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Topical antioxidants such as CE ferulic acid can be considered in selected cases when patients understand the role of sunscreens & primary pigment correctors
It's important to note that the FDA-approved titration schedule allows flexibility, and slower dose escalation may help manage side effects including fatigue
That said, these effects are not yet well established clinically, and more research is needed to determine whether they are directly caused by the medication or influenced by factors such as weight loss, metabolic changes, or individual physiology
& Bloomgren, G
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