Since triple-combination creams haven't worked, you have several effective alternatives. Topical creams containing azelaic acid, kojic acid, topical tranexamic acid, or cysteamine are excellent options that gently lighten melasma by regulating pigment production. Incorporating niacinamide or vitamin C can also support skin brightening. Crucially, daily application of a broad-spectrum sunscreen (SPF 30 or higher) is vital, as even minimal sun exposure can trigger melasma. Since this has persisted for three years, I highly recommend consulting a dermatologist. They can safely guide your transition to these alternatives or discuss advanced options like mild chemical peels or laser therapies tailored to your skin type.