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Li P, Zhong C, Li S et al (2018) Plasma concentration of trimethylamine-N-oxide and risk of gestational diabetes mellitus

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If no improvement is seen by ~8-12 weeks, the physician might discontinue the cream because lack of response by that time could indicate that the melasma is not responding to topical therapy (some melasma, especially dermal/deep type, is very resistant)

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