when the benefits of treatment outweigh the potential side-effects and risks”….Meaning, it’s up to the individual to educate themselves and ultimately decide when it’s right for them….And as much as we focus on our inner beauty, I’ve seen melasma rob women of their confidence and self-esteem…both professionally as a makeup artist and as a friend of women who suffer from it. I mean, as much as I LOVE makeup…nothing hurts my heart more than a women who feels that she can’t live without it.
That’s my two cents! Thanks to Dr. Downie for an outstanding interview and putting up with my Skypeing technical short-falls. (Seriously, could NOT get the mic on my computer to work so we looked at each other while I talked to her on my cellphone…lol!).
What are your thoughts on this my Dear Readers?….You better dish.
Be Beautiful Y’all…..
