Brief Answer: No strong evidence to support its use Detailed Answer: Dear XXXX Thanks for the query. The disclaimer is that this opinion comes from an allopathic doctor, but that being said, a strong believer in evidence-based medical recommendations. Milk thistle is a common term for the plant Sybilum marianum, which has a pretty purple flower and grows in the wild. Extracts from the plant contain several compounds, the most active being sylibinin, which has been claimed to be a powerful antioxidant, especially in people with liver disease. However, the data does not support that. A metanalysis or systematic review from the Cochrane database showed in almost 1000 patients no significant benefit in patients with cirrhosis, and concluded that no firm recommendations can be given for this use in the abscence of better trials. Now, pertainin to your case with severe dandruff and probably a tendency for cutaneous fungal infections, some limited case reports have claimed acivity from this herb against certain fungi, like tinea. Again, not strong evidence but mostly anecdotal. So at the end of the day, should be a decision between you perceived benefits (you indicate your skin looks healthier) versus the limited evidence, versus the costs, versus any potential side effects (some of the extracts, since it is a wild plant, have been reported to be tainted with traces of mushroom poison). Hope that helps, wish you the best, Dr Brenes-Salazar MD Mayo Clinic Cardiology

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