26 replies to this topic

[heyeddy]

Hello all,

 

I've been through various acne treatments over the last 15 years. In short topical things do not work for me (I've tried every one of them literally), antibiotics do not work, accutane is to be tested (120mg/kg dosage, i've tried low dose course before). However so far only two things worked:

 

- ketogenic diet (two days and 95% of pustules/cysts were gone) (i can't follow this diet any more due to personal reasons)

- Milk thistle or NAC (i can use them in exchange) - 2 hours after eating the capsule my acne stops hurting, 2-3 days after it is healing rapidly (although the acne is not cured 100% - i am 95% clear).

 

Obviously next day I stop the supplements (or the diet) I am getting painful breakouts (cystic) typically all around my mouth and jaw line. The questions is why those supplements help me? I know they are antioxidants but so is vitamin C and vitamin E and they have never helped me (including massive dosage).

 

I've seen one study that claims milk thistle is antiandrogenic and it is helpful for people with prostate cancer:

http://carcin.oxford...22/9/1399.short

 

On the other hand though there was a study where they found NAC + selenium to be a testosterone booster:

http://www.ergo-log.com/senac.html

 

 

There is one other study saying this is because of this supplement effect on oxidative stress:

http://www.omicsonli...3.php?aid=10078

 

So what is the probable explanation here? and what are the chances of accutane nuking it for good in this case? Please keep in mind all my hormones are in range appending to the blood tests. Same goes for liver and overall health. 

 

 

thanks for hints

[sativa]

Perhaps its the ability of NAC and milk thistle to aid detoxification of toxins and heavy metals?

[heyeddy]

Perhaps its the ability of NAC and milk thistle to aid detoxification of toxins and heavy metals?

 

i don't think so also all those "detoxing" theories look like quackery to me. 

the most plausible theory is that it somehow blocks the androgen receptors in the skin 

[sativa]

I think your perception of quackery is misinformed! It's well known that NAC boosts the glutathione detoxification pathway and milk thistle boosts liver function (probably enhances phase 1 and 2 detoxification pathways)

[heyeddy]

I think your perception of quackery is misinformed! It's well known that NAC boosts the glutathione detoxification pathway and milk thistle boosts liver function (probably enhances phase 1 and 2 detoxification pathways)

 

my liver tests are perfect even without NAC/milk thistle (additionally confirmed by ultrasound and MRI). Apparently glutathione can be risen through vitamin C&E, l-glutamine, selenium, MSM, SAMe supplementation - none of those supplements made any difference to my acne.  

 

I've been testing various detoxing supplements over the years, spent a lot of money on it and I believe I can say for me this entire "detox" business is a quackery. At least in my case it didn't work. 

Edited by heyeddy, 13 April 2016 - 10:19 AM.

[sativa]

I see! Well, your conclusion is understandable but as it's an n=1 you can't come to such general conclusions that detoxing is quackery. Also, there is plenty of sound biological logic, knowledge and understanding that supports it.

But anyway, what's your diet like? Do you consume any artificial substances? (That are mentioned in the ingredients ie artificial sweeteners, preservatives etc etc)

[. Gymscience]

It depends also strongly on the type of acne you got. A swab is always helpfull to figure out which bacteria are responsible for youre problem ( mostly Propionibacterium acnes - normally its commensal).

The hormones likes testerone normaly make acne worse due to increased serum production.

Which treatment you had ? Vitamin A analogues (Tretinoins) ?

 

 

 

btw stress is always a factor :D any changes here in lifestyle etc. ?

Edited by . Gymscience, 13 April 2016 - 12:00 PM.

[heyeddy]

1) painful cystic acne - around mouth and jawline (5-6 of those cysts usually), rather moderate but painful one but every other treatment failed so far, so if I will not figure anything out soon I go with accutane

2) no bacteria found other than the one that is present on everybody's skin (s. epidermidis)

3) yeah I have some increased sebum production, blood hormones levels are normal but it means nothing since we have androgen receptors in the skin

4) yeah stress makes things worse I have anxiety & depression but I don't know which was first like maybe acne induced them. I've tried some antidepressants no effects on my skin 

5) no topical shit works on it (i mean like every topical drug out there)

Edited by heyeddy, 13 April 2016 - 01:46 PM.

[Kinesis]

This may remain a mystery. The first thing that occurred to me when you mentioned milk thistle and acetylcysteine was what do they have in common - they're both known to support liver function. But then you say your liver function tests come out good.

And since you posted this in the Brain Health forum, maybe you suspect a mental connection? Aside from the link between emotional state and hormonal status, none come to mind. But as long as milk thistle and acetylcysteine work for you, it seems reasonable to continue using them.

Edited by Kinesis, 13 April 2016 - 07:31 PM.

[heyeddy]

yeah liver seems to be fine, except slightly elevated bilirubin levels but my doctor says it is nothing important

 

as for brain/mental connection i've some anxiety and anger problems + depression related to the acne but I've never found a scientific proof that this can cause acne by itself rather than just make it slightly worse 

 

when I was on ketogenic diet my acne too got better and as far as I know it is related to dropping androgen levels.

 

As for milk thistle the problem is it makes my acne better but it does not cure it, therefore the problem still remains.  

[uekte]

Research Article: Effects of Oral Antioxidants on Lesion Counts Associated with Oxidative Stress and Inflammation in Patients with Papulopustular Acne

 

http://www.omicsonli...3.php?aid=10078

 

"The use of the well known antioxidants (Silymarin, N-Acetylcysteine and Selenium) orally, resulted in elevating the serum level of GSH significantly and reducing the serum level of MDA and IL-8 and in the acne patients. Furthermore; all the three antioxidants reduced the number of the inflammatory lesions, although the percentage and the level of significance of this reduction was not the same for all the agents. The results of the present study are compatible with other studies regarding the presence (and targeting) of oxidative stress and inflammation in acne."

Edited by uekte, 14 April 2016 - 12:18 PM.

[heyeddy]

Research Article: Effects of Oral Antioxidants on Lesion Counts Associated with Oxidative Stress and Inflammation in Patients with Papulopustular Acne

 

http://www.omicsonli...3.php?aid=10078

 

"The use of the well known antioxidants (Silymarin, N-Acetylcysteine and Selenium) orally, resulted in elevating the serum level of GSH significantly and reducing the serum level of MDA and IL-8 and in the acne patients. Furthermore; all the three antioxidants reduced the number of the inflammatory lesions, although the percentage and the level of significance of this reduction was not the same for all the agents. The results of the present study are compatible with other studies regarding the presence (and targeting) of oxidative stress and inflammation in acne."

 

 

Yes I've mentioned this study in my first post. My point is I've used different supplements for reducing oxidative stress already and none of them worked except those two - where milk thistle worked the best. So my assumption was it is not because of the oxidative stress properties but rather blocking the androgen receptor sensitivity. Does it make any sense? 

Edited by heyeddy, 14 April 2016 - 03:09 PM.

[heyeddy]

I've made another test, I've stopped eating milk thistle for 2 days and got highly inflamed pimples (cysts) mouth/jawline area within 48hrs. Then again I've used milk thistle (i'm using this one: http://www.nowfoods....eg-Capsules.htm  -- contains also dandelion root + artichoke) and literally over night 85% of inflammation was gone. This is not 100% cure but still something sensational for me. But I still don't understand how can it work so fast !? it makes no sense.   

[sativa]

This is not 100% cure but still something sensational for me. But I still don't understand how can it work so fast !? it makes no sense.

What is your diet like? Specifically allergens you might not have realised are allergens [to your body] or contributing to this "issue".

Also, what is your digestion and gut flora like - Have you used antibiotics in the past?

Edited by sativa, 21 April 2016 - 08:35 PM.

[heyeddy]

I had multiple allergic tests food panel (from blood also skin pricking) and appending to the tests I'm not allergic to anything. I'm on gluten free and dairy free diet for couple of years already. Tried elimination diet too. Nothing works as long as milk thistle is not involved. When I am on milk thistle I can eat anything and my skin is not getting worse. 

 

As for antibiotics I've used them in the past but always with a lot of top shelf probiotics they never made any difference to me.  

 

My inflammation and pimple size is 90% reduced right now, not painful at all. However my chin is still oily. 

Edited by heyeddy, 22 April 2016 - 04:08 AM.

[heyeddy]

Ok I'm still on milk thistle + dandelion root my acne seems to still be improving. However I started to have problems with urination - voiding mainly (sign of BPH). This is not severe but it seems to correlate with my theory regarding hormonal influences of this supplement. 

[sativa]

Regarding your use of "top shelf probiotics" from what I gather these are not very effective for replenishing gut bacteria. Perhaps you could try a more established method such as water kefir (I'd recommend this!!) or fermented foods. Who knows, with all the complex interactions that gut bacteria have with the body as a whole, a healthy gut bacterio population might just have a beneficial impact regarding your acne. (Whether it be direct or indirect)

Ok I'm still on milk thistle + dandelion root my acne seems to still be improving. However I started to have problems with urination - voiding mainly (sign of BPH). This is not severe but it seems to correlate with my theory regarding hormonal influences of this supplement.

Hmmm seems milk thistle can increase prolactin levels, which likely has many downstream effects on other hormones etc

Silymarin BIO-C, an extract from Silybum marianum fruits, induces hyperprolactinemia in intact female rats.

...
In conclusion, we have shown that an extract from S. marianum fruits significantly increases circulating prolactin levels in female rats; this effect seems to involve, at least in part, dopamine D(2) receptors.

www.ncbi.nlm.nih.gov/pubmed/19303749

[heyeddy]

Ok I've managed to do some medical tests which confirmed my primary suspects:

 

After 2 week sylimarin (milk thistle) course - dosage: 500mg:

Estradiol - 56 pg/ml (norm: 20-47) - HIGH

Prolactin - 7 ng/ml (norm: 2.7 - 13.3) 

FSH - 5 mlU/ml (norm: 1.27 - 19.3)

LH - 5.7 mlU/ml (norm: 1.24 - 8.62)

DHEA SO4 - 220 ug/dl (90 - 470)

Testosterone - 620 ng/dl (175 - 790)

 

As you can see the only abnormal result here is Estradiol which seems to be increased. So for two weeks I've stopped the milk thistle supplementation and did one more test just to verify my theory:

 

Estradiol - 40 pg/ml (20-47) - NORMAL

 

As you can see my estrogen level dropped to normal levels and acne re-appeared again.

 

There are some problems with this approach (supplementing milk thistle):

- acne is not solved 100% - I would say 90% better, I still experience breakouts after serious physical activity

- milk thistle makes me tired, can't lift

- brain fog

- prostate enlargement, trouble urinating !!!

 

Those side effects mostly go away after stopping the treatment but then acne reappears. 

 

I suspect those side effects are due to elevated estradiol. Now questions for you guys:

 

- Can this situation lead to more problems in the future?

- Secondly would it be better to risk using isotretinoin with hormonal acne like this?  

[gamesguru]

salcylic acid may help.
its also possible milk whistle has selective antibiotic properties toward Acne, which I believe, is how retinols and Accutane work.
I think between the liver protection, antioxidative and antibacterial effect, and antiandrogen activity, milk thistle is kind of a perfect storm. not sure how it ties in with nac and selenium.

"... growth of the tested bacteria was completely attenuated after 2–6 h of treatment with the MBC of silibinin, regardless of whether it was administered alone or with ampicillin or gentamicin."

[vader]

Milk thistle and NAC should be good combo, NAC should reverse any risk of BHP supposedly. It really helps with voiding speed and ejaculatory force, so i do think it makes the prostate smaller.

[jack black]

My wife has a perimenstrual acne. I told her about NAC and milk thistle, she took them for several days and it didn't help. I guess everyone is different.

[airplanepeanuts]

its also possible milk whistle has selective antibiotic properties toward Acne, which I believe, is how retinols and Accutane work.
 

I don't think so: http://www.aocd.org/...etinoidstopical

 

You should be more cautious with your posts because half truths and bro science are bringing down the quality of the discussion.

Edited by airplanepeanuts, 12 October 2016 - 07:04 PM.

[gamesguru]

True. Since Accutane is a last-line treatment (usually reserved for after antibiotics have failed), milk whistle is unlikely to be as effective. Milk thistle is unlikely to work as well as the antibiotics tried first. One source claims it works by increasing bike production and flushing away testosterone byproducts. The testosterone I'm doubtful of, but the whole gut-skin and liver detox idea sounds plausible. The bile is what carries toxins. A longshot. But no, I didn't find any similarities between retinoids and milk thistle. Nothing about epithelial stem cells or growth. The closest I found was a study titled Positive effect of silymarin on cell growth and differentiation in bovine and murine mammary cells and another called Silymarin enhanced fibroblast proliferation and tissue regeneration in full thickness skin wounds in rat models; a stereological study

 

I even found one suggesting anti-collagen effects.  And according to a final study it shares a few things in common with the retinoids:

"... DNA metabolism and repair, transcription, intracellular signaling, cell-cell communication, cell growth, apoptosis inhibition and ultimately cell survival"

Edited by gamesguru, 12 October 2016 - 08:22 PM.

[Al4ina]

I started taking supplements 2-3 months ago for my ADHD and as a counter to dexamphetamine side effects. I noticed that by a lucky coincidence my acne got like 50% better within a month. I never had acne as a teenager, it flared up after I had my son 9 years ago and did not want to go away, no matter what. No topical stuff fixed it for me either. Salicylic acid made it worse, benzoyl peroxide did nothing except make my dry and flaky, Antibiotics did nothing. I tried vit B5 as well but that did very little. I was not even sure if the small questionable effect I saw was placebo or real.

 

For what its worth milk thistle 250mg/day is one of the things I have started taking lately. But on the other hand so are 15 other supplements, accompanied with different eating habits, better mood, organizing skills, less stress and so on. But still there is a chance that the milk thistle could have been one of the things contributing to the clearing of my acne.

Edited by Al4ina, 03 December 2017 - 12:32 AM.

[jack black]

 

 accompanied with different eating habits, better mood, organizing skills, less stress and so on. But still there is a chance that the milk thistle could have been one of the things contributing to the clearing of my acne.

 

Thanks for reporting, but I would look into sugars in your diet. My adolescent son reports his acne is directly proportional to the amounts of sugar he eats.

 

That would also agree with my wife's experience when she has it perimenstrually when she craves sugars/chocolate (combined with stress).

 

On the other hand, milk thistle is known to increase estrogen and low estrogen/high testosterone is associate with acne, so it may work in some.

 

Whole milk/cheese consumption increases estrogens too, would that decrease hormonal acne?

 

Edit: surprisingly, the answer for the last question is no. Milk increases acne by increasing insulin production and insulin promotes acne: https://www.facingac...ing-milk-acne/ 

 

That explains my family experience, cutting sugars cuts insulin levels. Milk thistle also effects blood glucose and insulin levels and this may tie in with the OP experience too (even though didn't work for my wife).

Edited by jack black, 03 December 2017 - 05:35 PM.

[Al4ina]

"I would look into sugars in your diet"

 

 

Yes sugar is definitely something I eat less of post meds, mostly cause I eat less of everything. Before I started ritalin and then went over to dex I had undiagnosed Binge-eating disorder (BED). Another bonus thing which is now completely cured, as long as I am medicating anyway, don't know if it's permanent without meds. 

 

On the other hand I have done diets in the past where I counted calories obsessively and lost 10-30kg every time. I never noticed any change in my acne because of the diets, if anything it may have gotten slightly worse because of the stress my dieting brought on.

 

At those times I ate minimum amounts of sugar, fast carbs and bad fats. I ate low amounts of healthy fats and mostly protein, also high fiber carbs in beans, seeds and veggies. I managed to keep the diets up for 2-12 months every time. but because of the amount of obsessiveness I had to squeeze my mind into in order to go through with the diet I was very stressed, anxious, depressed and generally felt like crap. As soon as I stopped obsessing and counting calories, trying to get back to a more natural relaxed healthy eating, I went straight back to Binge-eating in a week's time.

 

Just a thought... studies show that that oxidative stress exists in the acne patients. Sugar increases insulin resistance which may have a role in the pathogenesis of acne. If one assumes that acne gets worse by oxidation, but better with less sugar. The less sugar benefit could have been mitigated by the oxidation caused by my stress during my previous dieting. Whilst now the "dieting" is effortless and magic. I just give it a little thought and from time to time consciously chose a healthier alternative in favor of the whole princess cake. The cake I normally would have consumed on my own within 45 minutes waited half an hour and be rummaging through the pantry for Twinkies. Even If now I do chose to eat cake sometimes, I take one slice not the whole thing. Plus, I’m feeling generally better because my life is working smoother. Thus post med, the oxidative stress is lower and the sugar is lower, maybe = less acne

 

https://www.ncbi.nlm...les/PMC1533901/

Our findings show that oxidative stress exists in the acne patients. It will be useful to apply at least one antioxidant featured drug along with the combined acne treatment.

https://www.ncbi.nlm...les/PMC4565837/

These results suggest that insulin resistance may have a role in the pathogenesis of acne.

 

 

[Al4ina]

My experience could support that milk thistle may beneficial at least in conjunction with other acne treatment since it does have anti-oxidant properties. But if that’s the case so would every other antioxidant out there. OP says she has tried “various detoxing supplements” I would assume that at least some of them would have been antioxidants. If milk thistle is in fact superior to other antioxidants it must have some unique property other antioxidants lack.

 

Since OP states she gets similar results with NAC my first thought was it could have a correlation with the liver/ glutathione. Her/his liver tests are fine thou. A wild and unlikely guess could be that, maybe the liver does something to combat acne that is not measured in liver tests? That the liver seems fine but still may be malfunctioning in some ways we don’t understand. And that milk thistle/ NAC alleviates that mysterious thing? This is pure speculation on my part and probably wrong.

 

OP tried “vitamin C&E, l-glutamine, selenium, MSM, SAMe supplementation” which according to OP raises glutathione (GSH), I’m too lazy to verify :-P Here the possible explanation could be that silymarin in milk thistle and NAC maybe are the strongest glutathione raisers? I can’t find any studies that compare Silymarin and NAC to other GSH raisers but I haven’t searched very hard either. Maybe even thou the previously tried weaker supplements do raise glutathione that raise may not be enough to see acne benefits, but with Silymarin/NAC a threshold is reached and acne benefits occur?

 

Other things one could look into is the effect Milk thistle and NAC specifically has to the skin. I found these but I’m to tired to go through them:

 

Milk thistle and skin

Topical delivery of silymarin constituents via the skin route

https://www.ncbi.nlm...les/PMC4002699/

 

The treatment of melasma by silymarin cream

https://www.ncbi.nlm...les/PMC3519762/

 

Formulation and clinical evaluation of silymarin pluronic-lecithin organogels for treatment of atopic dermatitis

https://www.ncbi.nlm...les/PMC4790491/

 

Comparison of imatinib, nilotinib and silymarin in the treatment of carbon tetrachloride-induced hepatic oxidative stress, injury and fibrosis

https://www.ncbi.nlm...les/PMC3895503/

 

Silibinin enhances the repair of ultraviolet B-induced DNA damage by activating p53-dependent nucleotide excision repair mechanism in human dermal fibroblasts

https://www.ncbi.nlm...les/PMC4741848/

 

N-acetylcysteine (NAC) and skin

Antioxidants and NOX1/NOX4 inhibition blocks TGFβ1-induced CCN2 and α-SMA expression in dermal and gingival fibroblasts

https://www.ncbi.nlm...les/PMC5648211/

 

Use of oral N-acetylcysteine for protection of melanocytic nevi against UV-induced oxidative stress: towards a novel paradigm for melanoma chemoprevention

https://www.ncbi.nlm...les/PMC2787788/

 

Topical N-Acetylcysteine Improves Wound Healing Comparable to Dexpanthenol: An Experimental Study

https://www.ncbi.nlm...les/PMC4400934/

 

Topical N-Acetylcysteine Accelerates Wound Healing in Vitro and in Vivo via the PKC/Stat3 Pathway

https://www.ncbi.nlm...les/PMC4057691/

 

Effect of Oxidative Stress on Protein Tyrosine Phosphatase-1B in Scleroderma Dermal Fibroblasts

https://www.ncbi.nlm...les/PMC3309078/

Edited by Al4ina, 03 December 2017 - 08:49 PM.