• Juhasz Margit L W MLW http://orcid.org/0000-0002-5723-6167 Department of Dermatology, University of California, Irvine, Irvine, California. and Melissa K Levin.
• Department of Dermatology, University of California, Irvine, Irvine, California.
• J Cosmet Dermatol. 2018 Dec 1; 17 (6): 1144-1157.

BackgroundPigmentation of the skin occurs as a result of increased melanin production or deposition due to various reasons including age, hormonal imbalances, endocrine disease, inflammation, and/or exposure to damaging radiation, resulting in dermatologic conditions such as lentigines, melasma, or postinflammatory hyperpigmentation. Although numerous topical therapies exist for skin lightening, they are limited by efficacy and pigmentation recurrence after treatment cessation. New research into systemic therapies for hyperpigmentation has been promising.ObjectiveTo summarize the current literature for systemic skin lightening therapies.MethodsA review of the literature surrounding systemic skin lightening therapies was completed using PubMed (US National Library of Medicine).ResultsMultiple systemic therapies for skin lightening exist including oral carotenoids, glutathione, melatonin, Polypodium leucotomos hydrophilic extract, procyanidin, and tranexamic acid. Preliminary data for the treatment of hyperpigmentation are promising, and currently, these oral treatments appear safe. It is not suggested to use intravenous glutathione for skin lightening due to the increased risk of adverse events.ConclusionWith the patient population seeking effective systemic treatments for skin pigmentation, it is important for dermatologists to understand the properties, the efficacy, and the adverse events profile of each compound, thus ensuring proper use by patients, and that patients are appropriately counseled regarding treatment expectation and safety.© 2018 Wiley Periodicals, Inc.

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