For how we live.
The brown facial patches come from overactive pigment cells in sun-aged skin. Triple-combination cream beats hydroquinone alone (risk ratio 1.58) and tranexamic acid helps, but relapse is the rule.
Sun-driven brown patches are hard to shift. A Cochrane review found a triple-combination cream beat hydroquinone alone; newer meta-analyses point to tranexamic acid and PRP, on thinner evidence.
Cochrane pooled 106 randomised trials in 13,631 people; a phenotype-led update reached 152 studies. The best evidence is feature-by-feature — brimonidine for redness, ivermectin and azelaic acid for pustules.