Long-term use of cardio mariano fruit extract contributes to homeostasis in acne-prone skin
In acne-prone skin, in addition to visible acne lesions, normal-looking facial skin is studded with infraclinical abnormalities called microcomedones; they represent the first step for all future clinical lesions for acne growth.
The formation of microcomedones corresponds to a change in the differentiation program of sebaceous stem cells located in the isthmus epithelium: in homeostasis, these stem cells are able, through their lineage, to generate both the sebaceous gland itself (sebaceous differentiation) and the epithelia of the sebaceous duct and isthmus (duct epithelial differentiation). Loss of homeostasis in acne skin results in the expansion of the epithelium, which underlies the microcomedone.
Maintenance of homeostasis in this system has appeared as a new goal in acne patients. Because sebaceous stem cells are located in the isthmus epithelium, closer to the surface, they are more accessible to topical products than the sebaceous gland itself. This gives more credence to topical delivery for this target.
Molecular pathways potentially involved in sebaceous stem cell lineage determination and comedo change have been identified.
Milk thistle (S. marianum) fruit extract has been identified as the first topical extract capable of interfering with this mechanism of blackhead switching.
Milk thistle fruit extract (S. marianum) protects sebocytes exposed in vitro to a strong comedogen, TCDD, and modulates the expression of keratins and lipid droplet proteins, such as Plin2 and CIDEA, produced by sebaceous stem cells.
In a proof-of-concept study of 23 subjects, the use of milk thistle (S. marianum) fruit extract for 48 weeks was associated with an initial decrease in microcomedones index (as demonstrated by repeated skin surface biopsies) and maintenance of a low microcomedones index over months. This reduction in microcomedones index was correlated with a similar reduction in clinical lesions.
As of 2019, a product based on milk thistle (S. marianum) fruit extract is available worldwide as a “field cosmetic” to maintain homeostasis in acne-prone skin of adolescents and young adults and is currently being used for extended periods of time.
Homeostasis in the sebaceous stem cell differentiation program has been identified as a key step in comedogenesis and should be a goal for the treatment of acne-prone skin.
The objective of this one-year international multicenter study on the actual use of a patented natural product containing the extract of milk thistle (S. marianum) fruit that has been shown to modulate molecular players in the early stages of comedogenesis.
The present study, with a follow-up of 12 months, included 54 adolescent and young adult subjects with mild to moderate facial acne, which aimed to replicate a real-life context of use.
The mean total lesion count was 88.3 at the time of inclusion. There was a sustained and highly significant decrease over months in clinical lesion counts (45.6 percent improvement after 6 months and 59.6 percent improvement at 12 months) and other markers of efficacy, associated with a significant decrease in the overall amount of microcomedones on biopsies of the superficial skin surface in Cyan Acrylate.
Tolerance to long-term daily use of milk thistle (S. marianum) fruit extract was good.
In conclusion, this multi-center, open, real-world, one-year study confirms a previous 48-week proof-of-concept study and qualifies the use of milk thistle (S. marianum) fruit extract as a “field cosmetic” that contributes to the homeostasis of acne-prone skin.
If your company would like to develop and/or manufacture a product for the treatment of mild to moderate acne
Source: Saurat JH, Reygagne P, Josse G, et al. Long-Term Use of Silybum marianum fruit extract Contributes to Homeostasis in Acne-Prone Skin-A 12-Month Follow-Up International “Real Life” Cohort Study. J Pers Med. 2022 Dec 31;13(1):96.
