Melasma is a common acquired pigmentary disorder that occurs usually in women (more than 90% of cases) of all racial and ethnic groups. Melasma is an acquired increased pigmentation of the skin characterized by symmetrical and confluent grey- brown patches usually on the areas of the face exposed to the sun. Silymarin (also known as milk thistle) strongly prevents photocarcinogenesis, and significantly prevented melanin production. A study assessed the benefits of topical Silymarin (SM) cream in a double-blind placebo controlled study for treatment of 96 adult melasma patients seen at an outpatient clinic.

Patients were randomized in a double-blind manner to receive one of the following treatments: Group I (G I) SM (7 mg/ml) cream, Group II (G II) SM (14 mg/ml) cream, or Group III (G III) placebo, applied topically to the affected areas, twice daily for 4 weeks.

Topical Silymarin and MSM For Rosacea

A study evaluated a topical treatment of silymarin and methylsulfonylmethane (dimethyl sulfone, MSM) to improve erythematous-telangiectactic rosacea. Forty-six patients affected by stage I-III rosacea entered this double-blind, placebo-controlled study. Subjects were treated for 1 month. Clinical and instrumental evaluations were done at baseline, after 10 and 20 days, and at the end of the study. Itching, stinging, erythema, and papules were investigated clinically as well as hydration and erythema instrumentally with capacitance and color measurements. A statistically significant improvement was observed in many clinical and instrumental parameters investigated. In particular, improvement of skin redness, papules, itching, hydration, and skin color occurred.

The combination of silymarin and S-MSM can be useful in managing symptoms and the condition of rosacea skin, especially in the rosacea subtype 1 erythemato-telangiectatic phase. The action can be considered multicentric and multiphasic because of the direct modulating action on cytokines and angiokines normally involved and up-regulated in this skin condition.

J Cosmet Dermatol. 2008 Mar;7(1):8-14.

Patients were also advised to avoid sun exposure and to use topical sunscreen with sun protection factor (SPF) of 15+ during the entire period of treatment and thereafter. The patients were seen regularly every week for one month for assessment; the response to treatment was evaluated by the response; lesion size, melasma area and severity index score, physician global assessment, and subjective assessment.

Clinically, patients treated with topical silymarin showed significant excellent pigment improvement & lesion size reduction from the 1st week. Silymarin significantly prevented melanin production in a dose-dependent manner. Silymarin showed tremendous improvement of melasma in a dose-dependent manner, and was effective in prevention of skin damage caused by U.V. sunlight. Patients’ satisfaction was recorded as 100%. During the period of treatment, no local or systemic adverse effects were observed.

BMC Dermatol. 2012; 12: 18. Published online 2012 Oct 2