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HOW CELLGEVITY AIDS SKIN PIGMENTATION
A good number of pharmaceutical companies are creating different solutions for skin lightening. Topical depigmenting agents such as hydroquinone, glycolic acid, arbutin, kojic acid, vitamin C, vitamin E and niacinamide have been launched and made available already. The invention of newer depigmenting molecules such as pycnogenol, orchid and marine algae extracts, cinnamic acid, soy, aloesin and Boswellia has offered more topical options.
Despite the adverse effects of these agents, the crucial drawback is the localization of their effect to the area of application alone. Agents that have been lauded and recommended for skin lightening include viz; Glutathione, tranexamic acid, l-cysteine peptide and vitamin C.
GLUTATHIONE AS A SKIN LIGHTENING AGENT
This article aims to highlight the use of CELLGEVITY as a skin-lightening agent. Media speculations about Glutathione’s overhyped effects as a “skin lightening” agent and over-the-counter availability of supplements like Cellgevity have resulted in consumption of improper doses.
The truth is, consumers, as well as dermatologists who prescribe oral glutathione for general skin lightening or as an adjuvant for disorders of hyperpigmentation, are often unaware about its effectiveness, dosing and adverse effects. Dermatologists meet patients who are blown away by the manufacturers’ claims about Cellgevity; therefore leading them to try self-medication.
Oral and intravenous glutathione
Oral and intravenous glutathione have been available in some countries such as the Philippines for many years. It has been noted that the social media enthusiasts and fiends are the most likely patients who keenly seek lighter skin or treatment for their refractory facial melanosis.
Most of them are loaded with money to afford pricey medical services. Pharmaceutical companies that produce intravenous glutathione have a marketing strategy and coerce dermatologists to administer this supplement to such patients.
Not surprisingly, the trend of recommending and administering intravenous glutathione has increased within months of it becoming available, despite the potential adverse effects and lack of evidence.
It is important that dermatologists know about glutathione: its efficacy, the mechanism of hypopigmentary effects, pharmacokinetics, evidence-level and safety profile. In this article, we seek to sort out these concepts and examine the current evidence supporting the efficacy of glutathione as an inhibitor of skin pigmentation.
Evidence-based efficacy of glutathione as an oral-lightening agent
There is a note-worthy study that apparently expounded the efficiency of oral glutathione as a skin-lightening agent. A randomized, double-blind, two-arm, placebo-controlled study carried out in the Thai population studied the effect of orally administered glutathione on the skin melanin index in sixty healthy medical students The specimens received glutathione capsules at random in a dose of 500 mg/day in two divided doses.
After 4 weeks of observation, the melanin indices decreased significantly and steadily at all six sites in the glutathione group.
LIMITATIONS OF THE REASEARCH ON GLUTATHIONE SKIN LIGHTENING ABILITY
The drawback of this study is basically a short study period, lack of follow-up, lack of measurement of serum glutathione levels and the choice of cohort, which consisted of a young and healthy population. Despite these shortcomings, this study was the first to demonstrate the beneficial effects of oral glutathione in skin lightening.
Due to the low bioavailability of oral glutathione, intravenous injections are being promoted to provide desired therapeutic levels in the blood and skin and to produce “instant” skin-lightening. Interestingly, intravenous injections of glutathione have been used for years but there is not even a single clinical trial evaluating its efficacy. Manufacturers of intravenous glutathione injections recommend a dose of 600–1200 mg for skin lightening, to be injected once to twice weekly. The duration for which they should be continued is not specified. Intravenous administration is expected to deliver 100% bioavailability of glutathione, much more compared to that achieved by oral administration. However, there are no studies to support this hypothesis. Although intravenous glutathione delivers a much higher therapeutic dose that enhances its efficacy, it also provides a narrower margin of safety due to the possibility of overdose toxicity.
It is nearly impossible to ascertain the efficiency of intravenous glutathione as there is little or no available data that supports its skin lightening ability. However, the data on safety are available, but rare to find.
In an animal-based study, no noticeable negative effects were reported in dogs, who were administered up to 300 mg of glutathione per kg body weight every day for 26 weeks. Human studies in which parenteral glutathione was administered for male infertility (600 mg/day glutathione intramuscularly for two months), or given to enhance insulin secretion in people with impaired glucose tolerance, did not report any significant adverse effects. However, the adverse effects of intravenous glutathione have been documented from the Philippines, one of the leading consumers of glutathione. The Food and Drug Administration of Philippines have issued a position paper with a public warning regarding the safety of off-label use of glutathione injection [Box 5] and the adverse drug reactions reported from the use of intravenous glutathione for skin lightening [Box 6]. Proponents of intravenous glutathione suggest that these adverse effects may be attributed to other additives present in the glutathione injection vials and the risk is minimized if pure glutathione is used instead.