Living with eczema can mean long-term challenges with dry, red, severely itchy skin. What provides relief can be very individual, and for some, that relief comes in the form of milk thistle.

Eczema is a collective term for a handful of inflammatory skin conditions that present with symptoms of dry skin, sensitivity, and itchiness — just to name a few.

Of these, atopic dermatitis is the most common type of eczema, affecting more than 9.6 million children and 16.5 million adults in the United States.

The symptoms of eczema can vary significantly between people. For some it can mean red, inflamed patches of skin, while for others it might involve itchiness, crusting or oozing, and skin discoloration.

Finding relief from eczema can be just as individual as the symptoms themselves. This article looks at the effectiveness of using milk thistle in atopic dermatitis.

Milk thistle is a flowering plant native to Europe but is now found throughout much of the U.S. It is also known as “silymarin,” after its primary extract, or Silybum marianum and Carduus marianus, its Latin names.

Spikey in appearance, milk thistle has a pink-purple flower of varying hues that sits atop a bundle of long, slender leaves at the end of a long stem.

It looks very similar to other genuses of thistles, such as Canada thistle and bull thistle, which can make foraging risky for those without extensive thistle knowledge.

What is silymarin?

Silymarin is the main extract from milk thistle, a combination of multiple flavonolignans such as silybinin, silychristin, and silydianin.

Flavonolignans are bioactive compounds in plants that may have therapeutic benefits. They are made up partly of flavonoids, plant compounds known for their antioxidant, anti-inflammatory, and health-promoting effects.

Milk thistle’s use in the treatment of eczema is an area of current research.

While it appears to hold promise as a therapeutic option, much is yet unknown about universal dosage, safety, best routes of administration, and potential side effects.

In 2016, a study published in the journal Drug Design, Development and Therapy looked at the effectiveness of a topical gel formulation of silymarin on atopic dermatitis in 15 people. Overall, the gel formulation had a high skin penetration ability and hydration effect. Participants experienced a significant improvement in their eczema symptoms.

In 2022, research published in the journal Avicenna Journal of Phytomedicine looked at a cream formulation of silymarin, combined with extracts from another plant, Fumaria officinalis. In 35 participants, the cream preparation was found to be just as effective as the prescription medication mometasone 0.1%.

A 2018 review published in the Indian Journal of Dermatology, Venereology and Leprology looked at the use of silymarin across multiple skin conditions. In relation to atopic dermatitis, authors noted studies were minimal and often animal-based.

Overall, silymarin’s anti-inflammatory, antioxidant, immunomodulatory, and cell-stabilizing properties made it a promising candidate for dermatological conditions, said researchers, but evidence for its use in humans is not yet very strong.

Research on milk thistle for eczema has focused on specific topical formulations.

While commercial milk thistle products are available, how similar they may be to research models is unknown. Quality can also vary significantly when it comes to over-the-counter products. It’s a good idea to research the manufacturing company for quality standards or reviews.

The Food and Drug Administration (FDA) considers topicals used to treat eczema as drugs; however, labeling matters. Formulations can get around FDA regulations by avoiding the term “treatment,” or by using nonspecific language. This can impact the quality and quantity of ingredients.

Milk thistle can also be taken in oral form, but there is no scientific evidence supporting this route of administration for eczema.

There is no “best” herb for eczema. Relief can vary significantly between people, and what is “best” for one might not be the same for others.

Herbs cited in research as traditional eczema treatments include:

A 2016 systematic review published in the British Journal of Dermatology looked at 25 years’ worth of randomized controlled trials for topical herbal eczema remedies.

The authors concluded there was insufficient evidence to support the use of any of the herbs involved in the research, which included popular options like chamomile.

Herbal remedies may still provide relief for some people, but large-scale evidence is lacking.

At its recommended doses, milk thistle is considered safe. Rare side effects can include:

  • headache
  • diarrhea
  • gastroenteritis
  • allergic reactions

Milk thistle should be used with caution if there are existing allergies to plants in the same family, such as ragweed or marigold. It’s also not recommended for children or pregnant women, due to the lack of research or testing in these populations. A person should talk with their doctor before using.

It may also contribute to low blood sugar levels in people living with type 2 diabetes.

Little is known about the interactions between milk thistle and specific eczema medications.

A 2019 review into the safety and toxicity of silymarin, published in the journal Phytotherapy Research, found that overall, silymarin has a low level of drug interactions, but its availability in the body may be affected by the use of other medications.

Milk thistle appears to have a low rate of interaction with other medications.

Checking with a doctor or dermatologist before adding milk thistle to a treatment routine can help prevent medication clashes.

Milk thistle is growing in popularity as an herbal remedy for eczema.

While research suggests it holds promise for a number of dermatological conditions, not enough scientific evidence supports its use as a universal treatment for atopic dermatitis.

Milk thistle is generally considered safe, but it may not be for everyone. Speaking with a doctor before using milk thistle products can help lower the risk of adverse effects.