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Ogden CL, Carroll MD, Flegal KM

JS, YX, ZZ and HS were responsible for literature retrieval, screening and evaluation

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Professional intervention becomes necessary when over-the-counter treatments fail after 12 weeks - dermatologists can safely prescribe stronger options like 4% hydroquinone or recommend laser treatments

The NAD+/NADH ratio stays around 700:1 in healthy mammalian tissues, which creates ideal conditions for oxidative reactions

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