A recent study indicates that silymarin cream may be an effective and tolerable alternative to hydroquinone in patients with melasma.

Hydroquinone is an effective treatment for melasma; however, the associated side effects may restrict its use. Nevertheless, silymarin cream may be a safer alternative.

A split-face study that compared silymarin 1.4% with hydroquinone 2% in epidermal or mixed-type melasma included 25 Asian participants who were randomized to silymarin cream on one side of the face and hydroquinone on the other side for 3 months.

It assessed treatment effects using a colorimeter, with the results calculated by the relative lightness index (RL*I). The study also evaluated the modified Melasma Area and Severity Index (MASI) score and patient self-assessment.

Twenty-three participants completed the test and showed no statistical difference between silymarin and hydroquinone. Both groups showed significant differences from baseline in RL*I, with silymarin yielding a 14.56% improvement and hydroquinone yielding a 12.82% improvement.

Similarly, both treatments showed improvements in the modified MASI score, with a 17.97% statistically significant reduction in hydroquinone and a 7.11% reduction in the silymarin group, indicating no statistical difference between the two interventions.

Similarly, in the patient assessment, hydroquinone showed a 69.6% good-excellent rating for improvement and a visual analog scale (VAS) satisfaction score of 7.82; and silymarin showed a 73.9% good-excellent improvement rate with a VAS score of 7.65.

The treatments were associated with mild adverse events, with 3 participants in the hydroquinone group compared with two in the silymarin group reporting side effects.

Thus, although hydroquinone shows a better response, topical silymarin effectively treats epidermal and mixed-type melasma with fewer side effects.

Source: Healio [Internet].  Silymarin may be alternative to hydroquinone for melasma. December 16, 2022. Available from: https://www.healio.com/news/dermatology/20221216/silymarin-may-be-alternative-to-hydroquinone-for-melasma