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e-ISSN 2544-1620 Medical Science Pulse 2021 (15) 1
B
Acne vulgaris is an inammatory disease charac-
terized by skin eruptions such as comedones, nod-
ules, pustules, papules, blackheads and whiteheads.
ese lesions most commonly appear on the face, es-
pecially in the T-zone (forehead, nose, chin), but are
also observed on the mandible and upper back area.
e development of acne vulgaris may be due to fol-
licular hyperkeratinisation, colonization of Cutibacte-
rium acnes, or too high a level of testosterone. A poor
diet rich in simple sugars, dairy products, and spicy
food may also contribute to deterioration of the skin
condition in these patients [1]. Severe forms of acne
cause scarring, and, consequently, can diminish the
quality of life. Scars or facial deformities aect up to
20% of teenagers [2,3,4]. Skin lesions formed after
acne treatments may negatively inuence daily life
activities and, eventually, lead to depression, suicidal
thoughts and suicide attempts [5,6].
Various cosmetic treatments are eective at re-
ducing skin lesions and sebum secretion. ese in-
clude cosmetic acids such as azelaic (AzA), salicylic
and pyruvic acids. Szymańska et al., showed that
peels containing 30% AzA reduced acne skin erup-
tions and secretion of sebum. Similarly, Jaary et al.
found that pyruvic acid (50%) and salicylic acid (30%)
improved mild and moderate acne without side ef-
fects [7,8]. Cosmetic acids can also be used to re-
duce skin discoloration, which often occurs in people
struggling with acne. In the treatment of skin hyper-
pigmentation, dierent levels of exfoliation are used,
depending on the nature of the discoloration. e
most frequently used acids in this case are glycolic,
Case reports
THE EFFECTIVENESS OF ALKALINE WATER
ON OILY AND ACNEPRONE SKIN:
A CASE REPORT
Published online: 31 March 2021 DOI: 10.5604/01.3001.0014.8295
A – study design, B – data collection, C – statistical analysis, D – interpretation of data, E – manuscript preparation, F – literature review, G – sourcing of funding
K C1 A,D-F
ORCID: 0000-0002-6435-0179•
M R1 E
ORCID: 0000-0001-6467-7633•
I D1 E
ORCID: 0000-0002-5800-7817•
1 Department of Health Sciences , Institute of Health Sciences,
University of Opole, Opole, Poland
ABSTRACT
Background: Skin lesions and excess sebum on the surface of epidermis occur mainly among people suer-
ing from acne vulgaris. Scientists are constantly searching for cosmetic procedures that, can not only comple-
ment dermatological treatment and decrease sebum production, but also increase patients’ quality of lives.
Aim of the study: To evaluate the eectiveness of alkaline water in the treatment oily skin and acne vulgaris
in a 21-year-old woman.
Case report: A 21- year-old female reported problems with too high a sebum level and skin eruptions like
blackheads, whiteheads, and pustules. e sebum level was measured and the global acne severity scale
(GAGS) score was used to check the amount of skin eruptions before and after a series of treatments with
alkaline water.
Conclusions: After a series of cosmetological treatments with alkaline water, there was a signicant reduc-
tion of sebum secretion and skin eruptions.
KEYWORDS: alkaline water, oily skin, cosmetology, women, sebumeter
Medical Science Pulse 2021 (15) 1
e eectiveness of alkaline water on oily and acne-prone skin: a case report
trichloroacetic, and salicylic acids. However, it should
be noted that these cosmetic acids often cause side
eects after application, including redness, burning,
irritation of the skin, and peeling, which often causes
discomfort [9].
Preparations containing plant extracts also are
extremely helpful in treating acne or excess sebum
production. In the case of problematic skin, plant
extracts such as green tea or lotus can be used. Mah-
mood et al. examined the eectiveness of the above-
mentioned plant extracts for treating oily skin in
men. In one study, green tea and lotus extracts were
used externally, resulting in a signicant reduction
in sebum levels. In another study conducted by the
same authors, a 3% green tea gel was used externally
for 8 weeks, which also reduced sebum on the skin
surface [10,11].
Cosmetology is an interdisciplinary science which
is constantly developing. Scientists are continually
looking for new methods to treat acne-prone skin
types. Recently, hydrogen cleansing has been intro-
duced. is treatment is based on pushing active hy-
drogen particles into the skin at a high pressure. Hy-
drogen cleansing is a non-invasive procedure with no
reported side eects such as skin reddening, burning,
or breaking. e electrolysis apparatus used for this
treatment produces alkaline water (pH=9).
It should be noted that a cosmetic treatment is
selected for each patient individually, and contrain-
dications for potential treatments are extremely im-
portant to consider. Not every person suering from
acne will be able to undergo a treatment with the use
of cosmetic acids, plant extracts or ultrasound, for
example. erefore, a preliminary interview to deter-
mine the indications and contraindications for a pro-
cedure are necessary for the selection of a safe and
eective individual treatment method.
A
e purpose of this study was to assess the e-
cacy of alkaline water in reducing acne skin eruptions
and decreasing sebum levels.
M
Study design, setting and duration
Hydrogen purication with alkaline water was
used as a cosmetic treatment in the current study.
e procedure consisted of 6 treatments with the al-
kaline water (pH=9) occurring every 7 days. Make-
up was removed with a micellar uid before each
treatment. e treatment was performed with the
use of alkaline water generated by the apparatus.
To obtain high pressured alkaline water a special tip
was used. e water used during the procedure was
sucked into a special container and the vacuum set
at 12%. Each treatment lasted 10 minutes and was
nished with the application of tonic and a mois-
turising cream. is study was conducted between
January 2020 and February 2020 at Opole Univer-
sity in Poland.
Participant
e participant was a 21-year-old female who re-
ported some problems with excessive sebum secre-
tion and skin eruptions such as blackheads, whitehe-
ads and pustules. e condition was present in the
patient for the past 6 years.
Inclusion criteria
e patient met the inclusion criteria for the
study including an age of 19–23, no dermatological
treatment within last 12 months, mild-to-moderate
acne as measured by the global acne severity scale
(GAGS), and no current hormonal contraception.
Exclusion criteria
Exclusionary criteria for this study were pregnan-
cy, breastfeeding, active inammation of the skin,
bacterial, viral, allergic, and fungal skin diseases, dis-
turbed skin condition, active rosacea, eczema, psoria-
sis, numerous telangiectasias, numerous melanocytic
nevi, skin cancers, oral contraceptive pill use, oral
antibiotic use within the previous three months, or
isotretinoin use within the previous year.
Ethical Considerations
e study was approved by Human Research Eth-
ics Committee of the Opole Medical School (KB/54/
NOZ/2019), according to the principles of the Dec-
laration of Helsinki. e participant was informed
about the principles and purpose of the study, signed
a voluntary written consent form, and was informed
that she could withdraw from the study at any time
without giving a reason.
Data sources/ Measurements
e participant was diagnosed with mild acne vul-
garis (GAGS score=17). e GAGS scale divides the
body into areas (forehead, cheeks, nose, chin, chest
and back) and assigns a factor to each area on the ba-
sis of size. e location and factors are: Forehead – 2;
Right cheek – 2; Left cheek – 2; Nose – 1; Chin – 1;
Chest and upper back – 3. Each type of lesion is also
given a value depending on severity: no lesions=0,
www.medicalsciencepulse.com
K C, M R, I D
comedones=1, papules=2, pustules=3, and nodules=4.
e score for each area (Local score) is calculated us-
ing the following formula: Local score=Factor × Grade
(0–4). e global score is the sum of local scores, and
acne severity is graded using this metric. A score of
1–18 is considered mild, 19–30 moderate, 31–38 se-
vere, and >39 very severe [12,13].
Sebum measurement was performed using a Der-
ma Unit SCC 3 sebumeter. Measurements were taken
before the series of cosmetic treatments and 14 days
following the last treatment. e patient was asked
to remove make-up and not to apply any cosmetics
the evening before the examinations, which were
carried out in the morning hours. e temperature
in the examination room was 22 degrees Celsius and
the humidity was 40–50%. e patient was allowed
to acclimate to the conditions for 20 minutes prior to
each examination and the level of sebum was checked
between the eyebrows and on the chin.
e patient was informed that during the treat-
ment, and for the two weeks following, other cosmet-
ic procedures, dermatological treatments, applying
new cosmetics, going to a swimming pool or solari-
um, or supplementation with any substances reduc-
ing sebum were forbidden. She was recommended
to use only micellar uids and moisturising creams
in homecare. Cosmetics with mattifying or sebum-
regulating eects were also strongly contraindicated.
R
After the series of cosmetological treatments
using alkaline water, it was found that there were
reduced skin eruptions (Table 1) and sebum levels
(Table 2). ese measurements indicated an improve-
ment in the condition of the skin. Treatments reduced
the GAGS score from 17 to 10 and the level of sebum
decreased between the eyebrows (251 to152 µg/cm2)
and on the chin (183 to 130 µg/cm2).
Table 1. GAGS score before and after treatment
GAGS score
before the treatment
GAGS score 14 days
after the last treatment
17 10
Table 2. Sebum level before and after treatment
Area
of measurement
Sebum level
before
the treatment
(µg/cm2)
Sebum level
14 days after
the last treatment
(µg/cm2)
Between the eye-
brows 251 152
On the chin 183 130
D
Key results
Alkaline water is a useful treatment for people
struggling with skin eruptions (acne vulgaris) and
with those who have high levels of skin oiling.
Interpretation
e series of cosmetic treatments with alkaline
water in a 21-year-old female appeared to be very ef-
fective at reducing her skin eruptions. Alkaline water
has a high pH, which reduces sebum on the surface of
epidermis. It may also have an anti-inammatory ef-
fect [14]. Face washes such as soaps also have a high
pH, but when used daily may over dry the skin and
cause irritation [15]. e treatment in the current
study was performed weekly; therefore, the skin pa-
rameters improved rather than worsened. Alkaline
water is well-known in the world of science. Gadek
et al. showed that drinking 2 litres of alkaline water
daily decreased glucose HbA1c levels in people with
type 2 diabetes [16]. is substance has also been
used to treat cancer, and to decrease cholesterol and
creatinine [17,18]. As the application of alkaline wa-
ter to treat acne is relatively new, few studies exist in
the literature. However, Chilicka et al. examined the
use of hydrogen purication in people with acne, and
observed positive results in terms of the reduction
of skin eruptions [19]. Given these ndings, and our
own results, we hope that the study of alkaline water
treatments will become more popular among other
researchers.
As mentioned above, it is not only apparatus
treatments that are eective at reducing skin erup-
tions and excessive sebum levels. Plant extracts such
as green tea have produced positive results in many
studies. For example, Lu et al. found that the treat-
ment of acne patients with green tea capsules admin-
istered orally signicantly decreased skin eruptions
[20]. Moreover, Jung et al., in their study, obtained
a reduction of open comedones and pustules after us-
ing green tea [21].
Sebum is an oily material that is produced in the
sebaceous glands. It is a mixture of triglycerides, wax
esters, squalene, and cholesterol esters. High sebum
levels can be present on face (forehead, nose, chin),
shoulders, and back. Sebum has a protective func-
tion, but too much can increase the likelihood of de-
veloping acne. While acne treatments can decrease
sebum, it is important to note that, given its impor-
tant biological functions, cosmetological procedures
that reduce sebum levels by too much may result in
unwanted side eects [22].
Medical Science Pulse 2021 (15) 1
e eectiveness of alkaline water on oily and acne-prone skin: a case report
According to Fąk et al., microdermabrasion in
a group of healthy people was eective in reducing
sebum. In particular, a statistically signicant dier-
ence in stratum corneum hydration was found on the
cheeks 30 minutes after treatment and in the T-zone
immediately after the procedure. Sebum reduction
was observed immediately after the procedure irre-
spective of skin type and face area [23]. Kołodziejczak
et al. also showed that a series of mixed treatments,
including microdermabrasion and cavitation peeling,
improved the condition of seborrheic skin. Following
these treatments a statistically signicant improve-
ment in skin sebum levels was observed in all facial
areas examined [24].
e advantage of cosmetic treatment lies mainly
in its complete lack of side eects such as irritation of
the skin or burning of the epidermal surface. On the
contrary, cosmetic acids, despite their positive eects
on the acne and oily skins, produce side eects that
may cause some discomfort [1,5].
Study limitations and recommendations
While the current results are promising, it would
be useful to verify the eectiveness of this treatment
in a larger sample of patients, including the opposite
sex. In addition, it would be informative to include a
placebo control group using only normal mineral wa-
ter in future studies.
C
Cosmetic treatment with alkaline water appears
to be safe and eective in patients suering from
acne vulgaris and excess sebum secretion. is treat-
ment signicantly reduced both skin eruptions and
sebum levels. It is worth noting, however, that a cos-
metic procedure cannot replace a dermatological
treatment. us, treatment with alkaline water may
be useful as a complementary therapy in cooperation
with a dermatologist.
R
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K C, M R, I D
Word count: 1936 •Tables:2 •Figures:1 •References:24
Sources of funding:
e study was funded by rst author.
Conicts of interests:
e authors report that there were no conicts of interest.
Cite this article as:
Chilicka K, Rusztowicz M, Dzieńdziora I.
e eectiveness of alkaline water on oily and acne-prone skin: a case report.
Med Sci Pulse 2021; 15(1): 50-4. DOI: 10.5604/01.3001.0014.8295.
Correspondence address:
Karolina Chilicka, PhD
Institute of Health Sciences, University of Opole
ul. Katowicka 68, 45-060 Opole, Poland
E-mail: karolina.chilicka@poczta.onet.pl
Received: 05.02.2021
Reviewed: 15.02.2021
Accepted: 21.02.2021
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