ABSTRACT
Silymarin, is a phytoactive constituent isolated from the fruits and seeds of Silybum maria-num L Gaetn.), also called milk thistle belonging to the family of Asteracease. The phytoactive has been used to treat several physiological disorders. The objective of this manuscript was to review the therapeutic prospective of silymarin due to its ability to treat several physiological disorders. The da-tabases such as Pubmed, Elsevier, and Google Scholar were reviewed for the investigations or reviews published related to the title. The discussion is focused on the immunomodulatory, chemopreventive, and anti-inflammatory mechanisms of silymarin in various metabolic and dermatological disorders. In addition, the review discusses the different therapeutic potentials of silymarin such as the management of the liver disorder, skin carcinogenesis, cardiovascular disorders, diabetes mellitus, neurodegenera-tive disorders, and several dermatological disorders such as melasma, anti-aging, acne, rosacea, atopic dermatitis, and psoriasis. Silymarin is safe even with a dose higher than the therapeutic dose. Si-lymarin had good potential for the safe and effective treatment of numerous metabolic and dermatological disorders. © 2023 Bentham Science Publishers.
ABSTRACT
Background: Online searches have become a popular source of medical information, especially in the COVID-19 era. Methods: On February 13, 2021, we performed a YouTube search of “melasma treatment” with the “view count” filter on a private browser. The first 102 videos yielded were screened, and the top 30 videos meeting our inclusion criteria were independently evaluated by 2 reviewers using the DISCERN instrument. Results: The mean DISCERN score for the 30 videos was 41.4 points, categorizing them as “fair” in quality. The mean score for videos uploaded by dermatologists was similar at 46.3 points (“fair”) compared with 31.3 points (“poor”) by profit companies. It is concerning that only 53% of videos supported shared decision-making with a physician/dermatologist. Almost one-third of videos focused on natural home remedies, which generated the most views. A video using raw potato with 3.8 million views claimed to permanently “cure” melasma in weeks. Such false claims pose unrealistic expectations for viewers. Furthermore, only 17% of videos discussed melasma recurrence, and 60% mentioned treatment risks. Popular home ingredients (i.e., raw potato, lemon, etc.) that videos classified as “harmless” can certainly cause contact urticaria, anaphylaxis, or exacerbate melasma. Conclusions: The top 30 most-viewed videos with 15.5 million views contained mostly fair-quality medical information with a focus on home remedies without reliable sources of evidence. Dermatologists should be aware of common misconceptions propagated by these videos and thus underscore treatment risks, recurrence, and insufficient evidence in the literature on the efficacy of home remedies for melasma.