{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:10:55Z","timestamp":1793034655282,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hyperpigmentary disorders, including melasma, are challenging to treat. Glutathione has anti\u2010melanogenic and antioxidant properties, which led to its use as a skin\u2010lightening agent. Our objective was to review the published evidence and literature on the efficacy and safety of glutathione as a skin\u2010lightening agent and in the treatment of melasma. A literature search was done in the PubMed, Embase, and Cochrane library databases using the search terms \u201cglutathione as a skin\u2010lightening agent\u201d and \u201cglutathione in melasma\u201d for the past 10\u2009years. The level of evidence, strength of recommendation, and risk of bias assessment were evaluated. Among various forms of topical glutathione, glutathione 0.5% was significantly more effective compared to glutathione 0.1% and placebo. For glutathione alone versus glutathione plus microneedling, more improvement was seen. Five randomized controlled trials and a single open\u2010arm clinical study on oral glutathione at doses of 250\u2009mg once a day, 250\u2009mg twice a day, and 500\u2009mg once a day showed a significant reduction in the melanin index compared to placebo. The combination of topical 2% glutathione plus oral glutathione was superior to monotherapy alone. There was only one placebo\u2010controlled study on intravenous (IV) glutathione [6\/16 (37.5%) vs. 3 (18.7%), (p0.054)]. The risk of bias assessment showed that almost an equal number of studies have low and high risk of bias. Topical versus oral glutathione both provide moderately efficacious skin\u2010lightening outcomes that are localized versus generalized and have minimal versus substantial adverse effects, but they are unsustainable, with variable costs. IV glutathione is contraindicated due to lack of efficacy and side effects. It may work more as an antioxidant in melasma.<\/jats:p>","DOI":"10.1111\/ijd.17535","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T01:14:42Z","timestamp":1729732482000},"page":"992-1004","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Glutathione as a skin\u2010lightening agent and in melasma: a\u00a0systematic review"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8768-4879","authenticated-orcid":false,"given":"Rashmi","family":"Sarkar","sequence":"first","affiliation":[{"name":"Department of Dermatology and STD Lady Hardinge Medical College and Sucheta Kriplani Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0509-8169","authenticated-orcid":false,"given":"Vidya","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD Lady Hardinge Medical College and Sucheta Kriplani Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1604-8553","authenticated-orcid":false,"given":"Twinkle","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD Lady Hardinge Medical College and Sucheta Kriplani Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5610-5828","authenticated-orcid":false,"given":"Janaani","family":"P","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD Postgraduate Institute of Medical Education &amp; Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5183-624X","authenticated-orcid":false,"given":"Irena","family":"Mandal","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Maulana Azad Medical College Delhi  New\u00a0Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,23]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.179088"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.37319\/IQNJM.4.1.14"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.15242"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S68424"},{"issue":"1","key":"e_1_2_5_6_1","first-page":"4","article-title":"The efficacy of skin care products containing glutathione in delivering skin lightening in Indonesian women","volume":"11","author":"Etnawati K","year":"2019","journal-title":"Dermatol Rep"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12338"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/09546631003801619"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S128339"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.15573"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12999"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.14137"},{"key":"e_1_2_5_13_1","first-page":"E53","article-title":"Evaluating oral glutathione plus ascorbic acid, alpha\u2010lipoic acid, and zinc aspartate as a skin\u2010lightening agent: an Indonesian multicenter, randomized, controlled trial","volume":"14","author":"Sitohang IB","year":"2021","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_5_14_1","first-page":"10010","article-title":"Glutathione as a systemic skin whitening agent via the buccal mucosa: an open\u2010label, single\u2010arm study","volume":"74","author":"Castillo J","year":"2016","journal-title":"J Am Acad Dermatol"},{"issue":"3","key":"e_1_2_5_15_1","first-page":"177","article-title":"Efficacy of intravenous glutathione vs. placebo for skin tone lightening","volume":"26","author":"Zubair S","year":"2016","journal-title":"J Pak Assoc Dermatol"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8547960"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12747"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.15834"},{"issue":"1","key":"e_1_2_5_19_1","article-title":"A study on the efficacy of mesotherapy using glutathione and vitamin C for the treatment of melasma","volume":"3","author":"Puri N","year":"2020","journal-title":"J Clin Exp Cosmet Dermatol"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/jewd.jewd_43_23"},{"key":"e_1_2_5_21_1","first-page":"141","article-title":"Comparison of the efficacy and safety of topical 4% hydroquinone cream vs topical 10% glutathione plus 5% ascorbic acid cream in patients with epidermal melasma","volume":"28","author":"Hamayun S","year":"2020","journal-title":"Hong Kong J Dermatol Venereol"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12874"},{"key":"e_1_2_5_23_1","first-page":"819","article-title":"Comparative efficacy of oral tranexamic acid versus oral glutathione when given in combination with modified kligman regimen in the management of melasma","volume":"32","author":"Rao NN","year":"2023","journal-title":"Med J Dr DY Patil Vidyapeeth"},{"key":"e_1_2_5_24_1","first-page":"2823","article-title":"Clinical observation on tranexamic acid combined with reduced glutathione for the treatment of chloasma","volume":"31","author":"Feng C","year":"2018","journal-title":"Pak J Pharm Sci"},{"key":"e_1_2_5_25_1","first-page":"12833","article-title":"The efficacy of 1064\u2010nm Q\u2010switched Nd: YAG laser combined with tranexamic acid, glutathione, and vitamin C in the treatment of chloasma","volume":"12","author":"Chen X","year":"2019","journal-title":"Int J Clin Exp Med"},{"key":"e_1_2_5_26_1","first-page":"202011\u2013004","volume-title":"Safety on the off\u2010label use of glutathione solution for injection (IV)","author":"Lazo SH","year":"2011"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.17535","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijd.17535","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.17535","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T17:34:21Z","timestamp":1770917661000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.17535"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,23]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/ijd.17535"],"URL":"https:\/\/doi.org\/10.1111\/ijd.17535","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,23]]},"assertion":[{"value":"2024-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}