triple combination as adjuvant to cryotherapy in the treatment of solar lentigines investigatorblinded randomized clinical trial background postinflammatory hyperpigmentation is a frequent concern when treating solar lentiginesobjectives to assess the safety and efficacy of a triple combination cream with fluocinolone acetonide 001 hydroquinone 4 and tretinoin 005 as adjuvant to cryotherapy in the treatment of solar lentigines in hands dorsum and in the prevention of postinflammatory hyperpigmentation after cryotherapymethods this prospective randomized controlled investigatorblinded singlecentre study enrolled 50 patients twentyfive patients received a 2week daily triple combination cream plus sunscreen pretreatment and 25 received sunscreen alone after that cryotherapy was performed in all patients followed by a 3week recovery period after this period patients received the same initial treatment and were followed up for 8 weeks melanin and erythema levels of a target and a control lentigo were objectively measured using a narrowband reflectance spectrophotometer lentigines count colour homogeneity and global improvement were also assessedresults the number of solar lentigines reduced in the first 2 weeks only in patients who used the triple combination 25 7 vs 22 8 p 00001 and reduced at the end of the study for both groups p 00001 the melanin levels also reduced in the first 2 weeks only in patients who used the triple combination 297 69 vs 273 66 p 00001 and reduced at the end of the study for both groups p 00001 erythema and residual blisters from cryotherapy were the reported adverse reactionsconclusion triple combination cream can be used to enhance the resolution of solar lentigines and to significantly reduce melanin levels and lentigines count improving treatment results it was welltolerated and did not increase the occurrence of neither erythema nor other sideeffects after the cryotherapy