The Potential of Forest Honeybee on Decreasing Malondialdehyde

Levels in Adult with Mild Acne Vulgaris

Evelyn Angie1, Hairus Abdullah2, Ahmad Raif Martinus1, Refi Ikhtiari1,2

1Laboratory of Biomolecular Chemistry, Graduate School of Biomedical Science
Universitas Prima Indonesia
2
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 (UNPAD, Bandung, Indonesia), bee businesses are

mostly considered as a part time farming activity
Indonesia has a surface area of 1.91 Mkm2 and with and not only parts of the local community, but
its more than 18,000 islands and ~113 Mha (2010) people from every social class are not aware of the
of forest area, the country harbors flora and fauna bees’ benefits (Chantawannakul, Williams, &
rich in diversity (Abood, Lee, Burivalova, Garcia- Neumann, 2018). As found in a survey by UNPAD
Ulloa, & Koh, 2015; Cribb & Ford, 2009; Hansen et and CV. Primary Indonesia (Labtek Indie), among
al., 2013; United Nations, 2018). The remarkable 80 citizens 57.5% had certain prejudices against
diversity is also reflected by the number of bee bees. Those range from insufficient profitability, to
species. Thus, 8 out of 9 species of the genus Apis, fear of bee stings, to a lack of knowledge on the
with Apis laboriosa as the only absent one, as well importance of bees as pollinators. Furthermore, there
as more than 40 stingless bee species were observed are field owners fearing bees have a negative impact
in Indonesia (Gupta, Reybroeck, van Veen, & on their crops’ productivity. They do not want bees
Gupta, 2014). or beehives near their property and in a consequence
It has been estimated that 66% of the world’s some of them are willing to burn those colonies, if
crop species are pollinated by bees, including honey verbal warnings were ignored by the beekeepers.
bees, bumble bees and solitary bees (Kremen, Indonesia is the 4th most populous country
Williams, & Thorp, 2002; Partap, 2011). worldwide with a population that reached 264
Beekeeping not only positively contributes to million in 2018 (FAOSTAT, 2018). The population
income gain, it also plays a role in increased food growth is accompanied by a significant stress for the
security, but beekeeping activity and its potential Indonesian ecosystem and a continuous increase of
receives only subordinate attention within the used land area, triggered by rising demands of
Indonesian government and population. According natural resources like timber and food (Abood et al.,
to scientists from the Universitas Padjadjaran 2015). To antagonize the existing trend, beekeeping
can be used to sensibilize the population towards the

309
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
Copyright c 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

importance of forest conservation and non-timber Visweswara Rao Pasupuleti, 2017). Traditional
materials. medicine around the world has described honey as
So far, local beekeepers use mostly native honey efficacious in the treatment of various skin
bee species like Apis cerana or Meliponini colonies disorders. Some have assumed that it has healing
for managed beekeeping (Figure 2) (Schouten, properties in regards to acne vulgaris (Pauline
Lloyd, & Lloyd, 2019), but it is also common to Mcloone, 2016; Khoiroh Umah and Oriza Herdanti,
practice the art of honey hunting from wild living, so 2017).
far not-manageable, Apis dorsata colonies (Crane, Honey is highly rich in bioactive compounds
Van Luyen, Mulder, & Ta, 1993; Gupta et al., 2014). such as poliphenols and vitamins. Phenolic
Besides honey hunting and beekeeping, Bradbear compounds are bioactive compounds; phenols are
and FAO (2009) defined a third type of apicultural defined as organic compounds with an aromatic ring
activity: “Bee maintaining”; an intermediary stage of which is chemically bonded to one or additional
beekeeping, where humans safeguard wild living hydrogeneted substituents in the presence of
colonies. The colonies are not kept in hives, but corresponding functional derivatives. In honey,
honey collectors often provide artificial nesting phenolic compounds are commonly present as
places, for example traditional tikung, tingku or also flavonoids. Antioxidative in honey produces anti-
called sunggau (wooden honey boards or tree inflammatory effects which may reducelocalized
trunks) (Hadisoesilo, 2002). A similar method to inflammation that develops with acne. Honey is a
maintain A. dorsata colonies, observed in Indonesia complementary theraphy dating back to hippocrates.
and elsewhere in South-East Asia, is the use of Raw unprocessed wild forest honey sustainably
special rafters (Bradbear & FAO, 2009; Crane et al., harvested by the indigenous communities of
1993). Tikungs are trapezium shaped boards often Sumbawa, Flores, Kalimantan, Sulawesi and
made from banyan (Ficus benghalensis) wood, Sumatra. Each island has a distinct flavour profile
which are placed between tree branches to attract ranging from delicate and floral to rich and intense,
feral A. dorsata colonies. If the tikung is occupied, reflecting the diversity of the regional ecosystems.
the bees build their nest on it while they forage on 100% raw and unheated, as a result our honey
the same and on neighboring trees in flower. retains all of nature's goodness: the pollen, enzymes,
Harvesting takes place during the rainy season and vitamins, amino acids, antioxidants, propolis,
honey collectors cut only the top of the honey minerals and its natural flavour.
containing part of the comb to protect the brood and The forest honey comes from the 'Apis Dorsata',
to maintain the colony. To obtain the honey and the giant rock bee. It is the biggest bee in the world
separate it from beeswax, it is not common to at about 2.5 cm long. This wild bee cannot be
squeeze, but gently let the honey flow through filter domesticated like other honeybees.
fabric (WWF, 2010) (Figure 1). Once a tikung is Sustainable harvesting of wild forest honey
occupied by a swarm, it is believed, that the same supports the indigenous communities and helps
colony remigrates to it every year (Paar, Oldroyd, protect the rainforests of Indonesia.
Huettinger, & Kastberger, 2004). This method may Prophet Muhammad used honey for one week to
be a good alternative to the less secure and more treat acne, honey was applied in the area of acne,
common practice of honey hunting and is also used one or two hours before going to sleep and left until
in other Asian countries (de Jong, 2000; Mahindre, morning, to reduces acne vulgaris (Visweswara Rao
2000). Pasupuleti, 2017; Darul Hadrahah, 2014; Alex
Plants also have been used for healing in many Semprini, 2015. Honey have been used as an anti-
cultures for centuries. Generally, plants act to inflammatory agent for centuries.ogist, used honey
stimulate and supplement the body’s healing to treat patients (Gunawan, 2017).
process (Nwanko C.M, Ezekoye C.C, and Igbokwe In ancient Greece, PedaniusDioscorides, a doctor
S.O, 2014). The problem: limited use in modern and pharmacologist, used honey to treat patients
medicine due to lack of scientific evidence (Gunawan, 2017). The four etiologies are
supporting it (Tahereh Eteraf Oskouei and Moslem hyperproliferation of follicular epidermis, excess
Najafi 2012). sebum production, Propionibacterium acnes
Honey is a viscous liquid produced by bees bacteria, and inflammatory reactions.
from nectars and flowers; the active components The term of “acne” is derived from the greek
of honey such as glucose, fructose, flavonoid, word “acme” which is used to describe the peak and
polyphenols, and organic acid play an important vulgaris which means “common” (Zohra FT, 2017;
role in its quality (Serene Hilliary ,2017; Ginard I Henry, 2018). According to a study from

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

the Global Burden of Disease (GBD), acne vulgaris inflammation in the pathogenesis of Acne vulgaris
affects 85% of young adults aged 12-25 years. It is (Sylvia Anggraeni, 2017). Recent research reports
a chronic inflammatory disorder of the the possible role of reactive oxygen species (ROS)
pilosebaceous gland which manifests clinically in in particular fat peroxidation in the onset of
the form of blackheads, papules, pustules and cysts inflammation. Malondialdehyde (MDA) is the end
(Darren D lyyn, 2016; Irma Bernadette. S. Sitohang result of lipid peroxidation which is commonly use
and Sjarif M. Wasitaatmaja, 2017; Amit Batra, as a marker of lipid peroxidation. This study was
2014). Honey have been used as an anti- conducted to examine the relationship between
inflammatory agent for centuries. serum MDA levels and the severity of acne in male
Acne is often to be correlated with oxidative patients.
stress mechanism in adults. Oxidative stress is an According to a study by Dr. Sardjito, a total of
imbalance between oxidants (free radicals) and 60 patients with acne visited the Skin Polyclinic;
antioxidants. The damage that occurs due to an RSUP Dr. Sardjito who fulfilled the inclusion and
imbalance between production and issued ROS exclusion criteria was involved in the study. From
(Reactive Oxygen Species) on the skin. ROS in the their research, patients were grouped into three
skin comes from normal cell metabolism; for groups, namely patients with mild, moderate and
example: mitochondrial respiration and enzymatic severe acne vulgaris. Blood samples of all the
activity. Additionally, ROS derived from exogenous patients were taken and the serum MDA levels were
factors is produced by various environmental determined with a spectrophotometer. The mean
factors, such as UV light or the presence of a chronic serum MDA level in patients with acne vulgaris
inflammatory process on the skin. To regulate the increased. The mean serum MDA levels of severe
level of ROS, the skin has an antioxidant defense acne group (1.85 ± 0.368 μmol/L) were significantly
system, which goal is maintaining homeostasis. higher than that moderate acne group (0.79 ± 0.159
(Amanda wong, 2016) One of the biomarkers of μmol/L) (p = 0.000) and that mild acne group (0.52
oxidative stress in the cells is lipid peroxidation and ± 0.239 μmol/L) (p = 0.000) (Aprilina Dwi
the end product known as malondialdehyda (MDA). Sulistyowati, 2014).
The physiological process of the emergence of The ability of honey to prevent oxidative damage
free radicals in the body is closely related with may be caused by its phenolic antioxidant content
prooxidant; it is balanced with an endogenous which may have triggered the modulation of
defense mechanism by producing substances that antioxidant enzyme activity. (Zulaikha Sahhugi, et
have anti-oxidative properties (Euis Reni Yulianti, al, 2014). The antioxidative and anti-inflammatory
2017). Honey is known as a natural antioxidant; properties of honey have been recognized by various
lately many studies have focused on the composition studies. It is related to the content of polyphenols
of honey and its biological properties as an contained in honey. All types of honey contain a
antioxidant, anti-inflammatory and antimicrobial, mixtureof sugar, protein, vitamins, minerals,
which are thought to be effective in treating skin polyphenols, and antioxidative mostly from
problems (Lee Suan Chua, 2013). polyphenols. In one study (Serene Hilary, et al
Oxidative stress can cause disturbances in 2017), honey had an antioxidative effect which was
biological functions such as ion homeostasis, characterized by a decrease in MDA levels in the
enzyme activity, membrane integration, cell blood.
function, even cell damage or death (Euis Reni Honey releases hydrogen peroxide, which is an
Yulianti, 2017). Several studies have been carried antibiotic that can also remove bacteria and clear
out to determine the trigger of oxidative stress in the acne The anti-inflammatory properties of honey
pathogenesis of acne vulgaris. The lipid oxides reduce the redness of acne. Its acidic property stops
formed can activate proinflammatory cytokine bacteria from growing (Elin Julianti, 2017). The
production and activation of Peroxisome clinical severity of acne in this study was assessed
proliferator-activated receptor (PPAR). PPAR is a using a grading system, participants were grouped
nuclear transcription factor that helps in lipids and into 2 subgroups: mild and moderate acne vulgaris.
inflammatory reactions. PPAR-α is often involved The aim of the study was to investigate the use of
with β-oxidation of fatty acids and lipid catabolism, honey masks in decreasing malondialdehyde level
whereas PPAR-γ is associated with the process of and reducing lesions in acne vulgaris.
lipidogenesis. PPAR-ivasi activation can also induce The aim of the study was to investigate the use of
the expression of cyclooxygenase-2 (COX-2) and honey masks in decreasing malondialdehyde level
prostaglandin E2 (PGE2), causing further and reducing lesions in acne vulgaris.

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

2 RESEARCH METHODOLOGY 2.2.4 Detection of Saponins

2.1 Materials and Instruments Distilled water (2 ml) was added to each extract and
shaken in a graduated cylinder for 15 mins
Materials used were honey acquired from the forest. lengthwise. Formation of 1 cm foam indicated the
NaOH, Mayer Reagen, Gelatin Solution 1%, presence of saponin (Asokan S and Jayanthi, 2017).
Aquadest (distilled water), chloroform, anhydride
acid, and sulfurate acid, Trichloroacetic acid (TCA) 2.2.5 Detection of Terpenoids
40%, Hypochlorite acid (HCl), Na-thiosulfate
Chloroform (2 ml) and concentrated sulphuric acid
(NaThio) 1 N, 3cc of Blood Samples.Instruments
was added carefully to 0.5 ml of extract. Formation
used weremicro pipets, cuvette rack, gloves.
of red-brown colors at the surface indicated the
tourniket, spuit, centrifuge 1 unit, Sample rack 1
presence of terpenoids (Asokan S and Jayanthi,
unit, microtube, cuvette, waterbath, UV-
2017).
Spectrophotometer, test tubes, and shaving brush.
Honey used in this study was purchased from local
bee keepers in North Sumatera, Indonesia. Honey,
2.3 Participants
which had been tested for phythochemical, was
In this study, the participants were grouped into mild
packaged and given to the participants. The honey
acne vulgaris and assessed using a grading system.
was applied once per day for seven days as a mask;
Participant’s criteria should be young adults with
7 packages were given per participant and each
acne vulgaris aged 18-22 years, and have not
package contained 10cc.
received acne therapy for the previous two weeks
either topical therapy or systemic therapy, and a
2.2 Phytochemical Analysis willingness to be included in the study. Participants
were grouped based on levels of severity according
Before applying honey, aphytochemical analysis
to the IGA scoring system: mild (IGA 2); informed
was carried out to determine its antioxidant content.
consent sheets were given to all the participants.
In this study, qualitativetest for phythochemical such
as flavonoids, alkaloids, Tannins, Saponin, and
Table 1: Investigator’s Global Assesment (IGA)Scale
terpenoids content of honey samples were carried (Linda Stein Gold, 2017)
out.
Levels of Severity Indication
2.2.1 Detection of Flavonoids Clear Skin with no
Clear (IGA 0) inflammatory or non
Alkaline Reagent Test: A few drops of diluted inflammatory lesions
NaOH were added to the extracts. An intense yellow A few Scaltered
colour was produced and became colorless after of a Almost Clear (IGA 1) comedones and a few
few drops of diluted acid were added; this indicated small papules
the presence of flavonoids (Asokan S and Jayanthi, Easily recognizable, Less
2017). than half the face is
Mild (IGA 2) involved, some comedones
2.2.2 Detection of Alkaloids and some papules and
pustules
Mayer’s Test: 50 cc of solvent free extracts were More than Half of the face
stirred with a few ml of diluted HCL and filtered; is involved, many
Moderate (IGA 3)
comedones, papules and
then a few drops of Mayer’s reagent were added by
pustules
dripping on the side of the test tube. The white or Entire face is involved,
creamy precipitate indicated a positive result covered with comedones,
(Asokan S and Jayanthi, 2017). Severe (IGA 4) numerous papules and
pustules, few nodules may
2.2.3 Detection of Tannins or may not be present

Gelatin Test: A 1% gelatin solution containing Lesions were calculated before and after applying
sodium chloride was added to the extract. honey as a mask for 7 days using the criteria from
Formation of a white precipitate indicated the Fakultas KedokteranUniversitas Indonesiathe
presence of tannins (Prashant Tiwari, 2011). method of calculating lesions showed in table 2

312
 The Potential of Forest Honeybee on Decreasing Malondialdehyde Levels in Adult with Mild Acne Vulgaris

Table 2: Criteria for severity of Lesions 3 RESULTS AND DISCUSSION

Acne Blackh Inflammatory Total
Degree eads Lesions Lesions Phytochemical screenings of honey samples have
Mild <20 <15 <30 showed the presence of flavonoid, alkaloid, saponin,
Moderate 20-100 15-30 30-125 and terpenoids. The result of phytochemical
screening of honey can be seen in the table 3 below:
Inflammatory lesions include: Papules, pustules,
Table 3: Result of Phytochemical Screening of Honey
nodules. (Irma Bernadette S. Sitohang and Sjarif M.
Samples
Wasitaatmadja, 2017).
Procedure : Phytochemical Content Indication
1. Student whom suffered acne vulgaris at Fakultas Flavonoid +
Kedokteran Universitas Prima Indonesia were Alkaloid +
chosen. Student that gave their approval was Tannin -
accepted into the study. Saponin +
2. Based on the physical examination, the research Terpenoid +
subjects were grouped according to levels of
acne vulgaris mild and moderate. The aim of this phytochemical screening of
3. Examination of blood before honey is applied. honey samples was to investigate its bioactive
4. Participants were given 7 packages of honey as a compounds such as flavonoid, alkaloid, tannin,
mask that was used for 7 days at a dose of 10 ml saponin, and terpenoid. Honey contains vitamins
per pack. Participants were required to wash their which may serve as sources of polyphenol and
faces before using honey when they wanted to dietary antioxidants. Honey mainly consists ofsugars
sleep. After the mask was dry, the participants and water but also contains several vitamins,
rinsed their faces with water. especially B complex and vitamin C, and minerals.
5. After using the masks for 1 week, blood samples It possesses anti-bacterial, anti-inflammatory, and
of participants were extracted at 3cc antioxidative properties that may be beneficial for
/participants. combating multi-drug resistant bacteria;
6. Examination of MDA levels. additionally, it may also be useful for preventing
7. Analysis of data. chronic inflammatory processes, such as acne
vulgaris (M. Assaduzaman, 2015; Halah Musthafa
Measurement of Malondialdehyde Level has
Ya’qub,2013).
been conducted as the following:
1. Blood samples were inserted into a rack blood Table 4: The T-test of MDA levels in Mild Acne
samples were inserted into the Centrifuge
machinend centrifuged at 2500 rpm for 8 Degree of
minutes to produce serum. Acne Mean T- test
Vulgaris
2. Serum was taken out using a micropipette and
inserted into microtube Before
Application Mild 0,909 (P= 0,000)
3. 0.5 cc of serum added with: (1) TCA 40% 2.5 µl,
of Honey (N= 35)
(2) 200 µl HCl 1 N, (3) 0.5 cc aquabides, and (4) and MDA
NaThio 1% 100 µl Measuremen
4. It was then heated at 100 °Cfor 25 minutes using t
a water bath machine. AfterApplic
5. Afterwards it was centrifuged at 3000 rpm for 5 ation of Mild 0,808 (P= 0,000)
minutes and then the formed supernatant was Honey and (N= 35)
taken out MDA
6. The supernatant was put in a vacuum tube and Measuremen
t
aquabides (3 cc) was added.
7. Then the supernatant was inserted into the
Table 4 above showed a decreased MDA level
cuvette, then the cuvette was inserted into the
after application of the honey. In this study, an
UV-Spectrophotometer machine. Then amount
Independent T Tests was carried out before and after
of absorption at a wavelength of λ 532 was
MDA measurement in mild acne vulgaris. A mean
measured.
score of 0,909 in mild acne vulgaris was calculated.

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

After the application of honey for 7 days, a mean of honey (due to the p value) and all of the people
score of 0,808 in mild acne vulgaris was calculated. (with mild acne) experienced a decrease in the
This shows a statistically significant decrease in amount of acne (due to all the samples being in the
MDA level. negative rank).
Honey was shown to have anti inflammatory In this study, Dependent T Test was carried out
activities which reduced acne vulgaris lesions. There before and after the application of honey masks to
was a visible improvement after the use of honey moderate acne vulgaris, it can be seen in table 6
masks. Similar results were reported by Khoiroh below:
Umah and Oriza Herdanti. Their studies used
statistical tests gained from Paired Sample Tests Table 6: The dependent T-test of MDA levels in Mild
which resulted in the rejection of the null hypothesis Acne
with a value of α = 000. This meant that the students Acne
that had undergone treatment using the honey had
Vulgaris Dependent T test
statistically significant differences in the amount of Degree
acne vulgaris compared to before the application of
Before
the honey. The study was conducted by PSIK
Application of
students from Gresik University (Khoiroh Umah and Moderate ( p= 0,040)
Honey in
Oriza Herdanti,2017). (N= 35)
Moderate Acne
In this study, an Wilcoxon Signed Ranks Test
Vulgaris
was carried out before and after the application of
honey masks to mild acne vulgaris, it can be seen in After
table 5 below: Application of Moderate
( p= 0,000)
Honey in Mild (N= 35)
Table 5: The Wilcoxon test of MDA levels in Mild Acne Acne Vulgaris

Degree of Wilcoxon Signed

Table 6, normality test (Shapiro-Wilk) shows a
Acne Ranks Test
p value of more than 0.05; therefore, the null
Vulgaris
hypothesis, that the data distribution is normal, is
Before accepted. Dependent T test is a test to determine if
Application of there is a statistically significant difference before
Mild t = -5.173
Honey in
(N= 35) ( p= 0,019) and after the application of honey on the amount of
Mild Acne
acne. Since only the data of people with moderate
Vulgaris
acne (Before & After) is normally distributed, the
After
dependent t-test is used. The result: a p value of less
Application of Mild than 0.01 for people with a moderate amount of
t = -5.168
Honey in (N= 35) acne. This meant that the null hypothesis, there was
( p= 0,019)
Mild Acne
no difference between before and after the
Vulgaris
application of honey, was rejected. It can be
The normality test (Shapiro-Wilk) shows a p concluded that there was a statistically significant
value of less than 0.05; therefore, the null difference between before and after the application
hypothesis, that the data distribution is normal, is of honey (due to the p value) and all of the people
rejected. This is a test to determine if there is a (with moderate acne) experienced a decrease in the
statistically significant difference before and after amount of acne.
the application of honey on the amount of acne (the Application of honey as face masks in mild and
same person is measured twice before and after the moderate acne vulgaris can be seen in figure 1 and
test). Since only the data of people with mild acne figure 2 respectively.
(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

314
 The Potential of Forest Honeybee on Decreasing Malondialdehyde Levels in Adult with Mild Acne Vulgaris

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.
Figure 1: Before and after application of honey on mild
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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