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Chronic obstructive pulmonary disease (COPD) may coexist, particularly in patients with smoking history

The primary molecular actions relevant to skin are: modulation of TGF- signaling (upregulating TGF-1 for collagen I/III synthesis while suppressing TGF-2 to prevent scarring), decorin upregulation for orderly collagen fibril assembly, MMP suppression paired with TIMP upregulation to preserve ECM integrity, and copper-dependent lysyl oxidase activation for collagen crosslinking

Dermatologists frequently encounter patients who are inclined to self-medicate with glutathione, enticed by the manufacturers' claims

And without needing the painful intramuscular injections