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standard topical glutathione has limited skin penetration due to its molecular size, but the exosome delivery vehicle carries it deeper into the skin where it inhibits tyrosinase activity, neutralizes free radical damage and brightens from within 25ppm glutathione in this form is significantly more effective than higher concentrations in conventional formats

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The Q statistic and Eggers test were used to assess heterogeneity and risk of publication bias, respectively

The pain prevents running and can interfere with daily activities, such as going down the stairs