MIRROR MIRROR ON THE WALL LOOK WHO IS FAIREST OF THEM ALL!

Skin colour has a very important place in people’s physiological and social space. People with fairer skin tone have been considered a superior trait in most of the races, thus causing low confidence amongst person with darker skin complexion. This has led to a number of skin whitening products being launched in the market either for local or systemic skin whitening.Systemic skin whitening is now a day’s gaining lot of popularity as these products promise to give 3-4 shades lighter tone to the whole body for a sustained period of time.

WHAT IS SYSTEMIC SKIN LIGHTENING?

Systemic skin whitening is a process wherein we give high doses of medicines either orally or intravenously which inhibit the production of melanin which is responsible for imparting colour to the body. Different individual has different skin colour and it is because of the difference between the amount and type of the melanin which body is producing, which in turn depends on genetic as well as external factors. The drugs which are getting more and more available in the market stops or reduces the melanin production to such an extent that it makes the skin of overall body look fairer. 

WHAT ARE THE AGENTS WHICH ARE AVAILABLE? 

There are different products available in the market and are listed as follows:

  1. GLUTATHIONE: The most commonly used systemic skin whitening agent has GSH used alone or in various combinations, both as oral and intravenous formulations. GSH is an antioxidant synthesized It is also available naturally in watermelon, avocado, broccoli, spinach, and tomatoes. GSH is involved in various biochemical processes especially those involving scavenging of free radicals and detoxification of toxic compounds, it acts as a coenzyme and helps in the transport of amino acids across the cell membranes. The role of GSH as a skin whitening agent was an accidental discovery when skin whitening was noticed as a side effect of large doses of GSH. This led to extensive studies establishing its role in melanogenesis and the recent use of GSH as systemic skin whitening agent.GSH for skin whitening is available in both tablet and injectable form. When taken orally. Even when large oral doses were administered, it was found very less amount of it is getting absorbed into the blood stream from the gut thus reducing its efficacy thus making use of intravenous form more popular. GSH is given at a dose of 20 and 40 mg/kg/body weight/day which is divided into two doses with a maintenance dose of 500 mg/day. The gradual systemic effect will be seen 1-3 months in a medium brown skin, in 3-6 months in dark brown skin, in 6-12 months in a very dark skin and in 2 years are more in black skin. Injectable GSH is given at a dose of 900 -2000 mg weekly by the intravenous or intramuscular method and the sessions can be repeated 2-3 times a week depending upon the dose to be administered. Skin whitening can be seen as early as 2-3 weeks.

  2. L-CYSTEINE PEPTIDE: L-cysteine peptide, which is claimed to be 3-5 times more potent than GSH and is BFAD approved. Natural sources of L-cysteine include poultry, yogurt, egg yolks, red peppers, garlic, onions, broccoli, Brussel sprouts, oats, and wheat germ. It also improves the colour by blocking the enzymes required for the conversion of basic substrates into melanin or stops converting light colored melanin into dark-colored melanin thus improving the skin tone.

  3. TRANEXEMIC ACID: Tranexemic acid (trans-4-aminomethyl cyclohexane carboxylic acid), a plasmin inhibitor, commonly used as a haemostatic agent owing to its antifibrolytic action is also promoted as a systemic skin whitening agent especially as oral or intradermal injections for melasma. Both arachidonic acid and α-MSH can activate melanin synthesis by melanocytes. Tranexemic acid by way of its antiplasmin activity depletes the keratinocyte pool of arachidonic acid involved in an ultraviolet (UV) induced melanogenesis. It has been used at a low dose of 250 mg twice a day for at least 3 months for the treatment of melasma and found to be effective. But, it is not safe to use it for a long duration and sufficient data is not available regarding its role in whole body skin whitening thus making it less popular as systemic skin whitening agent. intravenous injection for skin whitening at a dose of 500 mg every week for 1 or 2 months and 500 mg every month for maintenance. Tranexamic acid has been found to produce a good synergistic effect when combined with ascorbic acid or its derivatives and L-cysteine.  

  4. MISCELLANEOUS AGENTS: Apart from these, large doses of vitamin C, hyaluronic acid, epidermal growth factor and combinations of multiple natural extracts (natural collagen extracts, bearberry extract, Glycyrrhiza glabra extract, Lycopene, Kelp, olive leaf extract, hawthorn, jujube, sea buckthorn, starch, coix seed, pearl extracts, etc.,) are also promoted for skin whitening in the form of food or dietary supplements with low scientific evidence.

Beautiful skin requires commitment and not a miracle!