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Historically, hydroquinone (HQ) 4% as monotherapy, but also in combination with tretinoin and topical steroids (triple cream), has been an established topical, first-line treatment over years, but concerns about its side effects (permanent depigmentation, ochronosis, potential risk of cancer due to its metabolites) have prompted the use of potentially safer alternatives and the withdrawal of HQ in many countries

Limited Adverse Effects: Current evidence indicates that glutathione supplementation is generally well-tolerated, with minimal adverse effects reported

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Kiyosawa N, Ito K, Sakuma K, Niino N, Kanbori M, Yamoto T, Manabe S, Matsunuma N: Evaluation of glutathione deficiency in rat livers by microarray analysis