Hello and thank you for your question. Triluma is a strong lightening cream consisting of a steroid cream, the lightening agent hydroquinone and tretinoin 0.05%.
As accutane consists of isotretinoin which is in the same family of drugs as tretinoin, there is a risk that you may develop irritation of the skin when both are used together.
If your accutane dose is fairly low (20mg or less), you can try using very small amounts of the Triluma over the melasma area. If your skin is not too sensitive, you may just be lucky enough use both together.
Best regards
Dr Stephanie H
