Beyond the Surface - Skin Community - Silymarin (milk thistle) for acne

Oral antioxidants, Silymarin, N-acetylcysteine, and Selenium, effectively reduce oxidative stress and inflammation in acne patients, improving clinical improvement and biochemical data. Sahib, A., Al-Anbari, H., Salih, M., & Abdullah, F. (2013). Effects of Oral Antioxidants on Lesion Counts Associated with Oxidative Stress and Inflammation in Patients with Papulopustular Acne. Journal of clinical & experimental dermatology research, 3, 1-6. https://doi.org/10.4172/2155-9554.1000163. "The results of our study indicated that the silymarin therapeutic effects are comparable to doxycycline in the GAGS index, although it is lower compared to doxycycline in the ASI (Figures 1–3). This study also examined the synergistic effects of silymarin and doxycycline compared to doxycycline alone. Adding silymarin to the doxycycline regimen improved the effect of doxycycline therapy." Morteza, M., Hayati, Z., Namazi, N., & Majd, F. (2019). Efficacy and safety of oral silymarin in comparison with oral doxycycline and their combination therapy in the treatment of acne vulgaris. Dermatologic Therapy, 32. https://doi.org/10.1111/dth.13095. Silymarin effectively prevents increased liver enzymes in patients taking isotretinoin, making it a low-cost, low-complication treatment for this issue. Mirnezami, M., Jafarimanesh, H., Rezagholizamenjany, M., Alimoradian, A., & Ranjbaran, M. (2020). The effect of silymarin on liver enzymes in patients taking isotretinoin: A randomized clinical trial. Dermatologic Therapy, 33. https://doi.org/10.1111/dth.13236. "Supplementation of silymarin may be effective and safe for the management of diabetes mellitus and hyperlipidemia." Xiao, F., Gao, F., Zhou, S., & Wang, L. (2020). The therapeutic effects of silymarin for patients with glucose/lipid metabolic dysfunction: A meta-analysis. Medicine, 99(40), e22249. https://doi.org/10.1097/MD.0000000000022249 (edited)

Potential side effects:

Rarely associated with allergic reactions
May cause gastrointestinal upset in some individuals
Potential hormonal effects due to its weak estrogenic properties

"Topical silymarin cream 1.4% showed comparable results to Salicylic acid 30% peels. It can be considered a promising safe treatment modality for mild to moderate acne vulgaris." Atallah, Dalia Abdel-Aziz, et al. "Topical silymarin cream as a novel therapy versus salicylic acid peels in acne vulgaris: a split-face clinical trial." Journal of Cutaneous Medicine and Surgery 28.1 (2024): 22-28.