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ARTICLE INFO
AUTHOR’S AFFILIATIONS
Department of Anatomy, Faculty of
Medicine, Universitas Wijaya Kusuma
Surabaya, Indonesia1
Department of Biomedical and
Biomolecular Research, Faculty of
Medicine, Universitas Wijaya Kusuma
Surabaya, Indonesia 2,3
Department of Anatomy, Faculty of
Medicine, Hang Tuah University,
Indonesia4
CORRESPONDING AUTHOR
Ayly Soekanto, Department of
Anatomy, Faculty of Medicine,
Universitas Wijaya Kusuma Surabaya,
Indonesia
E-mail:
aylysoekantodr@yahoo.com
Article history
Received 03-06-2024
Revisited 05-09-2024
Accepted 13-09-2024
Available online 30-09-2024
Please cite this article in APA 7th
edition style as:
Soekanto, A., Tania, P. O. A., Agnez, A.,
& Hardiyono. (2024). Effectiveness of
the Combination of Facial Acupressure
and Honey on Facial Skin Moisture.
Jurnal Ilmiah Kedokteran Wijaya
Kusuma, 13(2), 125-134
https://dx.doi.org/10.30742/jikw.v13i
2.3783
Effectiveness of the Combination of Facial
Acupressure and Honey on Facial Skin Moisture
Ayly Soekanto1*, Putu Oky Ari Tania2, Andra Agnez3, Hardiyono4
Abstract
Background: Facial skin is the most sensitive part, so it is
important to take care of it. Facial skin care is a treatment to
keep facial skin elastic and maintain facial skin moisture. Facial
acupressure is a method of treatment that begins with
massaging the meridian points so that blood flow becomes
smooth and facial muscles feel more relaxed. Using honey is a
facial skin care method that is made into a mask. Objective: The
research aims to determine the effectiveness of the
combination of facial acupressure and honey on facial skin
moisture. Methods: This research is an analytical experimental
study, with a sample of 30 women aged 40 - 50 years. In the first
treatment, a moisture test was carried out, followed by the
second treatment, the moisture test was measured for the facial
acupressure and after the third treatment, the combination of
the facial acupressure with a honey mask was subjected to a
moisture test. The research was carried out twice a week for 4
weeks for a total of 8 times. The research was carried out in April
– May 2024 at the Wijaya Surabaya clinic & in a doctor's practice
and used a Skin Moisture Analyzer as a measuring tool to
measure skin moisture. Using statistical analysis with the Mann-
Whitney test (α= 0.05) with a p-value of 0.000. Result: The
results of the third treatment showed an increase in facial skin
moisture until it reached 93.4%, including moist skin and 6.6%,
which was considered normal skin criteria. Conclusion: It has
been proven that the combination of facial acupressure and
honey is effective on facial skin moisture, experiencing very
significant changes in humidity starting from the first, second
and third treatments.
Keywords: Facial acupressure, honey, skin moisture
Original Research Article
INTRODUCTION
Facial skin is a sensitive part of the human body compared to other parts, so it requires special care
and top priority because the layer of facial skin is anatomically thinner compared to other parts of the
body, such as the skin on the palms of the hands and soles of the feet (Labellapansa et al., 2018). Skin
problems increase with age, so skin care needs to be done to maintain the elasticity and moisture of
facial skin (As’ary et al., 2022; Neighbor et al., 2022). Facial skin care is important skincare so it must
be prioritized to keep facial skin healthy. An attractive appearance in women can be seen in healthy
and bright white skin (Kumarahadi et al., 2020). Facial skincare that is done correctly and according to
your skin type will result in skin that looks healthy and bright. Anatomically, the skin is the outermost
part of the human body, wrapped in skin. The skin has the function of protecting the body from
Effectiveness of the Combination of Facial Acupressure and Honey on Facial Skin Moisture
Ayly Soekanto, Putu Oky Ari Tania, Andra Agnez, Hardiyono
126 | Page
exposure to sunlight which contains ultraviolet rays that can affect the surface of the skin. Apart from
that, the important role of the skin is also as a sense of touch, preventing dehydration, regulating body
temperature, and giving aesthetics to a person's appearance so that it looks attractive, especially on
facial skin (As’ary et al., 2022; Rahmawaty, 2020; Wulandari, 2019). The three layers of skin consist of
the outer layer called the epidermis, the middle layer called the dermis, and the inner layer called the
hypodermis. There are layers of the epidermis, namely from the bottom upwards, starting with the
basal stratum, stratum spinosum, stratum granulosum, stratum lucidum, and at the outermost stratum
corneum there are protein lipids and water which function to maintain water release as a skin barrier.
The dermis layer is rich in blood vessels, nervous tissue, melanocyte cells, mast cells, macrophage cells,
lymphocyte cells and elastin and collagen fibers, fat glands and sweat glands, sensory receptors for
mechanoreceptors and thermoreceptors, nociceptors, mechanoreceptors. The hypodermis layer
consists of lipid cells associated with elastic fibers and collagen fibers (Neighbor et al., 2022; Yuniarsih
et al., 2021). Aging will change the morphology of all anatomical components, including facial skin
which affects all layers of the skin. Facial skin is the part that is exposed to more sunlight than other
areas (Kim et al., 2019). Exposure to the surrounding environment will provide interactions that can
disrupt the balance of water levels in the skin and have the effect of disrupting skin moisture. Exposure
such as temperature, air humidity, and ultraviolet light will affect the water content in the skin which
will affect skin moisture. Low skin moisture levels cause the skin to become dry, whereas well-
maintained skin moisture will make the skin smoother (As’ary et al., 2022; Wulandari, 2019).
It is necessary to use natural ingredients that are around us which can be useful for healthy facial
skin, such as honey. Honey is produced by honey bees in the form of a thick liquid derived from flower
nectar. Honey is often used to beautify facial skin and soften facial skin. The use of honey for facial skin
care is made in the form of masks, soap, shampoo, body scrubs, and lotions because honey is a natural
ingredient intended to moisturize facial skin. The antioxidant content in honey contains lots of vitamins
C, K, B6, B2, B1, flavonoids, amino acids, and alpha hydrolytic acid which are useful for providing
moisture and elasticity to the skin. Using a honey mask is an alternative option for providing natural
nutrition to the face which can be used to treat and restore facial skin disorders. Honey is a natural
ingredient that can soften and beautify the skin. The antioxidant and vitamin C content in honey can
have the effect of tightening the skin, shrinking pores on the skin, and making facial skin firm (Budiono
et al., 2022; Sinulingga et al., 2018; Tanggasari & Septianingsih, 2023).
Facial acupressure is a beauty treatment method that is carried out by massaging the facial area
with emphasis on certain meridian points which are useful for tightening facial muscles, removing
wrinkles on the face, making the face bright, and relaxing the facial muscles. This face acupressure
begins by massaging the forehead, cheeks, and then the neck and shoulders. Massage for 5-10 minutes
which is carried out according to the anatomical structure of the facial region and added emphasis on
the meridian points will provide smooth blood flow and smooth facial skin, look more youthful, and
facial muscles feel more relaxed (Pardede, 2022; Surtiningsih et al., 2022). Face acupressure through
gentle massage on the face has the effect of relaxing the facial muscles and preventing the reduction
of wrinkles on the face (NWO, Ceria et al., 2021; Soekanto et al., 2022). If facial acupressure is done
regularly, the dead skin cells will be removed from the exfoliation process on the facial skin, making
the skin healthy and bright (Surtiningsih et al., 2022). In previous research on the effectiveness of facial
acupuncture and acupuncture on facial acupressure, the muscle appeared more supple and elastic
with facial acupuncture therapy (Soekanto et al., 2022). By continuing this research, the aim is to
determine the effectiveness of the combination of facial acupressure and honey, using a honey mask
on facial skin moisture. The importance of this research is by combining facial acupressure and honey
mask, which is a natural nutritional ingredient that can be used to provide treatment and recovery for
facial skin disorders and is efficacious in smoothing and beautifying facial skin and the novelty in this
research is by combining facial acupressure and honey on moisturize the facial skin and assess its
effectiveness by looking at any changes in moisture starting from before facial acupressure, after facial
acupressure and after being given a combination of facial acupressure and Haney's clover honey mask.
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MATERIALS AND METHODS
This research has been recommended as ethically sound with number 84/SLE/FK/2024, using a non-
parametric analytical experimental research design, with a research sample of 30 respondents,
conducting the research in April – May 2024 at the Wijaya Surabaya clinic and in a doctor's practice.
This research method uses Mann-Whitney and IBM SPSS statistical software, then continues with the
Games-Howell difference test (α= 0.05) to see the differences in three treatments, with treatment
details as follows: first treatment, no treatment at all then a moisture test was carried out, the second
treatment was given a facial acupressure treatment and continued with a moisture test and the third
treatment was given a combination of facial acupressure and a clover honey mask and a moisture test
was carried out(Adiputra et al., 2021; Fadli, 2021; Notoatmodjo, 2012). The inclusion criteria for this
study were women aged 40 - 50 years who had no history of allergies, were healthy and had no facial
abnormalities or defects, had never had facial treatment, were willing not to use moisturizer on the
face being treated, and were willing to take part in this study until completion, and The exclusion
criteria for this study were women having a history of allergies to honey(Astuti et al., 2018; Masluhiya
AF & Fidiastuti, 2019; Soekanto et al., 2022). Each respondent received treatment before facial
acupressure, giving facial acupressure and a combination of facial acupressure with honey. In this
study, treatment was carried out twice a week and carried out for 4 weeks, a total of 8 treatments
were carried out. Data were taken from photos before treatment and photos after treatment, and
facial skin moisture was measured using a Skin Moisture Analyzer.
RESULTS
The results for correspondents who received treatment are seen in the following picture:
A
B
C
D
Figure 1. Corresponds to (A) before treatment, (B) after facial acupressure (C) using a combination of facial
acupressure and clover honey, (D) after treatment (source: Primary Data).
From Figure 1 above, the correspondent in (A) before the treatment only received a moisture test on
the face on the left cheek, all moisture tests were carried out on the face on the left cheek, and the
data was recorded, then continued in part (B) the face acupressure treatment was carried out during
15 minutes and after the facial acupressure, a moisture test is carried out, followed by treatment (C)
after the facial acupressure use clover honey, honey mask evenly on the face, use a compressor mask
and leave for 30 minutes, then a moisture test is carried out and continue with (D) after the
acupressure combination treatment. face and honey mask are finished then a moisture test is carried
out. Each of the 30 correspondents received this treatment and it was carried out 2 to 8 times a week.
Then processing of this research data was carried out.
Effectiveness of the Combination of Facial Acupressure and Honey on Facial Skin Moisture
Ayly Soekanto, Putu Oky Ari Tania, Andra Agnez, Hardiyono
128 | Page
The facial acupressure performed on the correspondent has steps for the acupressure face in
the following order: First, clean the face with cleansing soap, cleansing followed by rinsing with clean
water so that the dirt stuck to the pores of the face will be removed, the second step, is to apply
pressure on the face at each point for 1 – 2 minutes and done repeatedly for up to 15 minutes
according to the acupuncture points, pressure is applied with the first location of the piercing on the
forehead around the eyebrows, and then the second part in the area around the eyes and cheeks, nose
and around the ears, the third part around the upper jaw and the fourth around the lower jaw, and
next to the edge of the lower ear. After completing the piercing, continue with clover honey which is
spread thinly evenly on the face and continued by attaching the compressor mask on top of the honey
smear to form a honey mask (NWO, Ceria et al., 2021; Smith et al., 2020; von Arx et al., 2018). The
piercing area can be seen in Figure 2 below.
Figure 2. Face acupressure area (1) Frontalis; (2) Pre-orbitalis; (3) Upper mandible (4) Lower mandible (Smith et
al., 2020; von Arx et al., 2018)
In Figure 2, the area where the piercing is carried out is in the area (1) the frontalis of the forehead
which is directed superiorly, (2) the pre-orbital area around the eye where the piercing is directed
laterally and circularly towards the edge of the zygomaticum, (3) the upper mandible continues
towards the right maxilla and left maxilla circularly reach the edge of the inferior zygomatic, (4) the
lower mandible continues towards the inferior edge of the mandible and continues towards the edge
of the lower ear. This piercing, if done regularly, will provide elasticity to the facial muscles and will
have the effect of eliminating wrinkles in the facial area(Barrett, 2005; Donoyama et al., 2012; Smith
et al., 2020; Yun et al., 2013).
Figure 3. Tool for measuring skin moisture (Skin Moisture Analyzer)
In figure 3 Skin Moisture Analyzer is a tool for measuring skin moisture with humidity values entering
3 criteria, the criteria for dry skin are shown on a scale of 0 – 35%, normal skin on a scale of 36 – 45%,
and moist skin on a scale of 46 – 100%. How to use: Apply directly to facial skin and the moisture value
will be visible on the skin analyzer after 4-5 seconds.
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Table 1. Measurement of facial skin moisture
Respondent
Skin Moisture
Number
Age
Before face
acupressure
(%)
After facial
acupressure
(%)
Combination of
facial acupressure
and honey mask
(%)
1
40
10
37
56
2
43
23
41
52
3
40
32
44
59
4
45
27
36
42
5
42
13
25
49
6
40
27
48
60
7
48
23
56
61
8
47
37
48
55
9
45
12
34
51
10
44
10
33
55
11
46
14
39
48
12
41
23
41
55
13
43
33
54
59
14
42
27
46
51
15
42
33
49
53
16
45
10
37
56
17
47
23
41
52
18
43
32
44
59
19
40
27
36
42
20
47
13
25
49
21
48
27
48
60
22
41
23
56
61
23
44
37
48
55
24
46
12
34
51
25
42
10
33
55
26
48
14
39
48
27
43
23
41
55
28
45
10
37
56
29
45
23
41
52
30
47
32
44
59
Procentase
100% Dry
skin
20% dry skin,
50% normal
skin,
30% Moist
Skin
6.6% normal skin,
93.4% moist skin
In Table 1, the resulting scale for measuring skin moisture uses parameters, namely dry skin on a scale
of 0 – 35%, secondly normal skin on a scale of 36 – 45%, and thirdly moist skin on a scale of 46 – 100%,
using the Skin Moisture Analyzer tool. A total of 30 correspondents each received the same three
treatments, in treatment one (before facial acupressure) the lowest value of facial moisture was 10%
and the highest was 33%, this included dry skin criteria, then in the second treatment, namely after
facial acupressure, the humidity increased by the lowest result was 25% (normal skin) and the highest
was 56% (including moist skin criteria), even after receiving the third treatment the lowest moisture
result was 42% (including normal skin criteria) and the highest was 61% (including moist skin criteria).
The higher the moisture content on the facial skin, the smoother the facial skin will be, and the
moisture of the facial skin will be maintained (Herawan et al., 2022; Jap et al., 2023; Virgita &
Krisnawati, 2014). Percentage results can be seen in Graph 3 below.
Effectiveness of the Combination of Facial Acupressure and Honey on Facial Skin Moisture
Ayly Soekanto, Putu Oky Ari Tania, Andra Agnez, Hardiyono
130 | Page
Description Series 1, 2, 3 = Treatment 1, 2, 3
Figure 3. Graph of differences in facial skin moisture between treatments
Table 2. Results of measuring facial skin moisture in total treatment
Descriptive Statistics
N
Minimum
Maximum
Mean
Std. Deviation
Skin moisture
90
10.00
61.00
39.0111
15.09780
Treatment
90
1.00
3.00
2.0000
.82107
Valid N (listwise)
90
The total number of samples was 90 samples, the lowest skin moisture value was 10% while the
highest was 61%, with an average moisture value of 39%.
Table 3 results of the effect of treatment
Test Statisticsa
Skin moisture
Mann-Whitney U
.000
Wilcoxon W
465.000
Z
-6.668
Asymp. Sig. (2-tailed)
.000
a. Grouping Variables: Treatment
The effect of giving treatment to the three groups obtained a p-value of 0.000 (p<0.05), which means
there was an effect of giving treatment on skin moisture. To see the differences between treatment
groups, you can see the Games-Howell test in Table 4.
In Table 4, the measurement results show differences in treatment between the first
treatment which was given no treatment, the second treatment which was given only facial
acupressure treatment, and the third treatment which was given facial acupressure as well as honey
(clover honey) and then analyzed using the Games-Howell difference test. The first treatment showed
different skin moisture from the second treatment and the third treatment with a p-value of 0.000
(p<0.05). Meanwhile, the second treatment compared to the third treatment showed a difference in
skin moisture levels, namely with a p-value of 0.000. The third treatment, namely a combination of
facial acupressure and honey (clover honey), showed a significantly higher level of moisture compared
to the second group that received facial acupressure alone or the first group that was not given
treatment.
10
23
32 27
13
27 23
37
12 10 14
23
33
27
33
10
23
32 27
13
27 23
37
12 10 14
23
10
23
32
37 41 44
36
25
48
56
48
34 33
39 41
54
46 49
37 41 44
36
25
48
56
48
34 33
39 41 37 41 44
56 52
59
42
49
60 61
55 51 55
48
55 59
51 53 56 52
59
42
49
60 61
55 51 55
48
55 56 52
59
0
10
20
30
40
50
60
70
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Percentage of Facial Skin Moisture
Series1 Series2 Series3
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Table 4. Test of Differences between Groups with Games-Howell
Multiple Comparisons
Dependent Variable: Kelembapan kulit
Games-Howell
(I) treatment
(J) treatment
Mean
Difference
(I-J)
Std.
Error
Sig
95% Confidence
Interval lower
Bound
Upper Bound
(1) 1) not given
facial
acupressure
treatment
-19.16667*
2.17302
.000
-24.3960
-13.9373
facial
acupressure +
honey
treatment
-31.86667*
1.87894
.000
-36.4183
-27.3151
(2) given facial
Not given
treatment
19.16667*
2.17302
.000
13.9373
24.3960
facial
acupressure +
honey
treatment
-12.70000*
1.69910
.000
-16.8052
-8.5948
(3) facial
acupressur
e + honey
Not given
treatment
31.86667*
1.87894
.000
27.3151
36.4183
facial
acupressure
treatment
12.70000*
1.69910
.000
8.5948
16.8052
*. The mean difference is significant at the 0.05 level.
DISCUSSION
The results of the research measured humidity which was carried out 3 times, all measurements
were carried out on the left cheek, on 30 research samples. The first measurement was carried out on
30 correspondents who did not receive treatment, only moisture was measured. The results of 30
facial skin moisture measurements on each of these correspondents were found to be 100%, including
the criteria for dry skin with an average humidity of 22%, with results between 10% -37%. The second
measurement, after facial acupressure treatment for 15 minutes, facial skin moisture was measured,
the results showed that 6 people had dry skin criteria (20%), 15 people had normal skin criteria (50%)
and 9 people had moist skin criteria (30%). In the third treatment measurement, namely after receiving
a combination of facial acupressure and Clover honey, the results were 6.6% including normal skin
criteria, namely 2 people and 93.4% including moist skin criteria, namely 28 people.
In the first treatment, the first time compared with the second treatment until after receiving 8
treatments, the results of changes in facial skin moisture which were previously included in the criteria
for dry skin increased to normal skin after getting facial acupressure, this shows that facial acupressure
can effectively increase skin moisture. face. Facial acupressure that is done regularly will stimulate
blood circulation in the dermis area and regenerate skin cells to form collagen which provides
relaxation to muscle tension and provides freshness conditions in the facial muscles because it
stimulates the flow of chi in the meridian area which is connected to blood circulation
points(Masluhiya AF & Fidiastuti, 2019; Pardede, 2022; Surtiningsih et al., 2022; Virgita & Krisnawati,
2014).
The results of the third treatment, the original correspondent who had the lowest moisture
percentage, namely 25%, after receiving the first combination of facial acupressure and honey,
experienced an increase in skin moisture to 49%. Likewise, the correspondent with the highest
humidity the second time, namely 56%, after the third time also experienced an increase in humidity
to 61%. These results show that skin moisture is influenced by the water content in the stratum
corneum, the presence of fluid that flows in and out of the stratum corneum. There are endogenous
fluids in the stratum corneum and exogenous fluids. Endogenous fluid occurs due to a diffusion process
Effectiveness of the Combination of Facial Acupressure and Honey on Facial Skin Moisture
Ayly Soekanto, Putu Oky Ari Tania, Andra Agnez, Hardiyono
132 | Page
and the secretions of sweat glands in the dermis diffuse to the surface of the epidermis. Exogenous
fluids occur due to high humidity obtained from the surrounding environment. Skin moisture is
influenced by the presence of keratin cell bonds in the stratum corneum (Azizza & Kustianti, 2020;
Imani, 2022; Imasari & Emasari, 2022; Kevin et al., 2018).
Keratin cells bind water content and form bonds with elastin fibers which influence skin
moisture. The more water that is bound, the more moisture the skin will maintain. Dry skin will form
deep cracks due to the lack of binding of keratin cells with water, the skin will look dry and cracked.
Using a mask on facial skin functions to improve circulation and oxygenation of the skin and the mask
removes dead skin cells, smoothing the skin and shrinking facial pores so that the face becomes
smoother. Honey has a function as a natural moisturizer, honey is produced by bees which synthesize
flower nectar which is rich in flavonoids, amino acids, alpha hydroxy acid, vitamin K, C, vitamins B1, B2,
B6 which have the effect of making the skin supple, elastic and increasing moisture. on the skin (Khan
et al., 2018; Rahayu and Mutimatul, 2013).
In this study, correspondents after receiving the second treatment and continuing to the third
treatment, after wearing a honey mask for 30 minutes, the correspondents were shown to experience
changes in increased moisture in their facial skin until 93.4% of respondents had moist facial skin. The
overall results in this study in treatment one continued with the second treatment and finally the third
treatment gave very significant results, proven to show statistical test results with a p value of 0.000.
Using a honey mask has been proven to cause facial skin to maintain more moisture. Maintained
moisture will result in healthier and smoother looking skin.
CONCLUSION
The results of research on the effectiveness of the combination of facial acupressure and honey, the
use of a honey mask on the moisture of facial skin, proved that after carrying out facial acupressure
and using a honey mask the results experienced a very significant increase in moisture up to 93.4%,
which was included in the criteria for moist skin, whereas previously in the first treatment 100%
corresponded all of them entered the dry skin criteria, continued after receiving the second treatment
(given facial acupressure) the results changed the humidity to 20% (including dry skin criteria), 50%
(normal skin criteria) and 30% (moist skin criteria), and finally 93.4% was obtained. is a criterion for
moist skin.
CONFLICT OF INTEREST
There is no conflict of interest in this research.
ACKNOWLEDGEMENTS
Thank you to LPPM UWKS as the funder of this research and the respondents who agreed to support
this research.
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