Skin bleaching with IV glutathione is on the rise, despite potential risks, warns a doctor in The BMJ.

Both the US Food and Drug Administration (FDA) and the Dermatology Society in the Philippines -- where the practice is common -- have issued advisory warnings about the treatment.

Potential adverse side effects include toxicity of the nervous system, kidney and liver, headaches, and rare, but serious skin conditions such as Stevens Johnson syndrome and toxic epidermal necrolysis, reports Ophelia Dadzie, a consultant dermatologist at The Hillingdon Hospitals NHS Foundation Trust and Founder and Director of London Ethnic Skin Limited.

Other potential risks include transmission of infection, such as HIV, hepatitis C and B -- of particular concern when non-medical practitioners administer the treatment -- and there are theoretical concerns about long-term skin cancer risk.

There are no published clinical trials have evaluated the use of glutathione for skin bleaching, and no guidelines for appropriate dosing regimes, or guidance for treatment duration. This practice is usually provided by beauty and aesthetic clinics, and in some cases non-medical practitioners administer the treatment.

"The cost of this treatment can be very high," adds Dr. Dadzie, "yet there is no explicit approval for the use of glutathione for skin bleaching." "Clear public health information and advisory warnings in relation to this practice -- from governmental agencies such as the Medicines Health Regulatory Agency -- are needed in the UK."