Cosmetic Internal Medicine
Oral Medications (Self-Pay)
For those who wish to take oral medications to support skin-trouble care, brightening, and anti-aging, our clinic prescribes seven oral medications: Cinal, Transamin, Hibon, Pidoxal, Tathion, Hythiol, and Juvela.
For those with a skin condition, we of course treat it, and we aim for synergistic effects by combining these medications with everyday skincare such as cleansing, moisturizing, and sun protection, as well as topicals such as hydroquinone and tretinoin and cosmetic procedures in aesthetic dermatology.
Cinal Combination Tablets / Cinal Combination Granules(generic name: ascorbic acid (vitamin C) + calcium pantothenate)
Vitamin C is so well known for skin brightening that the two are almost synonymous, and this is that medication. It is also often used to treat melasma and to prevent post-inflammatory hyperpigmentation after laser treatment. More is not necessarily better, so take it according to the directed dosage.
Mechanism of action
Suppresses the formation of melanin pigment and converts already-formed oxidized black melanin into reduced, lighter-colored melanin. Involved in the production and maintenance of the collagen that supports the skin and blood vessels.
Dosage and administration
Take 1 to 3 tablets or 1 packet (each 1 g) one to three times a day. (Example: 1 packet per dose, 3 times a day.)
Main side effects
Stomach discomfort, nausea and vomiting, diarrhea, etc.
*Because of the ascorbic acid, urinary glucose may no longer be detected in a urine test. Likewise, occult blood, bilirubin, and nitrites may no longer be detected in a urine dipstick test, and occult blood may no longer be detected in a fecal occult blood test. When undergoing tests at a medical facility, or a health check-up or comprehensive medical exam, be sure to declare what oral medications you are taking.
Transamin(generic name: tranexamic acid)
This medication is often prescribed together with the vitamin C product Cinal, but for melasma, tranexamic acid has stronger evidence. (Vitamin C is often given together with tranexamic acid, and vitamin C alone does not seem to have been evaluated much.) Because it has an effect of making blood clot more easily, it is not recommended for people who have an arrhythmia or hyperlipidemia, or a family history of stroke or heart attack. Even those without such conditions should take care to prevent clots, for example by staying well hydrated.
Mechanism of action
Suppresses the production of inflammatory cytokines that promote melanin formation. (Regarding its effect on melasma, there is also speculation that it may be mediated by an action on blood vessels.) It also has hemostatic, anti-inflammatory, and anti-allergic effects.
Dosage and administration
Take 750 to 1,500 mg a day, divided into three to four doses. (Example: one 250 mg tablet per dose, 3 times a day.)
Main side effects
Thrombosis and embolism, convulsions (in dialysis patients), hypersensitivity, loss of appetite, nausea, vomiting, diarrhea, heartburn, drowsiness, itching, rash, etc.
Hibon(generic name: riboflavin butyrate, vitamin B2)
An important vitamin for maintaining the health of the skin, mucous membranes, nails, and hair. Together with Pidoxal, described next, it also helps prevent conditions caused by excess sebum production, such as seborrheic dermatitis and acne, as well as angular cheilitis and cheilitis. It also has an effect of suppressing rises in cholesterol.
Mechanism of action
Involved in the metabolism of the carbohydrates, proteins, and fats needed for energy production within cells. Promotes the repair and regeneration of the skin and mucous membranes. Controls sebum secretion.
Dosage and administration
Take 5 to 120 mg a day, divided into two to three doses. (Example: one 20 mg tablet per dose, twice a day.)
Main side effects
Diarrhea, nausea and vomiting, stomach bloating, abdominal bloating, stomach discomfort, loss of appetite, etc.
*Because of the riboflavin, your urine may turn yellow. When undergoing tests at a medical facility, or a health check-up or comprehensive medical exam, be sure to declare what oral medications you are taking.
Pidoxal(generic name: pyridoxal phosphate hydrate, vitamin B6)
Together with Hibon (described just above), it helps prevent conditions caused by excess sebum production, such as seborrheic dermatitis and acne, as well as angular cheilitis and cheilitis. It is also involved in the functioning of the nervous system.
Mechanism of action
As a coenzyme, pyridoxine is involved in amino acid metabolism and contributes to the maintenance of nerve function and to skin health. It helps suppress excess sebum secretion and reduce skin inflammation.
Dosage and administration
Take 10 to 60 mg a day, divided into one to three doses. (Example: one 30 mg tablet per dose, twice a day.)
Main side effects
Rhabdomyolysis, hypersensitivity, nausea, loss of appetite, abdominal bloating, diarrhea, vomiting, impaired liver function, etc.
Pidoxal(generic name: pyridoxal phosphate hydrate, vitamin B6)
Together with Hibon (described just above), it helps prevent conditions caused by excess sebum production, such as seborrheic dermatitis and acne, as well as angular cheilitis and cheilitis. It is also involved in the functioning of the nervous system.
Mechanism of action
As a coenzyme, pyridoxine is involved in amino acid metabolism and contributes to the maintenance of nerve function and to skin health. It helps suppress excess sebum secretion and reduce skin inflammation.
Dosage and administration
Take 10 to 60 mg a day, divided into one to three doses. (Example: one 30 mg tablet per dose, twice a day.)
Main side effects
Rhabdomyolysis, hypersensitivity, nausea, loss of appetite, abdominal bloating, diarrhea, vomiting, impaired liver function, etc.
Tathion(generic name: glutathione)
Under insurance coverage, this medication is sometimes used for various forms of poisoning because of its detoxifying action. It also has antioxidant effects and is sometimes used in the hope of an anti-aging effect; it is the ingredient well known from “white-jade” (glutathione) IV drips.
Mechanism of action
Glutathione is a tripeptide and, as a powerful intracellular antioxidant, reduces oxidative stress in cells. While glutathione reacts with dopaquinone to produce pheomelanin, its reducing action also converts dopaquinone back into dopa, making eumelanin harder to form and lightening the skin’s color.
Dosage and administration
Take 50 to 100 mg three times a day. (Example: one 100 mg tablet per dose, once a day.)
Main side effects
Rash, loss of appetite, nausea and vomiting, stomach pain, etc.
Hythiol(generic name: L-cysteine)
L-cysteine is a precursor of glutathione. Hythiol, along with Tathion, is known as an oral medication for skin brightening. As for brightening, rather than expecting results from using it alone, it is best positioned as support for other oral medications or for non-oral treatments.
Mechanism of action
By binding with dopaquinone to synthesize pheomelanin, L-cysteine reduces the production of eumelanin. It also suppresses melanin production itself by inhibiting tyrosinase activity. In addition, L-cysteine has a reducing action that converts oxidized melanin (blackened eumelanin) into the reduced form, lightening the color.
Dosage and administration
160 to 240 mg a day. (Example: one 80 mg tablet per dose, 3 times a day.)
Main side effects
Nausea, diarrhea, dry mouth, mild abdominal pain, etc.
Juvela(generic name: tocopherol acetate, vitamin E)
It has a powerful antioxidant action that reduces oxidative stress in the body. Because it also improves blood flow, it is covered by insurance for sensitivity to cold and peripheral circulatory disorders. In the field of aesthetics, it is sometimes used as an adjunct for skin trouble, spots, wrinkle prevention, and anti-aging. However, large-scale evidence showing a clear cosmetic effect of vitamin E alone is limited, and it is commonly used in combination with vitamin C, tranexamic acid, and the like in the hope of a synergistic effect.
Mechanism of action
By preventing the oxidation of lipids, it keeps cell membranes stable and removes the reactive oxygen species that cause aging. Dilates peripheral blood vessels and improves blood flow. It also has an activating effect on the endocrine system.
Dosage and administration
Take 50 to 100 mg two to three times a day. (Example: one 50 mg tablet per dose, 3 times a day.)
Main side effects
Constipation, stomach discomfort, diarrhea, etc.
*Administration of the above medications for cosmetic purposes is self-pay. However, even for the above medications, administration for a condition covered by insurance is covered by insurance. (This is determined by the doctor’s judgment based on diagnosis.)