Evaluation of the Efficacy and Safety of Topical and Oral Glutathione in Treatment of Melasma

Background: Melasma is an acquired symmetrical hyper-pigmentation that typically presents on the face. Its etiology is multifactorial; its treatment remains a challenge and unsat-isfactory. Glutathione is a major antioxidant which plays critical roles in protecting cells from oxidative damage and the toxicity of xenobiotic electrophiles, and maintaining redox homeostasis.Aim of the Work: To assess the efficacy and safety of topical and oral glutathione in the treatment of melasma.Patients and Methods: This study included 30 female patients with melasma were selected among those attending the Outpatient Clinic of Dermatology and Venereology De-partment, Tanta University Hospitals during the period between December, 2015 and February, 2017. The studied patients were divided into 3 groups. Group I (10 patients) applied glutathione (2%) cream to right side of the face while placebo cream to left side (as a control) twice daily for 10 weeks. Group II (10 patients) received oral glutathione capsules (500mg/day) for 4 weeks. Group III (10 patients) received oral placebo capsules (as a control) once daily for 4 weeks. Modified melasma area and severity index (MASI) score was calculated before and after therapy. The patients were followed up for a period of 3 months.Results: Significant reduction in modified MASI was observed in patients treated with topical and oral glutathione (p=0.011) and (p=0.007) respectively, while patients treated with topical or oral placebo had no response. Topical and oral forms of glutathione were safe and well tolerated.Conclusion: Glutathione is safe, tolerable and effective whitening agent when used in topical cream (2%) and also in oral form in treatment of melasma.