Concurrent infusion of glutathione, tranexamic acid, and Vitamin C as oral mesotherapeutic agents for management of gingival hyperpigmentation: A case series

Abstract

Gingival melanin pigmentation, although physiologically benign, often poses a significant esthetic concern, particularly in individuals with high smile lines. This case series aimed to assess the clinical outcomes of mesotherapy using a combination of Vitamin C, tranexamic acid, and glutathione as a minimally invasive approach to gingival depigmentation. Two systemically healthy patients exhibiting diffuse melanin pigmentation in the anterior maxillary gingiva were managed with intramucosal injections administered at weekly intervals over three sessions. Clinical evaluation was performed using the Dummett and Gupta Oral Pigmentation Index at baseline and at a 3-month follow-up. Both cases demonstrated a marked reduction in gingival pigmentation with satisfactory esthetic improvement and no reported adverse effects or recurrence. These preliminary findings suggest that mesotherapy with a synergistic combination of antioxidant and depigmenting agents may offer a viable, conservative alternative to conventional depigmentation techniques.

Keywords: Ascorbic acid; gingiva; glutathione; hyperpigmentation; melanin; oral mesotherapy; tranexamic acid.

Figure 1

(a) Preoperative clinical picture of Case 1, (b) intraepithelial injection of mesotherapy agents, (c) clinical picture immediately after injection, (d) 3-month follow-up

Figure 2

(a) Preoperative image of Case 2, (b) 1^st week after mesotherapy, (c) 2^nd week after mesotherapy, (d) 3^rd week after mesotherapy, (e) 3-month follow-up