Abstract
Background: There has been an increasing focus on the extent to which oxidative stress and inflammation are involved in the pathophysiology of acne. The aim of this study is to investigate the effect of oral Silymarin, N-acetylcysteine and Selenium in the treatment of acne vulgaris. Methods: A randomized prospective clinical trial was carried out on 56 patients with acne vulgaris who were examined clinically by dermatologist and classified according to disease severity. Serum levels of Glutathione, Malondialdehyde and Interleukine-8 in the acne patients were measured pre- and eight weeks post-treatment with oral antioxidants and compared to that of 28 healthy volunteers. The clinical follow- up was done every two weeks to assess the changes in the number of inflammatory lesions. Results: Administration of antioxidants to patients with acne vulgaris significantly reduce serum Malondialdehyde level; and increased serum level of Glutathione after eight weeks compared to pre-treatment value, also significantly reduce Interleukine-8 serum levels and the number of inflammatory lesions in patients with acne compared to placebo. Conclusion: The results obtained in this study clearly showed the beneficial effect of Silymarin, N-acetylcysteine and Selenium to patients with acne vulgaris as indicated by the clinical improvement that strongly and positively correlated with improvement in biochemical data.
Highlights
Acne vulgaris is an exclusively human disease and unique condition of human sebaceous follicles of the face, chest and back that begins in the prepubertal child
Data in table 1 showed that there was non-significant difference between the baseline values of serum levels of GSH, MDA, and Interleukine -8 (IL-8) for patients who were treated with Silymarin, N-Acetylcysteine and Selenium and the patients who were treated with placebo, in contrast, comparison with healthy subjects revealed highly significant change P ≤ 0.01 in the baseline level of mentioned markers
Results represent mean ± Standard deviation **represents highly significant P ≤ 0.01 change between healthy subjects and patients *represents significant P ≤ 0.05 change between healthy subjects and patients there was a highly significant difference in the last values of serum level of GSH and MDA, and only significant difference in the level of IL-8 between the patients who were treated with different antioxidants and the patients who were treated with placebo (Table 2)
Summary
Acne vulgaris is an exclusively human disease and unique condition of human sebaceous follicles of the face, chest and back that begins in the prepubertal child. The classical mediators in inflammation become involved prostaglandins, leukotrienes, macrophages, and complements [2]. Current studies show that some membrane fractions of P. acnes could sometimes act as super antigen causing amplification of the inflammatory reaction by activation notably of keratinocytes and release of inflammatory cytokines (IL-1α, β-Defensin-2, IL-8) through the activation of Toll-like receptors [3,4]. There has been an increasing focus on the extent to which oxidative stress and inflammation are involved in the pathophysiology of acne. The aim of this study is to investigate the effect of oral Silymarin, N-acetylcysteine and Selenium in the treatment of acne vulgaris
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