الفهرس 
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Abstract
This study was carried out at the Dermatology, Venerology and Andrology Department at Assiut University Hospitals, Egypt, to compare the efficacy and safety of both SA 30% peeling and topical silymarin 1.4% cream in treatment of mild and moderate acne vulgaris. It was carried out on 30 patients. The age ranged from 18 to 26 years, most of them were females (90%). The studied patients underwent to facial chemical peeling using SA 30% applied to the right half of the face every 2 weeks and topical silymarin 1.4% cream to the left half twice daily. The duration of the study was 3 months. The clinical evaluation of the outcome was calculated with GAGS. Both SA 30% peeling and topical silymarin 1.4% cream were effective in treatment of acne vulgaris. The difference between both in all studied parameters didn’t reach statistical significance. As regard to safety, no complications were reported from the patients on the side treated with topical silymarin 1.4% cream, while post-inflammatory hyperpigmentation occurred in 2 patients on the side of SA 30% peel. from the results of the present study the following points could be concluded: Both SA 30% peeling and silymarin 1.4% cream showed various degrees of improvement in most of the patients with mild and moderate acne vulgaris. The clinical effectiveness SA peeling and silymarin cream was not significantly different in mild and moderate acne vulgaris. Complications in form of post-inflammatory hyperpigmentation occurred only after SA 30% peel, so topical silymarin 1.4% cream is considered more tolerable and safer. Topical silymarin 1.4% cream serves therapeutic option not only effective, but safe modality for the treatment of acne vulgaris. Recommendation: Further studies on topical silymarin cream with larger sample size to confirm its efficacy and safety in treatment of acne vulgaris are recommended. Further studies on SA peeling and topical silymarin cream with larger sample size to evaluate difference in clinical outcome in different forms of acne lesions (inflammatory and non-inflammatory acne lesions) are recommended. Further studies on topical silymarin in combination with different modalities for acne treatment. Further studies on effect of adding silymarin on anti-acne products. Follow up is necessary to document the permanency of improvement and the rate of recurrence.