This research article describes a study that evaluated the clinical efficacy and biological impact of an anti-acne dermocosmetic containing Silybum marianum fruit extract (SMFE) on the microcomedone ecosystem in subjects with mild-to-moderate facial acne.

The researchers conducted a randomized, open-label, controlled trial involving 40 participants (20 in the test group using the SMFE product and 20 in a control group using a hydrating product). Over two months, the study employed a multiomics approach—analyzing metabolites, lipids, and the skin microbiota—alongside two-dimensional ultrastructural imaging to understand how the product works at a cellular level.

The study demonstrated that the SMFE-based formulation effectively addresses the four main pillars of acne:

• Clinical Efficacy and Comedolysis: There was a significant reduction in acne lesion severity in the test group compared to the control group. Ultrastructural imaging revealed that the product had a comedolytic effect, characterized by a loss of cohesion in keratinocytes and the swelling of cell membranes within microcomedones. This was further supported by a decrease in cellular membrane components like phospholipids.
• Hyperseborrhea and Lipids: The product significantly reduced levels of total free fatty acids and other specific lipids involved in comedogenesis, such as squalene, cholesterols, oleic acid, and arachidonic acid.
• Skin Dysbiosis: While the levels of Cutibacterium acnes remained stable, the study found a significant decrease in the abundance of Malassezia globosa fungi. These lipophilic fungi are known for high lipase activity that promotes the release of pro-inflammatory lipids.
• Inflammation: By reducing both pro-inflammatory lipids (like arachidonic acid) and the presence of M. globosa, the formulation helps limit local skin inflammation.