title: Combined effects of silymarin and methylsulfonylmethane in the management of rosacea: clinical and instrumental evaluation.
abstract: OBJECTIVE
  This study aims to evaluate a topical treatment based on silymarin/methylsulfonilmethane (S-MSM) to improve erythematous-telangiectactic rosacea.
  
  
  METHODS
  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.
  
  
  RESULTS
  A statistically significant improvement was observed in many clinical and instrumental parameters investigated (P < 0.001). In particular, improvement of skin redness, papules, itching, hydration, and skin color occurred.
  
  
  CONCLUSIONS
  The combination of silymarin and S-MSM can be useful in managing symptoms and condition of rosacea skin, especially in the rosacea subtype 1 erythemato-telangiectatic phase. The action can be considered multicentric and multiphase because of the direct modulating action on cytokines and angiokines normally involved and up-regulated in the case of such skin condition.
authors.affiliation: San Gallicano Dermatological Institute, Rome, Italy. berardesca@berardesca.it
authors.forename: Enzo
authors.initials: E
authors.lastname: Berardesca
authors.forename: Norma
authors.initials: N
authors.lastname: Cameli
authors.forename: Claudia
authors.initials: C
authors.lastname: Cavallotti
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Levy
authors.forename: Gérald E
authors.initials: GE
authors.lastname: Piérard
authors.forename: Gianfranco
authors.initials: G
authors.lastname: de Paoli Ambrosi
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000975:Antioxidants / Q000008:administration & dosage*; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012393:Rosacea / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D012838:Silymarin / Q000008:administration & dosage*; D012867:Skin / Q000737:chemistry / Q000473:pathology / Q000503:physiopathology; D013450:Sulfones / Q000008:administration & dosage*; D016896:Treatment Outcome; D014466:Ultraviolet Rays / Q000009:adverse effects
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D012838:Silymarin; D013450:Sulfones; C025910:dimethyl sulfone; D004121:Dimethyl Sulfoxide