Glutathione as Systemic Skin Lightening Peptide
RS AL Dr MIntohardjo / Klinik Spesialis Gracia Patricia Jakarta
“Nature gives you the face you have at twenty; it is up to you to merit the face youhave at fifty.-Coco Chanel-”
Glutathione is a low molecular weight thiol-tripeptide at the center stage of a multitude of cellular processes, including cell proliferation, differentiation, and apoptosis. Most of these molecular mechanisms linked to the modulation of cellular redox state.
Glutathione deficiency in elderly humans occurs because of a marked reduction in synthesis; this contributes to oxidative/nitrosative stress, a condition connected with the pathogenesis of many chronic degenerative diseases.
In addition to its remarkable antioxidant properties, the discovery of its antimelanogenic properties has led to its promotion as a skin-lightening agent .glutathione has regulatory properties on melanogenesis and antioxidants in general are protective against aging process
A lighter skin tone has been considered a superior trait in most races, especially in women of Asian or African descent who have Fitzpatrick skin types IV–VI.. Aggressive media campaigns about its exaggerated effects as a “skin lightening” agent and over-the-counter availability of this drug have resulted in consumption of improper doses and schedules patients who are inclined to self-medicate with glutathion
Its skin-lightening effects result from direct as well as indirect inhibition of the tyrosinase enzyme and switching from eumelanin to phaeomelanin production.
It is available in oral, parenteral and topical forms
Watanabe et al demonstrated that topically applied GSSG can significantly reduce melanin indices.
Apart from the local adverse effects of these agents, the limitation is the localization of their effect to the site of application alone; The necessity to apply topical antiwrinkle preparation to the entire skin is costly and impractical.
The search for systemic skin lightening logically ensued. The use of intravenous glutathione finds no evidence to support it and is further marred by its potential complications
Glutathione can be transported across the intestinal epithelium after oral supplementation Currently, there are three randomized controlled trials that support the skin-lightening effect and good safety profile of oral glutathione
Arjinpathana N et al demonstrated that oral glutathione, 500 mg/d, can reduce skin pigmentation after 4 weeks’ administration in young, healthy medical students.
Handog et al investigated the use of intraoral lozenge containing 500 mg of glutathione in an open-label study and demonstrated significant skin lightening after 8 weeks of administration
Weschawalit et al in their second study conducted a randomized, double-blind study that analyses the effect of glutathione, at a dose of 250 mg /d for 12 weeks in both reduced and oxidized forms in comparison with placebo
Both GSSG and GSH exerted their effects on melanin indices, which reached statistically significant levels at specific site and higher age group. GSH was significantly superior to placebo in its ability to improve wrinklesat some anatomic locations.
Overall, glutathione in both forms are well tolerated. No major adverse events took place during the study period. oral glutathione, 250 mg/d, in both reduced and oxidized forms have various beneficial effects on skin properties and is possibly an antiaging agent, at least in middle-aged female subjects.
However, key questions such as the duration of treatment, longevity of skin-lightening effect and maintenance protocols remain unanswered. More randomized, double-blind, placebo-controlled trials with larger sample size, long-term follow-up andand more diverse populations are warranted.
It is important that practicing physicians know about glutathione: its efficacy, the mechanism of hypopigmentary effects, pharmacokinetics, evidence-level and safety profile
Dilokthornsakul, Dhippayom, “The clinical effect of glutathione on skin color and other related skin conditions: A systematic review” Journal of Cosmetic Dermatology Vol18, issue 3, June 2019 https://doi.org/10.1111/jocd.12910
Grimes, P E et al. “New oral and topical approaches for the treatment of melasma.” International journal of women's dermatology vol. 5,1 30-36. 20 Nov. 2018, doi:10.1016/j.ijwd.2018.09.004
Sonthalia, Sidharth et al. “Glutathione for skin lightening: a regnant myth or evidence-based verity?.” Dermatology practical & conceptual vol. 8,1 15-21. 31 Jan. 2018, doi:10.5826/dpc.0801a04
Watanabe, Fumiko et al. “Skin-whitening and skin-condition-improving effects of topical oxidized glutathione: a double-blind and placebo-controlled clinical trial in healthy women.” Clinical, cosmetic and investigational dermatology vol. 7 267-74. 17 Oct. 2014, doi:10.2147/CCID.S68424
Weschawalit, Sinee et al. “Glutathione and its antiaging and antimelanogenic effects.” Clinical, cosmetic and investigational dermatology vol. 10 147-153. 27 Apr. 2017, doi:10.2147/CCID.S128339