Glutathione lozenges and skin lightening: the (white) elephant in the room
Question: Do you want to whiten your skin? Are you unhappy with your beautiful, brown skin, the kind that every freckled, burns-rather-than-tans Westerner probably envies?
Pardon the judgment apparent in my second question (and the rather tacky pun that is the title of this article). As someone who has once used sunblock in highschool – not for sun protection, but for skin lightening “after just four weeks” – I shouldn't thumb my nose at anyone who wants fairer skin.
Be honest: Would you buy these glutathione lozenges if they could whiten your skin?
I've grown to accept – no, love – my skin. The more I understood why I wanted my complexion to be fairer in the past, the more I realized it wasn't white skin that I wanted. I wanted acceptance, something that I knew had to start with me.
I realized a few things about our skin preferences and a glutathione preparation by Brady Pharma, Inc. that I wanted to share with you. You might want to read this carefully, especially if you're stubborn about wanting fairer skin.
Why we prefer whiter skin
White skin, in the quest for acceptance? Yeah, that might sound a little far-fetched, but hear me out. You probably know this already, but let's recap our history as a people.
For more than three centuries, the Spaniards ruled our country. Although they’re gone, their influence on us is still very much apparent:
1. We are still the largest Catholic country in Asia. Yep, we got that from our Spanish-speaking colonizers.
2. Some of us think that wearing short, skimpy clothes – something common and very appropriate in tropical countries like ours – is something “only loose women wear”. Say it isn’t so and I’ll say you’re either lying or living under a rock.
3. Some of us still feel that fair skin, just like that of the Spaniards, looks so much better than our very own brown complexion.
If you are Catholic (as I am) and hate skimpily-clad women (which I don't), that's your prerogative. I would, however, like to challenge your opinion about fair skin being more beautiful than brown skin.
Unlike fair skin, brown skin provides protection from cancer. It is that very pigment in our skin, melanin, which keeps the dangerous ultraviolet rays of the sun from causing mutations that lead to skin cancer.
It is also that pigment that protects our skin from sun damage, which is why many of us tend to have less wrinkles than our Caucasian brothers and sisters. (I'm not saying age makes you ugly, but if you're the type to think fair skin is beautiful, I'm almost betting you think young skin does, too.)
I'm saying this not to throw shade on people who want whiter skin. No. I'm reminding you why we think the way we do.
Skin whitening: Options that don’t work
As I've explained briefly above, brown skin actually looks better than white skin! Its color is more even without the presence of freckles. It protects you from cancer. It also keeps you from looking older than your age.
However, if you want fair skin, it is your right. I may not agree with your decision – you have beautiful skin, Juan and Maria! – but I won't keep you from healthy ways to whiter, fairer skin.
But please stop buying those glutathione tablets. Nope, they won't work the way you want them to. They are digested in the gut before they enter systemic circulation, which means they don't reach their destination.
In a nutshell, they don't get the chance to do their job.
This is why not all glutathione is made equal. While some get digested (such as oral tablets and pills), there is one glutathione preparation that Dr. Evangeline Handog, president of the International Society of Dermatology (ISD), says is effective in whitening skin. She based her statement on research she and her colleagues did in 2015, which was then published in the International Journal of Dermatology in 2015.
Dr. Evangeline Handog (second from left), by the way, is the first Asian (therefore the first Filipino) female president of ISD. Here, she is joined by Dr. Teresita Gabriel of RITM, yours truly, and Dr. Sharon Lim of Skin and Cancer Foundation.
Her research revolved around the whitening power of glutathione in a lozenge preparation, now marketed as Thiocell by Bradypharma. “There were 34 participants in the study, four of which dropped out. Before and after the study, we had the participants tested for their liver profile and CBC. It was the first study [on glutathione’s effectiveness in whitening skin] with lab tests.”
Glutathione lozenges: Do they work?
Let’s look at the evidence. Here's what Dr. Handog and her team did during their glutathione lozenge study.
“The participants were asked to melt the glutathione lozenges in their mouth in the morning. Every two weeks, we take readings in both sun-exposed and sun-protected areas. We scored these areas from 0 to 100.”
According to Dr. Handog, there was a statistically-significant lowering of readings of both sun-exposed and sun-protected areas. In other words, skin appeared whiter regardless of whether it was exposed to sunlight or not.
Dermatologists talk about skin whitening during the Thiocell glutathione lozenge press launch.
“In eight weeks, there was a decrease in melanine indices: 97 percent had moderate whitening.” She also mentioned that all lab results were normal after the study and that there were no side effects noted.
She and her team are presenting a poster of their next study during the American Academy of Dermatology Meeting. They extended the duration of treatment to 12 weeks and asked the patient to come back on the 16th week.
These studies serve as a stepping stone towards more research on skin whitening. Note, however, that they are not randomized control trials – placebo effect was not determined (those who took glutathione lozenges were not compared to participants who didn’t receive treatment).
The first study had 30 participants, a small number. There is also the issue of examiner bias: I did not have the opportunity to review the complete article, but I am under the impression that the people involved in determining skin color were not “blinded” – that is, they were aware that all the participants took glutathione.
Whether or not it whitens skin, however, it is assuring that each lozenge has 500 mg of glutathione, guaranteed. “In intravenous glutathione, the drug is gone from the blood in 10 minutes. If taken orally, it is gone in two to three hours. Our study is the first to test mucosal delivery.”
What does that all mean?
The study is small, there is no placebo, and no blinding. The findings of the study are promising, but even the label on the glutathione lozenge bottle says what I believe: There are “no approved therapeutic claims”.
If dermatologists advocate this glutathione lozenge for skin whitening, what will be the effect on the self-image of young girls and teens in the Philippines?
Dr. Sharon Lim of the Skin and Cancer Foundation (third from left) had this to say: “It’s not that dermatologists are saying we should whiten skin, but that we need to address the needs of our patients.”
“It’s not okay to tell young girls to take it because it might give them the idea that brown skin is bad,” clarified Dr. Handog. “However, this glutathione lozenge is safe, effective, and backed by research.”
Dr. Teresita Gabriel, chairman of Research Institute for Tropical Medicine (RITM) Department of Dermatology, added, “It's not just about having white skin, but also about having healthy, radiant, glowing skin. We can't say no to patients who want lighter skin. They will find a way and there are easily many products out there that aren't safe.”
Dr. Handog also emphasized the affordability of the lozenge. “It costs PhP2,600 per bottle, good for a month at one lozenge a day.”
Her advice: “Don't simply use it for whitening. Use it for its many benefits.” The lozenge contains Vitamin C, E, and other ingredients.
Should you buy them?
But I digress. Let's go back to the PhP2,600 question.
Should you buy these glutathione lozenges?
Well, I wouldn't. My childhood skin-whitening follies are no more and I'm very happy with my brown skin.
There are 500 milligrams of glutathione per lozenge, guaranteed. However, there are no approved therapeutic claims.
However, that’s my call, based on my preferences. To each his own. I know a lot of you out there are not content with a “just be yourself” advice so if you want whiter skin, please consult your dermatologist.
Go ahead; ask your doctor about the glutathione that comes in a lozenge preparation. Ask about how mucosal absorption may lead to higher plasma levels of glutathione. Ask about why the lozenge preparation of glutathione was the subject of a scientific study published in a peer-reviewed international journal.
In fact, ask about the many other options for skin whitening. I hope that in your quest for the perfect skin-whitening solution, you find what you need – not just white skin, but whatever else comes with it, may it be acceptance (as it used to be in my case), self-confidence, or happiness. You deserve it.