What topical and oral therapies do you prescribe for patients with recalcitrant melasma?

This is my Melasma algorithm:

1. Hydroquinone triple cream qhs x 6 months + azelaic acid in the AM + tinted sunscreen
2. Consider PO TXA (half of 650 mg tab bid), polypodium leucotomos bid (heliocare)
3. Maintenance: stop hydroquinone and switch to compounded TXA/kojic/tretinoin combo cream qhs + vitamin C/azelaic in the morning
4. Cysteamine cream a few times weekly at bedtime
5. Add on microneedling to topicals before higher-risk things (peels, lasers)