The Potential of Forest Honeybee on Decreasing Malondialdehyde

Levels in Adult with Mild Acne Vulgaris

Evelyn Angie

, Hairus Abdullah

, Ahmad Raif Martinus

, Refi Ikhtiari

1,2

Laboratory of Biomolecular Chemistry, Graduate School of Biomedical Science

Universitas Prima Indonesia

Laboratory of Materials Engineering, Faculty of Industrial Engineering,

Universitas Prima Indonesia

Emails: (Evelynangie, Hairusabdullah, Ahmadraif, refiikhtiari)@unprimdn.ac.id

Keywords: Honey bee; Oxidative Stress, Malondialdehyde (MDA), Acne Vulgaris

Abstract: Acne vulgaris is a common skin disorder, and it mainly affects adolescents. It affects more than 85% of the

population, age 12-24 years, and it is described as chronic inflammation of the pilosebaceous gland with the

distribution of the lesions mainly on the face, back, chest, and upper arms. Reactive Oxygen Species (ROS)

and oxidative stress play a role in the development of inflammatory, acne lesions. To protect against ROS,

the human body has an organized antioxidant system, which works synergistically. Antioxidants protect

cells against oxidative damage and can prevent the production of oxidative products. An imbalance between

oxidants and antioxidants, where the production of ROS exceeds antioxidant capacity, has the potential to

cause damage, which is called oxidative stress. One of the biomarkers of oxidative stress in cells is lipid

peroxidation and the end product known as malondialdehyde (MDA). The antioxidants in honey can reduce

lesions in acne vulgaris. The experiment results showed the honey decreased malondialdehyde level and

reduced lesion in acne vulgaris.

1 INTRODUCTION

Indonesia has a surface area of 1.91 Mkm

and with

its more than 18,000 islands and ~113 Mha (2010)

of forest area, the country harbors flora and fauna

rich in diversity (Abood, Lee, Burivalova, Garcia-

Ulloa, & Koh, 2015; Cribb & Ford, 2009; Hansen et

al., 2013; United Nations, 2018). The remarkable

diversity is also reflected by the number of bee

species. Thus, 8 out of 9 species of the genus Apis,

with Apis laboriosa as the only absent one, as well

as more than 40 stingless bee species were observed

in Indonesia (Gupta, Reybroeck, van Veen, &

Gupta, 2014).

It has been estimated that 66% of the world’s

crop species are pollinated by bees, including honey

bees, bumble bees and solitary bees (Kremen,

Williams, & Thorp, 2002; Partap, 2011).

Beekeeping not only positively contributes to

income gain, it also plays a role in increased food

security, but beekeeping activity and its potential

receives only subordinate attention within the

Indonesian government and population. According

to scientists from the Universitas Padjadjaran

(UNPAD, Bandung, Indonesia), bee businesses are

mostly considered as a part time farming activity

and not only parts of the local community, but

people from every social class are not aware of the

bees’ benefits (Chantawannakul, Williams, &

Neumann, 2018). As found in a survey by UNPAD

and CV. Primary Indonesia (Labtek Indie), among

80 citizens 57.5% had certain prejudices against

bees. Those range from insufficient profitability, to

fear of bee stings, to a lack of knowledge on the

importance of bees as pollinators. Furthermore, there

are field owners fearing bees have a negative impact

on their crops’ productivity. They do not want bees

or beehives near their property and in a consequence

some of them are willing to burn those colonies, if

verbal warnings were ignored by the beekeepers.

Indonesia is the 4

most populous country

worldwide with a population that reached 264

million in 2018 (FAOSTAT, 2018). The population

growth is accompanied by a significant stress for the

Indonesian ecosystem and a continuous increase of

used land area, triggered by rising demands of

natural resources like timber and food (Abood et al.,

2015). To antagonize the existing trend, beekeeping

can be used to sensibilize the population towards the

Angie, E., Abdullah, H., Martinus, A. and Ikhtiari, R.

The Potential of Forest Honeybee on Decreasing Malondialdehyde Levels in Adult with Mild Acne Vulgaris.

DOI: 10.5220/0009490803090316

In Proceedings of the International Conference on Health Informatics and Medical Application Technology (ICHIMAT 2019), pages 309-316

ISBN: 978-989-758-460-2

309

importance of forest conservation and non-timber

materials.

So far, local beekeepers use mostly native honey

bee species like Apis cerana or Meliponini colonies

for managed beekeeping (Figure 2) (Schouten,

Lloyd, & Lloyd, 2019), but it is also common to

practice the art of honey hunting from wild living, so

far not-manageable, Apis dorsata colonies (Crane,

Van Luyen, Mulder, & Ta, 1993; Gupta et al., 2014).

Besides honey hunting and beekeeping, Bradbear

and FAO (2009) defined a third type of apicultural

activity: “Bee maintaining”; an intermediary stage of

beekeeping, where humans safeguard wild living

colonies. The colonies are not kept in hives, but

honey collectors often provide artificial nesting

places, for example traditional tikung, tingku or also

called sunggau (wooden honey boards or tree

trunks) (Hadisoesilo, 2002). A similar method to

maintain A. dorsata colonies, observed in Indonesia

and elsewhere in South-East Asia, is the use of

special rafters (Bradbear & FAO, 2009; Crane et al.,

1993). Tikungs are trapezium shaped boards often

made from banyan (Ficus benghalensis) wood,

which are placed between tree branches to attract

feral A. dorsata colonies. If the tikung is occupied,

the bees build their nest on it while they forage on

the same and on neighboring trees in flower.

Harvesting takes place during the rainy season and

honey collectors cut only the top of the honey

containing part of the comb to protect the brood and

to maintain the colony. To obtain the honey and

separate it from beeswax, it is not common to

squeeze, but gently let the honey flow through filter

fabric (WWF, 2010) (Figure 1). Once a tikung is

occupied by a swarm, it is believed, that the same

colony remigrates to it every year (Paar, Oldroyd,

Huettinger, & Kastberger, 2004). This method may

be a good alternative to the less secure and more

common practice of honey hunting and is also used

in other Asian countries (de Jong, 2000; Mahindre,

2000).

Plants also have been used for healing in many

cultures for centuries. Generally, plants act to

stimulate and supplement the body’s healing

process (Nwanko C.M, Ezekoye C.C, and Igbokwe

S.O, 2014). The problem: limited use in modern

medicine due to lack of scientific evidence

supporting it (Tahereh Eteraf Oskouei and Moslem

Najafi 2012).

Honey is a viscous liquid produced by bees

from nectars and flowers; the active components

of honey such as glucose, fructose, flavonoid,

polyphenols, and organic acid play an important

role in its quality (Serene Hilliary ,2017;

Visweswara Rao Pasupuleti, 2017). Traditional

medicine around the world has described honey as

efficacious in the treatment of various skin

disorders. Some have assumed that it has healing

properties in regards to acne vulgaris (Pauline

Mcloone, 2016; Khoiroh Umah and Oriza Herdanti,

2017).

Honey is highly rich in bioactive compounds

such as poliphenols and vitamins. Phenolic

compounds are bioactive compounds; phenols are

defined as organic compounds with an aromatic ring

which is chemically bonded to one or additional

hydrogeneted substituents in the presence of

corresponding functional derivatives. In honey,

phenolic compounds are commonly present as

flavonoids. Antioxidative in honey produces anti-

inflammatory effects which may reducelocalized

inflammation that develops with acne. Honey is a

complementary theraphy dating back to hippocrates.

Raw unprocessed wild forest honey sustainably

harvested by the indigenous communities of

Sumbawa, Flores, Kalimantan, Sulawesi and

Sumatra. Each island has a distinct flavour profile

ranging from delicate and floral to rich and intense,

reflecting the diversity of the regional ecosystems.

100% raw and unheated, as a result our honey

retains all of nature's goodness: the pollen, enzymes,

vitamins, amino acids, antioxidants, propolis,

minerals and its natural flavour.

The forest honey comes from the 'Apis Dorsata',

the giant rock bee. It is the biggest bee in the world

at about 2.5 cm long. This wild bee cannot be

domesticated like other honeybees.

Sustainable harvesting of wild forest honey

supports the indigenous communities and helps

protect the rainforests of Indonesia.

Prophet Muhammad used honey for one week to

treat acne, honey was applied in the area of acne,

one or two hours before going to sleep and left until

morning, to reduces acne vulgaris (Visweswara Rao

Pasupuleti, 2017; Darul Hadrahah, 2014; Alex

Semprini, 2015. Honey have been used as an anti-

inflammatory agent for centuries.ogist, used honey

to treat patients (Gunawan, 2017).

In ancient Greece, PedaniusDioscorides, a doctor

and pharmacologist, used honey to treat patients

(Gunawan, 2017). The four etiologies are

hyperproliferation of follicular epidermis, excess

sebum production, Propionibacterium acnes

bacteria, and inflammatory reactions.

The term of “acne” is derived from the greek

word “acme” which is used to describe the peak and

vulgaris which means “common” (Zohra FT, 2017;

Ginard I Henry, 2018). According to a study from

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

310

the Global Burden of Disease (GBD), acne vulgaris

affects 85% of young adults aged 12-25 years. It is

a chronic inflammatory disorder of the

pilosebaceous gland which manifests clinically in

the form of blackheads, papules, pustules and cysts

(Darren D lyyn, 2016; Irma Bernadette. S. Sitohang

and Sjarif M. Wasitaatmaja, 2017; Amit Batra,

2014). Honey have been used as an anti-

inflammatory agent for centuries.

Acne is often to be correlated with oxidative

stress mechanism in adults. Oxidative stress is an

imbalance between oxidants (free radicals) and

antioxidants. The damage that occurs due to an

imbalance between production and issued ROS

(Reactive Oxygen Species) on the skin. ROS in the

skin comes from normal cell metabolism; for

example: mitochondrial respiration and enzymatic

activity. Additionally, ROS derived from exogenous

factors is produced by various environmental

factors, such as UV light or the presence of a chronic

inflammatory process on the skin. To regulate the

level of ROS, the skin has an antioxidant defense

system, which goal is maintaining homeostasis.

(Amanda wong, 2016) One of the biomarkers of

oxidative stress in the cells is lipid peroxidation and

the end product known as malondialdehyda (MDA).

The physiological process of the emergence of

free radicals in the body is closely related with

prooxidant; it is balanced with an endogenous

defense mechanism by producing substances that

have anti-oxidative properties (Euis Reni Yulianti,

2017). Honey is known as a natural antioxidant;

lately many studies have focused on the composition

of honey and its biological properties as an

antioxidant, anti-inflammatory and antimicrobial,

which are thought to be effective in treating skin

problems (Lee Suan Chua, 2013).

Oxidative stress can cause disturbances in

biological functions such as ion homeostasis,

enzyme activity, membrane integration, cell

function, even cell damage or death (Euis Reni

Yulianti, 2017). Several studies have been carried

out to determine the trigger of oxidative stress in the

pathogenesis of acne vulgaris. The lipid oxides

formed can activate proinflammatory cytokine

production and activation of Peroxisome

proliferator-activated receptor (PPAR). PPAR is a

nuclear transcription factor that helps in lipids and

inflammatory reactions. PPAR-α is often involved

with β-oxidation of fatty acids and lipid catabolism,

whereas PPAR-γ is associated with the process of

lipidogenesis. PPAR-ivasi activation can also induce

the expression of cyclooxygenase-2 (COX-2) and

prostaglandin E2 (PGE2), causing further

inflammation in the pathogenesis of Acne vulgaris

(Sylvia Anggraeni, 2017). Recent research reports

the possible role of reactive oxygen species (ROS)

in particular fat peroxidation in the onset of

inflammation. Malondialdehyde (MDA) is the end

result of lipid peroxidation which is commonly use

as a marker of lipid peroxidation. This study was

conducted to examine the relationship between

serum MDA levels and the severity of acne in male

patients.

According to a study by Dr. Sardjito, a total of

60 patients with acne visited the Skin Polyclinic;

RSUP Dr. Sardjito who fulfilled the inclusion and

exclusion criteria was involved in the study. From

their research, patients were grouped into three

groups, namely patients with mild, moderate and

severe acne vulgaris. Blood samples of all the

patients were taken and the serum MDA levels were

determined with a spectrophotometer. The mean

serum MDA level in patients with acne vulgaris

increased. The mean serum MDA levels of severe

acne group (1.85 ± 0.368 μmol/L) were significantly

higher than that moderate acne group (0.79 ± 0.159

μmol/L) (p = 0.000) and that mild acne group (0.52

± 0.239 μmol/L) (p = 0.000) (Aprilina Dwi

Sulistyowati, 2014).

The ability of honey to prevent oxidative damage

may be caused by its phenolic antioxidant content

which may have triggered the modulation of

antioxidant enzyme activity. (Zulaikha Sahhugi, et

al, 2014). The antioxidative and anti-inflammatory

properties of honey have been recognized by various

studies. It is related to the content of polyphenols

contained in honey. All types of honey contain a

mixtureof sugar, protein, vitamins, minerals,

polyphenols, and antioxidative mostly from

polyphenols. In one study (Serene Hilary, et al

2017), honey had an antioxidative effect which was

characterized by a decrease in MDA levels in the

blood.

Honey releases hydrogen peroxide, which is an

antibiotic that can also remove bacteria and clear

acne The anti-inflammatory properties of honey

reduce the redness of acne. Its acidic property stops

bacteria from growing (Elin Julianti, 2017). The

clinical severity of acne in this study was assessed

using a grading system, participants were grouped

into 2 subgroups: mild and moderate acne vulgaris.

The aim of the study was to investigate the use of

honey masks in decreasing malondialdehyde level

and reducing lesions in acne vulgaris.

The aim of the study was to investigate the use of

honey masks in decreasing malondialdehyde level

and reducing lesions in acne vulgaris.

The Potential of Forest Honeybee on Decreasing Malondialdehyde Levels in Adult with Mild Acne Vulgaris

311

2 RESEARCH METHODOLOGY

2.1 Materials and Instruments

Materials used were honey acquired from the forest.

NaOH, Mayer Reagen, Gelatin Solution 1%,

Aquadest (distilled water), chloroform, anhydride

acid, and sulfurate acid, Trichloroacetic acid (TCA)

40%, Hypochlorite acid (HCl), Na-thiosulfate

(NaThio) 1 N, 3cc of Blood Samples.Instruments

used weremicro pipets, cuvette rack, gloves.

tourniket, spuit, centrifuge 1 unit, Sample rack 1

unit, microtube, cuvette, waterbath, UV-

Spectrophotometer, test tubes, and shaving brush.

Honey used in this study was purchased from local

bee keepers in North Sumatera, Indonesia. Honey,

which had been tested for phythochemical, was

packaged and given to the participants. The honey

was applied once per day for seven days as a mask;

7 packages were given per participant and each

package contained 10cc.

2.2 Phytochemical Analysis

Before applying honey, aphytochemical analysis

was carried out to determine its antioxidant content.

In this study, qualitativetest for phythochemical such

as flavonoids, alkaloids, Tannins, Saponin, and

terpenoids content of honey samples were carried

out.

2.2.1 Detection of Flavonoids

Alkaline Reagent Test: A few drops of diluted

NaOH were added to the extracts. An intense yellow

colour was produced and became colorless after of a

few drops of diluted acid were added; this indicated

the presence of flavonoids (Asokan S and Jayanthi,

2017).

2.2.2 Detection of Alkaloids

Mayer’s Test: 50 cc of solvent free extracts were

stirred with a few ml of diluted HCL and filtered;

then a few drops of Mayer’s reagent were added by

dripping on the side of the test tube. The white or

creamy precipitate indicated a positive result

(Asokan S and Jayanthi, 2017).

2.2.3 Detection of Tannins

Gelatin Test: A 1% gelatin solution containing

sodium chloride was added to the extract.

Formation of a white precipitate indicated the

presence of tannins (Prashant Tiwari, 2011).

2.2.4 Detection of Saponins

Distilled water (2 ml) was added to each extract and

shaken in a graduated cylinder for 15 mins

lengthwise. Formation of 1 cm foam indicated the

presence of saponin (Asokan S and Jayanthi, 2017).

2.2.5 Detection of Terpenoids

Chloroform (2 ml) and concentrated sulphuric acid

was added carefully to 0.5 ml of extract. Formation

of red-brown colors at the surface indicated the

presence of terpenoids (Asokan S and Jayanthi,

2017).

2.3 Participants

In this study, the participants were grouped into mild

acne vulgaris and assessed using a grading system.

Participant’s criteria should be young adults with

acne vulgaris aged 18-22 years, and have not

received acne therapy for the previous two weeks

either topical therapy or systemic therapy, and a

willingness to be included in the study. Participants

were grouped based on levels of severity according

to the IGA scoring system: mild (IGA 2); informed

consent sheets were given to all the participants.

Table 1: Investigator’s Global Assesment (IGA)Scale

(Linda Stein Gold, 2017)

Levels of Severity

Indication

Clear (IGA 0)

Clear Skin with no

inflammatory or non

inflammatory lesions

Almost Clear (IGA 1)

A few Scaltered

comedones and a few

small papules

Mild (IGA 2)

Easily recognizable, Less

than half the face is

involved, some comedones

and some papules and

pustules

Moderate (IGA 3)

More than Half of the face

is involved, many

comedones, papules and

pustules

Severe (IGA 4)

Entire face is involved,

covered with comedones,

numerous papules and

pustules, few nodules may

or may not be present

Lesions were calculated before and after applying

honey as a mask for 7 days using the criteria from

Fakultas KedokteranUniversitas Indonesiathe

method of calculating lesions showed in table 2

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

312

Table 2: Criteria for severity of Lesions

Acne

Degree

Blackh

eads

Inflammatory

Lesions

Total

Lesions

Mild

<20

<15

<30

Moderate

20-100

15-30

30-125

Inflammatory lesions include: Papules, pustules,

nodules. (Irma Bernadette S. Sitohang and Sjarif M.

Wasitaatmadja, 2017).

Procedure :

1. Student whom suffered acne vulgaris at Fakultas

Kedokteran Universitas Prima Indonesia were

chosen. Student that gave their approval was

accepted into the study.

2. Based on the physical examination, the research

subjects were grouped according to levels of

acne vulgaris mild and moderate.

3. Examination of blood before honey is applied.

4. Participants were given 7 packages of honey as a

mask that was used for 7 days at a dose of 10 ml

per pack. Participants were required to wash their

faces before using honey when they wanted to

sleep. After the mask was dry, the participants

rinsed their faces with water.

5. After using the masks for 1 week, blood samples

of participants were extracted at 3cc

/participants.

6. Examination of MDA levels.

7. Analysis of data.

Measurement of Malondialdehyde Level has

been conducted as the following:

1. Blood samples were inserted into a rack blood

samples were inserted into the Centrifuge

machinend centrifuged at 2500 rpm for 8

minutes to produce serum.

2. Serum was taken out using a micropipette and

inserted into microtube

3. 0.5 cc of serum added with: (1) TCA 40% 2.5 µl,

(2) 200 µl HCl 1 N, (3) 0.5 cc aquabides, and (4)

NaThio 1% 100 µl

4. It was then heated at 100 °Cfor 25 minutes using

a water bath machine.

5. Afterwards it was centrifuged at 3000 rpm for 5

minutes and then the formed supernatant was

taken out

6. The supernatant was put in a vacuum tube and

aquabides (3 cc) was added.

7. Then the supernatant was inserted into the

cuvette, then the cuvette was inserted into the

UV-Spectrophotometer machine. Then amount

of absorption at a wavelength of λ 532 was

measured.

3 RESULTS AND DISCUSSION

Phytochemical screenings of honey samples have

showed the presence of flavonoid, alkaloid, saponin,

and terpenoids. The result of phytochemical

screening of honey can be seen in the table 3 below:

Table 3: Result of Phytochemical Screening of Honey

Samples

Phytochemical Content

Indication

Flavonoid

Alkaloid

Tannin

Saponin

Terpenoid

The aim of this phytochemical screening of

honey samples was to investigate its bioactive

compounds such as flavonoid, alkaloid, tannin,

saponin, and terpenoid. Honey contains vitamins

which may serve as sources of polyphenol and

dietary antioxidants. Honey mainly consists ofsugars

and water but also contains several vitamins,

especially B complex and vitamin C, and minerals.

It possesses anti-bacterial, anti-inflammatory, and

antioxidative properties that may be beneficial for

combating multi-drug resistant bacteria;

additionally, it may also be useful for preventing

chronic inflammatory processes, such as acne

vulgaris (M. Assaduzaman, 2015; Halah Musthafa

Ya’qub,2013).

Table 4: The T-test of MDA levels in Mild Acne

Degree of

Acne

Vulgaris

Mean

T- test

Before

Application

of Honey

and MDA

Measuremen

Mild

(N= 35)

0,909

(P= 0,000)

AfterApplic

ation of

Honey and

MDA

Measuremen

Mild

(N= 35)

0,808

(P= 0,000)

Table 4 above showed a decreased MDA level

after application of the honey. In this study, an

Independent T Tests was carried out before and after

MDA measurement in mild acne vulgaris. A mean

score of 0,909 in mild acne vulgaris was calculated.

The Potential of Forest Honeybee on Decreasing Malondialdehyde Levels in Adult with Mild Acne Vulgaris

313

After the application of honey for 7 days, a mean

score of 0,808 in mild acne vulgaris was calculated.

This shows a statistically significant decrease in

MDA level.

Honey was shown to have anti inflammatory

activities which reduced acne vulgaris lesions. There

was a visible improvement after the use of honey

masks. Similar results were reported by Khoiroh

Umah and Oriza Herdanti. Their studies used

statistical tests gained from Paired Sample Tests

which resulted in the rejection of the null hypothesis

with a value of α = 000. This meant that the students

that had undergone treatment using the honey had

statistically significant differences in the amount of

acne vulgaris compared to before the application of

the honey. The study was conducted by PSIK

students from Gresik University (Khoiroh Umah and

Oriza Herdanti,2017).

In this study, an Wilcoxon Signed Ranks Test

was carried out before and after the application of

honey masks to mild acne vulgaris, it can be seen in

table 5 below:

Table 5: The Wilcoxon test of MDA levels in Mild Acne

Degree of

Acne

Vulgaris

Wilcoxon Signed

Ranks Test

Before

Application of

Honey in

Mild Acne

Vulgaris

Mild

(N= 35)

t = -5.173

( p= 0,019)

After

Application of

Honey in

Mild Acne

Vulgaris

Mild

(N= 35)

t = -5.168

( p= 0,019)

The normality test (Shapiro-Wilk) shows a p

value of less than 0.05; therefore, the null

hypothesis, that the data distribution is normal, is

rejected. This is a test to determine if there is a

statistically significant difference before and after

the application of honey on the amount of acne (the

same person is measured twice before and after the

test). Since only the data of people with mild acne

(After1 - Before1) is not normally distributed, the

Wilcoxon test is used. The result: a p value of less

than 0.01 and a mean rate of ± 18 for negative ranks

which included all 35 people with mild amount of

acne. This meant that the null hypothesis, there was

no difference between before and after the

application of honey, was rejected. It can be

concluded that there was a statistically significant

difference between before and after the application

of honey (due to the p value) and all of the people

(with mild acne) experienced a decrease in the

amount of acne (due to all the samples being in the

negative rank).

In this study, Dependent T Test was carried out

before and after the application of honey masks to

moderate acne vulgaris, it can be seen in table 6

below:

Table 6: The dependent T-test of MDA levels in Mild

Acne

Vulgaris

Degree

Dependent T test

Before

Application of

Honey in

Moderate Acne

Vulgaris

Moderate

(N= 35)

( p= 0,040)

After

Application of

Honey in Mild

Acne Vulgaris

Moderate

(N= 35)

( p= 0,000)

Table 6, normality test (Shapiro-Wilk) shows a

p value of more than 0.05; therefore, the null

hypothesis, that the data distribution is normal, is

accepted. Dependent T test is a test to determine if

there is a statistically significant difference before

and after the application of honey on the amount of

acne. Since only the data of people with moderate

acne (Before & After) is normally distributed, the

dependent t-test is used. The result: a p value of less

than 0.01 for people with a moderate amount of

acne. This meant that the null hypothesis, there was

no difference between before and after the

application of honey, was rejected. It can be

concluded that there was a statistically significant

difference between before and after the application

of honey (due to the p value) and all of the people

(with moderate acne) experienced a decrease in the

amount of acne.

Application of honey as face masks in mild and

moderate acne vulgaris can be seen in figure 1 and

figure 2 respectively.

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

314

Figure 1: Before and after application of honey on mild

acne vulgaris.

Figure 2: Before and after application of honey on

moderate acne vulgaris.

Figure 1 and 2 showed the result of the

application of honey after seven days. The result:

reduced lesions of acne vulgaris. There was a visible

improvement after the use of honey masks. Similar

results were reported by Khoiroh Umah and Oriza

Herdanti. Their studies used statistical tests gained

from Paired Sample Tests which resulted in the

rejection of the null hypothesis with a value of α =

000. This meant that the students that had undergone

treatment using the honey had statistically

significant differences in the amount of acne

vulgaris compared to before the application of the

honey. The study was conducted by PSIK students

from Gresik University (Khoiroh Umah and Oriza

Herdanti,2017).

4 CONCLUSIONS

The MDA level decreased in acne vulgaris patients

after the application of honey. Honey releases

hydrogen peroxide, which is an antibiotic which can

remove bacteria and clear acne. The anti-

inflammatory properties of honey reduce the redness

of acne. Honey can decrease the MDA level and

reduce the lesion of acne vulgaris.

ACKNOWLEDGEMENTS

This research supported by Ministry of Research,

Technology and Higher Education by Funding

Contract No. 7/E/KPT/2019 and No.

T/63/L1.3.1/PT.01.03/2019.

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