It is a combination cream of tretinoin, hydroquinone and steroid into one. Tretinoin reduces the skin thinning effect of steroid and facilitates the skin penetration of hydroquinone. The steroid cream reduces irritation from tretinoin. Effect of Triluma cream may be observed as early as 4 weeks. A study showed 73% cleared at 1 month, 81% at 12 months with excellent safety profile over 12 months application of cream. It is applied once a day at night.