cosmetics

Article
A Green Tea Containing Skincare System Improves Skin Health
and Beauty in Adults: An Exploratory Controlled Clinical Study
Ruofen Liao, Tory Parker, Kelly Bellerose, David Vollmer and Xuesheng Han *

4Life Research, Scientific Research Division, Sandy, UT 84070, USA

* Correspondence: [email protected]

Abstract: Skin dryness, fine lines and wrinkles, red spots, red vasculature, and porphyrin count are
common indicators of skin health and beauty. The skincare system in this study contains scientifically
validated ingredients such as fermented green tea (Camellia sinensis) water, niacinamide, antioxidants,
and a variety of natural plant extracts. The purpose of this study was to evaluate the effectiveness
of this skincare system in improving facial-skin health and beauty. Twenty-six healthy adults, both
female and male, aged 18–54 and of all skin types and tones, were included in the study and
participated as either the active or the control group (competitor product) using designated topical
products for 30 days. Skin moisture, fine lines and wrinkles, porphyrin count, red spots, and red
vasculature count were measured through high-quality photography, Visia® complexion analysis,
FitSkin® skin analysis, and survey questions on day 0, day 8, and day 30. Significant improvements
were observed in facial moisture, red-spot count, red vasculature count, and porphyrin count on day
30 in comparison with the control group. Non-significant improvements were observed in pores, skin
texture, and wrinkles. With extensive well-documented functional ingredients, the studied skincare
system used daily may significantly improve key areas of skin health and beauty.
Citation: Liao, R.; Parker, T.;
Bellerose, K.; Vollmer, D.; Han, X. Keywords: green tea; skin health; skin beauty; hydration; wrinkles; porphyrins; red spots;
A Green Tea Containing Skincare red vasculature
System Improves Skin Health and
Beauty in Adults: An Exploratory
Controlled Clinical Study. Cosmetics
2022, 9, 96. https://doi.org/10.3390/ 1. Introduction
cosmetics9050096
Skin is often the first physical layer of protection for the human body; it functions
Academic Editors: Eduardo Perez, as the first line of immune defense and is an effective barrier against many chemical and
Christophe Hano and Enzo physical threats [1]. Healthy skin can be promoted and maintained through a variety of
Berardesca methods such as adequate hydration, vitamin supplementation [2], topical cosmetics [3],
Received: 25 July 2022
skin microbiome [4], healthy non-burning sun exposure [5], and protection from excessive
Accepted: 6 September 2022
sun exposure. Skincare products are generally intended for application on the skin to
Published: 12 September 2022
improve skin health and function beyond skin appearance. Ever since the COVID-19
pandemic, public awareness of and demand for skincare products have increased, but
Publisher’s Note: MDPI stays neutral
decreased for makeup products [6]. Such a phenomenon was mostly led by change of
with regard to jurisdictional claims in
lifestyle—many jobs now are not required to be performed in the office, and instead, have
published maps and institutional affil-
shifted to work-from-home permanently, which has made people become more mindful
iations.
about their skin health and function instead of simply skin appearance [7].
Along with the constantly rising demand for skincare products, there is concern in the
industry about certain chemicals, such as heavy metals, contained within some cosmetics
Copyright: © 2022 by the authors.
products that could be considered harmful or may be associated with increased risks for
Licensee MDPI, Basel, Switzerland. disease [8,9]. Therefore, ingredients included in cosmetics have shifted to becoming safer
This article is an open access article and more focused on consumers’ skin health. Antioxidants are some of these highlighted
distributed under the terms and ingredients due to their health-promoting potential and ability to function as effective
conditions of the Creative Commons stabilizers [10,11]; some of these antioxidants include niacinamide and other essential
Attribution (CC BY) license (https:// vitamins [12]. Some botanicals, such as green tea (Camellia sinensis), and their active
creativecommons.org/licenses/by/ compounds also possess strong antioxidant activity, and therefore have been implemented
4.0/). in many skincare formulations [13].

Cosmetics 2022, 9, 96. https://doi.org/10.3390/cosmetics9050096 https://www.mdpi.com/journal/cosmetics

Cosmetics 2022, 9, 96 2 of 11

Various measurements are often used to determine the effectiveness of a skincare prod-
uct, including the number of fine lines and wrinkles, red spots, skin moisture content, red
vasculature, and porphyrin skin concentration. Porphyrins are compounds and pigments
that can be produced by certain skin bacteria, specifically Cutibacterium acnes [14], which
plays an important role in the development of acnes vulgaris [15], which affects up to
50 million people in the American population annually [16]. The presence of porphyrins
in the skin can be detected by fluorescence surveillance because of its ability to absorb
UV light up to 400 nm, which can help determine the risk of skin acne [17]. It is already
known that P. acnes populate in areas where the sebaceous glands are abundant [18,19]; in
other words, individuals who have oily skin may have a higher concentration of P. acnes,
resulting in higher porphyrin levels [20,21]. Thus, certain skincare products target the
control of sebum production to control acne.
The äKwä six-step skincare system comprises various skincare products intended to be
applied both morning and night. Some of the notable ingredients included in the product
formulas are fermented green-tea water, other ferments, niacinamide, antioxidants, and
a variety of natural plant extracts. The purpose of the study was to evaluate the effectiveness
of the äKwä six-step skincare system by measuring skin moisture level, fine lines and
wrinkles, porphyrin count, red spots, and red vasculature count over a 30-day period.

2. Materials and Methods

2.1. Skincare Product
The skincare-product system used in this treatment group was the äKwä 6-step skin-
care system from 4Life Research USA, LLC. (https://www.4life.com/6613461/page/äKwä,
accessed on 22 June 2022), and the products used in the control group were participants’
own routine topical products. The product directions indicate to use the following products
morning and night in sequential order: First Wave Oil-to-Foam Cleanser, Glacier Glow
Four-Way Toner, Precious Pool Vitamin Essence, Ripple Refine Eye Cream, and RainBurst
Moisture Cream. After application in the morning, Neutrogena sunscreen (Sheer Zinc Face
SPF 50) was also applied. A Royal Bath sheet mask was used every Tuesday during the
study following the application of the Precious Pool Vitamin Essence. The contents for each
product, listed on a weight-percentage basis, were as follows:
First Wave Oil-to-Foam Cleanser: water, glycerin, dipropylene glycol, coco-betaine,
coco-glucoside, acrylates copolymer, polyglyceryl-10 laurate, sodium methyl cocoyl taurate,
1,2-hexanediol, Camellia sinensis leaf water, sea water, rice ferment filtrate (sake), Cucurbita
pepo (pumpkin) fruit extract, Saccharomyces ferment, bioflavonoids, Brassica oleracea italica
(broccoli) extract, Aloe barbadensis leaf extract, Helianthus annuus (sunflower) seed oil, Olea
europaea (olive) fruit oil, Geranium maculatum oil, Citrus aurantium bergamia (bergamot) fruit
oil, Cymbopogon martini oil, Lavandula angustifolia (lavender) oil, Citrus junos fruit extract,
Pinus densiflora leaf extract, Anthemis nobilis flower oil, Artemisia annua extract, Citrus
aurantium dulcis (orange) peel oil, ethylhexylglycerin, potassium cocoyl glycinate, sodium
chloride, tromethamine, potassium cocoate, propanediol, caprylic/capric triglyceride,
disodium EDTA, sodium lauryl glycol carboxylate, caprylyl glycol, and butylene glycol.
Glacier Glow Four-Way Toner: Camellia sinensis leaf water, isopentyldiol, glycerin,
butylene glycol, 1,2-hexanediol, niacinamide, water, Saccharomyces ferment, Rosa damas-
cena flower water, adenosine, Undaria pinnatifida extract, Laminaria japonica extract, Hizikia
fusiforme extract, Centella asiatica extract, Glycyrrhiza glabra (licorice) root extract, Camel-
lia sinensis leaf extract, Rosmarinus officinalis (rosemary) leaf extract, Chamomilla recutita
(matricaria) flower extract, Scutellaria baicalensis root extract, Polygonum cuspidatum root
extract, Camellia japonica flower extract, Andrographis paniculate extract, Morus nigra fruit
extract, allantoin, Citrus unshiu peel extract, ethylhexylglycerin, propanediol, betaine, and
disodium EDTA.
Precious Pool Vitamin Essence: Camellia sinensis leaf water, isopentyldiol, butylenegly-
col, dipropylene glycol, cetyl ethylhexanoate, methyl gluceth-20, niacinamide, 1,2-hexanediol,
polyglyceryl-3 distearate, octyldodecanol, water, Saccharomyces ferment, adenosine, ascor-
Cosmetics 2022, 9, 96 3 of 11

byl glucoside, Saccharomyces lysate extract, Acer saccharum (sugar maple) extract, Centella
asiatica extract, Glycyrrhiza glabra (licorice) root extract, Scutellaria baicalensis root extract,
Rosmarinus officinalis (rosemary) leaf extract, Camellia sinensis leaf extract, Camellia japonica
flower extract, arginine, allantoin, panthenol, Citrus unshiu peel extract, Morus nigra fruit
extract, Cymbopogon martini oil, Lavandula angustifolia (lavender) oil, Anthemis nobilis flower
oil, Chamomilla recutita (matricaria) flower extract, Geranium maculatum oil, Polygonum
cuspidatum root extract, Andrographis paniculata extract, Citrus aurantium bergamia (berg-
amot) fruit oil, Citrusaurantium dulcis (orange) peel oil, betaine, ethylhexylglycerin, glyceryl
stearate citrate, carbomer, propanediol, and caprylyl glycol.
Royal Bath Sheet Mask: water, glycerin, butylene glycol, niacinamide, Lactobacil-
lus/milk ferment filtrate, adenosine, hyaluronic acid, sodium hyaluronate, sodium
hyaluronate crosspolymer, hydrolyzed hyaluronic acid, hydrolyzed sodium hyaluronate,
colostrum, dried egg yolk, Camellia sinensis leaf extract, Glycyrrhiza glabra (licorice) root
extract, dipotassium glycyrrhizate, panthenol, Zingiber officinale (ginger) root extract, Coptis
chinensis root extract, allantoin, arginine, Citrus limon (lemon) fruit extract, Citrus nobilis
(mandarin orange) oil, Eucalyptus globulus leaf oil, Geranium maculatum oil, Lavandula
angustifolia (lavender) oil, Pinus palustris oil, trehalose, ethylhexylglycerin, carbomer, hy-
droxyethylcellulose, 1,2-hexanediol, disodium EDTA, PEG-60 hydrogenated castor oil, and
pentylene glycol.
Ripple Refine Eye Cream: Camellia sinensis leaf water, glycerin, butylene glycol, hydro-
genated polydecene, caprylic/capric triglyceride, polyglyceryl-3 distearate, 1, 2-hexanediol,
cetearyl alcohol, niacinamide, Olea europaea (olive) fruit oil, water, Butyrospermum parkii
(shea) butter, Tremella fuciformis (mushroom) extract, sodium hyaluronate, Saccharomyces
ferment, ascorbyl glucoside, adenosine, Cucumis sativus (cucumber) extract, Bambusa arun-
dinacea juice, Centella asiatica extract, Camellia sinensis leaf extract, Anthemis nobilis flower
oil, Polygonum cuspidatum root extract, Glycyrrhiza glabra (licorice) root extract, Rosmari-
nus officinalis (rosemary) leaf extract, Scutellaria baicalensis root extract, Camellia japonica
flower extract, Morus nigra fruit extract, Citrus unshiu peel extract, Lavandula angustifolia
(lavender) oil, Andrographis paniculate extract, Citrus aurantium bergamia (bergamot) fruit
oil, Geranium maculatum oil, Citrus aurantium dulcis (orange) peel oil, Cymbopogon mar-
tini oil, Chamomilla recutita (matricaria) flower extract, betaine, glyceryl stearate, glyceryl
stearate citrate, ethylhexylglycerin, sorbitan isostearate, disodium EDTA, propanediol,
behenyl alcohol, polyglyceryl-3 methylglucose distearate, ammonium acryloyldimethyl-
taurate/VP copolymer, hydroxyethylacrylate/sodium acryloyldimethyl taurate copolymer,
and caprylyl glycol.
RainBurst Moisture Cream: Camellia sinensis leaf water, water, butylene glycol, cetyl
ethylhexanoate, octyldodecanol, glycerin, cetyl alcohol, phytosteryl isostearyl dimer dili-
noleate, polyglyceryl-3 methylglucose distearate, Simmondsia chinensis (jojoba) seed oil,
niacinamide, hydrogenated vegetable oil, beeswax, 1,2-hexanediol, Panax ginseng root
extract, adenosine, Centella asiatica extract, sodium hyaluronate, Saccharomyces ferment,
honey extract, Andrographis paniculata extract, Betula platyphylla japonica juice, Scutellaria
baicalensis root extract, panthenol, Polygonum cuspidatum root extract, Camellia sinensis leaf
extract, Glycyrrhiza glabra (licorice) root extract, Rosmarinus officinalis (rosemary) leaf extract,
Anthemis nobilis flower oil, Morus nigra fruit extract, Chamomilla recutita (matricaria) flower
extract, Citrus unshiu peel extract, Citrus aurantium bergamia (bergamot) fruit oil, Lavandula
angustifolia (lavender) oil, Camellia japonica flower extract, Cymbopogon martini oil, Geranium
maculatum oil, Citrus aurantium dulcis (orange) peel oil, hydroxyacetophenone, glyceryl
stearate, caprylic/capric triglyceride, disodium EDTA, ethylhexylglycerin, microcrystalline
wax, glyceryl stearate SE, ammonium acryloyldimethyltaurate/VP copolymer, propanediol,
bis-diglyceryl polyacyladipate-2, caprylyl glycol, pentylene glycol, and dipropylene glycol.

2.2. Specific Usage Instructions Were as Follows

First Wave Oil-to-Foam Cleanser: Squeeze a dime-sized amount onto clean fingers
and massage lightly over dry face, making sure to cover and loosen eye makeup. Add
Cosmetics 2022, 9, 96 4 of 11

water, lather up, and rinse with clean, room-temperature water. Pat dry. Use both AM and
PM daily.
Glacier Glow Four-Way Toner: Saturate a cotton pad with toner. Lightly wipe across
face, neck, and closed eyes to remove any residual oil or makeup. Lightly pat dry until
absorbed. Use both AM and PM daily.
Precious Pool Vitamin Essence: Dispense a drop-sized amount onto fingertips and
gently sweep over face, neck, and around delicate eye area. Lightly pat into skin until
completely absorbed. Use both AM and PM daily.
Royal Bath Sheet Mask: After Cleanser, Toner and Essence, remove a premoistened
mask from the packaging. Gently lay it across the face to fit. Press lightly so the mask
comes in contact with the entire face. If possible, lie down and relax for 15–20 min, but can
also be used while remaining active. Afterwards, remove the mask and tap or gently rub
in any remaining moisture. Follow with the Eye Cream and the remaining steps. Use on
Tuesdays only.
Ripple Refine Eye Cream: Dispense a drop-sized amount onto fingertips and lightly
apply all around the delicate eye area, including eyelids and between the eyes. Lightly tap
with fingertips to set. Use both AM and PM daily.
RainBurst Moisture Cream: Apply a dime-sized amount onto face, neck, and chest and
allow to absorb. AM regimen: Follow with SPF 50 Day Moisturizer. PM regimen: Retire to
a restful night’s sleep.
Neutrogena Sunscreen (Sheer Zinc Face SPF 50): Apply a dime-sized amount evenly
across face and neck to achieve uniform coverage. Follow with powder foundation
and other color cosmetics as desired. Use AM as the last step of regimen before
applying makeup.

2.3. Clinical Study Design

Prior to the 30-day study, all participants were required to pass through a four-day
dry-out period. Following the dry-out period, all other skin products that were previously
being used by participants were not allowed to be used during the study period. The
treatment began thereafter, and results were measured on day 0, day 8, and day 30. Results
from the study were compared to a control group using a competitor’s products over the
same study period.

2.4. Subjects
The study was reviewed and approved by an ethics committee before starting. In-
formed consent from all study subjects was obtained at the beginning of the study. The
study is registered on ClinicalTrials.gov (NCT05476406).
Twenty-six (26) participants were recruited as volunteers from 4Life Research, LLC.
(Sandy, UT, USA); 15 individuals were randomly assigned to the äKwä group (12 female and
3 male) and 11 (8 female and 3 male) were assigned to the control group. The participants’
ages ranged from 18 to 54 years old (5 individuals were 18–24, 9 were 25–34, 6 were 35–44,
and 6 were 45–54), and all skin types were included (according to the Fitzpatrick scale) in
both groups as well as different skin tones (Hispanic, Asian, and Caucasian). Participants
had a wide range of skin sensitivities.

2.5. Inclusion Criteria

Individuals could participate who were at least 18 years old and in self-assessed
general good health.

2.6. Exclusion Criteria

Participants were excluded if they had allergies or contraindications to any ingredient
of the products, had a history of any acute or chronic disease that could interfere with or
increase the risk of study participation, or had had any medical procedures, such as laser
resurfacing or plastic surgery on the test sites within the last 12 months (including Botox,
Cosmetics 2022, 9, 96 5 of 11

Restylyn, or other fillers). Participants could not have chronic skin allergies (dermatitis,
eczema, psoriasis), have been treated for skin cancer within the last 12 months, or have
damaged skin near the facial area (e.g., sunburn, tattoos, scars, or other disfigurations).
Participants were not allowed to participate if they were pregnant or planning to become
pregnant in the following 12 weeks, or lactating.

2.7. Usage Schedule

Morning:
1. First Wave Oil-to-Foam Cleanser
2. Glacier Glow Four-Way Toner
3. Precious Pool Vitamin Essence
4. Ripple Refine Eye Cream
5. RainBurst Moisture Cream
6. Neutrogena Sunscreen
Night:
1. First Wave Oil-to-Foam Cleanser
2. Glacier Glow Four-Way Toner
3. Precious Pool Vitamin Essence
4. Ripple Refine Eye Cream
5. RainBurst Moisture Cream
6. The Royal Sheet Mask was worn every Tuesday.

2.8. Assessments
The specific markers that were measured during the study were skin moisture, fine
lines and wrinkles, porphyrin count, red spots, and red vasculature count.

2.8.1. VISIA® Complexion Analysis

VISIA complexion analysis (Model VISIA-6) was used to quantify brown and red skin
spots, wrinkles, pore visibility, red-area vasculature count, and UV spots. Skin porphyrin
presence was measured with UV-fluorescence imaging. A decrease in the score of any of
these markers was considered skin improvement.

2.8.2. Neutrogena Skin360® Skin Care Analysis

Skin moisture was measured using the Neutrogena Skin360® smartphone application
powered by FitSkin® . The application utilizes an extensive database of humans of various
genders, ages, and ethnicities as a comparative measurement when scanning the image
pixels from the facial scan. Fine lines and pores were also measured.

2.8.3. Professional Photography

Facial photographs of all participants were taken at the three measurement time points
of the study for the purpose of comparing noticeable changes in skin appearance.

2.9. Statistical Analysis

A t-test was performed to compare the differences between day 0, day 8, and
day 30 for the äKwä group, and between the äKwä group and the control group on day 30.
A p ≤ 0.05 was considered statistically significant.

3. Results
Several significant differences in skin health were found among the study partici-
pants. The results are summarized in Tables 1–3. Participants in the äKwä group showed
a significant improvement in skin-moisture level from day 8 (p = 0.035) compared to day
0. Interestingly, though there was no statistical difference between day 30 and day 0
(p = 0.154), 66.7% of participants showed an improvement in skin moisture on day 30.
Cosmetics 2022, 9, 96 6 of 11

Table 1. Facial-skin parameters for the äKwä group on day 0 and day 8.

Day 0 Baseline äKwä Day 8 äKwä p-Value

FitSkin Moisture 59.47 ± 8.86 66.07 ± 12.8 0.035 *
Red-spot count 71.47 ± 26.35 74.67 ± 29.17 0.418
Red-spot score 42.87 ± 30.36 54.53 ± 30.82 0.053
Red vasculature count 89.2 ± 42.03 77.47 ± 37.38 0.034 *
Wrinkle score 51.73 ± 29.1 42.53 ± 22.55 0.108
Wrinkle count 17.67 ± 7.94 18.27 ± 9.46 0.757
Porphyrin count 1457.13 ± 1106.98 734.33 ± 700.73 0.037 *
Porphyrin score 28.4 ± 28.56 58.8 ± 37.54 0.01 *
FitSkin lines 72.67 ± 12.3 83.2 ± 7.94 0.003 *
Pore count 827.47 ± 304.09 777.93 ± 328.29 0.34
Pore score 27.53 ± 30.48 30.13 ± 32.4 0.501
FitSkin pores 80.4 ± 9.36 70.27 ± 16.89 0.005 *
Texture count 748.53 ± 460.91 710 ± 470.6 0.583
Texture score 62.00 ± 36.64 65.53 ± 32.77 0.609
UV-spot count 265.4 ± 71.25 225.33 ± 108.73 0.064
UV-spot score 21.73 ± 15.56 36.33 ± 26.09 0.045 *
Brown-spot count 297.27 ± 48.56 294.8 ± 54.11 0.944
Brown-spot score 32.20 ± 18.57 39.27 ± 22.17 0.126
* Indicates significant differences were found (p ≤ 0.05); bolded text indicates significantly positive improvements.

Table 2. Facial-skin parameters for the äKwä group on day 0 baseline and day 30.

Day 0 Baseline äKwä Day 30 äKwä p-Value

FitSkin moisture 59.47 ± 8.86 65.4 ± 16.2 0.154
Red-spot count 71.47 ± 26.35 64 ± 26.98 0.069
Red-spot score 42.87 ± 30.36 55.93 ± 27.14 0.087
Red vasculature count 89.2 ± 42.03 68.13 ± 33.3 0.007 *
Wrinkle score 51.73 ± 29.1 41.87 ± 19.04 0.063
Wrinkle count 17.67 ± 7.94 17.13 ± 8.15 0.798
Porphyrin count 1457.13 ± 1106.98 706.8 ± 604.01 0.014 *
Porphyrin score 28.4 ± 28.56 55.8 ± 35.93 0.008 *
FitSkin lines 72.67 ± 12.3 78.53 ± 9.51 0.039 *
Pore count 827.47 ± 304.09 748.87 ± 276.48 0.089
Pore score 27.53 ± 30.48 28.33 ± 27.29 0.905
FitSkin pores 80.4 ± 9.36 74.47 ± 11.24 0.007 *
Texture count 748.53 ± 460.91 677.07 ± 414.7 0.19
Texture score 62.00 ± 36.64 67.6 ± 30.75 0.348
UV-spot count 265.4 ± 71.25 221.93 ± 112.75 0.065
UV-spot score 21.73 ± 15.56 37.53 ± 28.2 0.04 *
Brown-spot count 297.27 ± 48.56 289.6 ± 52.5 0.607
Brown-spot score 32.20 ± 18.57 37.8 ± 24.87 0.292
* Indicates significant differences were found (p ≤ 0.05); bolded text indicates significantly positive improvements.
Cosmetics 2022, 9, 96 7 of 11

Table 3. Facial-skin parameters for the äKwä group and the control group on day 30.

Day 30 äKwä Day 30 Control p-Value

FitSkin moisture 65.4 ± 16.2 66.64 ± 23.31 0.874
Red-spot count 64 ± 26.98 88.45 ± 33.33 0.0496
Red-spot score 55.93 ± 27.14 27.45 ± 30.59 0.0194 *
Red vasculature count 68.13 ± 33.3 109.36 ± 48.97 0.017 *
Wrinkle score 41.87 ± 19.04 47 ± 28.37 0.585
Wrinkle count 17.13 ± 8.15 18.55 ± 7.46 0.655
Porphyrin count 706.8 ± 604.01 1393.55 ± 832.14 0.022 *
Porphyrin score 55.8 ± 35.93 27.27 ± 32.31 0.048 *
FitSkin lines 78.53 ± 9.51 79.64 ± 7.66 0.755
Pore count 748.87 ± 276.48 923.91 ± 428.08 0.217
Pore score 28.33 ± 27.29 22.82 ± 29.59 0.628
FitSkin pores 74.47 ± 11.24 76 ± 14.62 0.765
Texture count 677.07 ± 414.7 962.82 ± 384.13 0.086
Texture score 67.6 ± 30.75 44.27 ± 34.76 0.083
UV-spot count 221.93 ± 112.75 272.09 ± 66.36 0.201
UV-spot score 37.53 ± 28.2 25.45 ± 25.16 0.27
Brown-spot count 289.6 ± 52.5 323.64 ± 48.96 0.1061
Brown-spot score 37.8 ± 24.87 25.82 ± 11.15 0.15
* Indicates significant differences were found (p ≤ 0.05); bolded text indicates significantly positive improvements.

The red-spot count was significantly reduced in the äKwä group on day 30 com-
pared to that of the control group (p = 0.0496). However, the red-spot score in the äKwä
group showed a significant increase compared to the control group over the same period
(p = 0.0194), whereas no statistical differences were seen in comparison with day 0
(p = 0.087). The red vasculature count on day 8 in the äKwä group was compared to
day 0 measurements, and significant reduction was reported (p = 0.034). Significance in the
reduction of red vasculature count was also established in the äKwä group on day 30 in
comparison with day 0 (p = 0.007) and the control group (p = 0.017).
A significant reduction in the porphyrin count was found between the äKwä group
and the control group (p = 0.022) on day 30, and between day 30 and day 0 for the äKwä
group (p = 0.014). Interestingly, the porphyrin score in the äKwä group on day 30 was
significantly higher compared to the control group (p = 0.008) and day 0 of the äKwä group
(p = 0.048). The same phenomenon was also observed in the UV-spot score in the äKwä
group, as it was significantly greater on day 8 (p = 0.045) and day 30 (p = 0.04) compared
to day 0, whereas no significant differences were seen compared to the control group
(p = 0.27).
There was no significant reduction in wrinkle score or wrinkle count on day 30 in
the äKwä group compared to the control group (p = 0.585, p = 0.655, respectively) or the
day 0 baseline scores (p = 0.063, p = 0.798, respectively). There were also no significant
differences in fine lines (p = 0.75) between the äKwä group and the control group on day 30
or in brown-spot count (p = 0.1061) and brown-spot score (p = 0.15). When comparing the
results of the wrinkle score, wrinkle count, brown-spot count, and brown-spot score in the
äKwä group on day 0 and day 30, we also did not find any statistical differences (p = 0.063,
p = 0.798, p = 0.607, p = 0.292, respectively)
Cosmetics 2022, 9, 96 8 of 11

4. Discussion
Healthy skin is an important aspect of one’s overall health and can help improve one’s
well-being and social confidence [22]. The present study showed that the äKwä skincare
system significantly improved several key areas of skin health and beauty—red vasculature
count, red-spot count, and porphyrin count—in the study group compared to the control
group; it also provided improvements in skin hydration, though non-significantly. Pores,
skin texture (smoothness), and wrinkles did not show significant differences over a 30-day
period, largely due to the small study size and short study duration.
Skin hydration has been an important area of skin health and beauty. Maintaining
sufficient hydration is critical to delaying the aging process of skin, as skin becomes less
elastic and more prone to developing wrinkles and infections when it is dry. A systematic
review on non-drug topical skin care in the aged population supported that leave-on
products with the addition of functional ingredients such as glycerin, petrolatum, and
paraffin would help prevent skin tears and improve overall skin health [23]. Glycerin,
a common ingredient used in skincare products, is known as a humectant that retains
moisture in skin [24] and prevents transepidermal water loss (TEWL) [25], and therefore is
a primary ingredient in all äKwä products except Precious Pool Vitamin Essence. A total of
66.7% of the participants in the äKwä group showed an increase in skin hydration, which
agrees with the studies mentioned previously [23,24].
Panthenol and butylene glycol also possess humectant properties [26,27] and are func-
tional ingredients in the majority of äKwä products. Occlusives such as beeswax and oils
function as a skin barrier to prevent moisture loss [25]. To reach the optimal effectiveness
of skin hydration, a combination humectants and occlusives is often recommended in mois-
turizers [25]. These functional humectant ingredients present in äKwä skincare products
support their positive effects on improving skin hydration and water retention.
Green tea (Camellia sinensis) is rich in bioactive compounds: polyphenols, catechins,
pigments, caffeine, polysaccharides, L-theanine, and others [28]. The presence of these ac-
tive compounds assists in many reactions that are beneficial to human skin. In
an in vitro study conducted by Wei et al., tea polysaccharides (TPS) and tea polyphenols
(TPP) provided protection to skin as well as water retention, especially in dry environ-
ments [29]. The authors also suggested the use of TPP as an ingredient in sunscreen because
of its capability to absorbing UV-A and UV-B, which have been proven to accelerate aging
of the skin. Based on the positive results seen in TPP and TPS extracted from green tea, the
authors concluded that the application of those compounds may promote skin health if
used in topical skincare products. Green-tea extract and green-tea leaf water are among the
major functional ingredients in äKwä skincare products. The present study showed that
daily use of äKwä skincare products improved key parameters of skin health and beauty. In
light of the protective effect of TPS and TPP in green tea on skin hydration and skin redness
against UV-A and UV-B [29], it is speculated that green-tea extract and green-tea water
partially contributed to the positive effects of äKwä skincare products on skin hydration,
red vasculature count, red-spot count, and porphyrin count reported in the present study.
A polyphenolic compound in green tea called catechin has become a research hotspot
in recent years due to its antioxidant effect, anti-inflammatory activity, and UV protection
activity, among many others [28,30]. Epigallocatechin-3-gallate (EGCG), the major catechin
in green tea, has been shown to have protective effects on the skin and moisture retention,
and an anti-melanogenesis effect [31]. Recently, Ud-Din et al. found that EGCG may
also be beneficial for wound healing [32]. The study compared the healing effects of
topical treatment between immediate application (zonal priming) after the injury versus
after the formation of a scar (delayed application), and the results suggested that zonal
priming had the greatest effect on reducing inflammatory activity, which has been linked
to decreasing the possibility of abnormal scarring. Consistent with the finding that äKwä
skincare products improved red vasculature count, red-spot count, and porphyrin count in
the present study, these studies support the contribution of green-tea extract and green-tea
leaf water to such improvements.
Cosmetics 2022, 9, 96 9 of 11

In addition to green-tea extract, other antioxidant-providing materials such as plant

extracts can also benefit human skin health in a similar fashion by absorbing UV and
blocking UV-induced damage [33]. Utilization of antioxidants in topical products has been
shown to inhibit UV-induced erythema and pigmentation in some skin types [34]. A review
by Petruk et al. provides ample evidence for why the use of antioxidants in exogenous
creams and products could be beneficial, suggesting UV absorption properties to prevent
damaging effects of UV exposure [35]. The äKwä skincare products contain various plant
extracts and oils that have been documented to contain a variety of bioactive compounds
and help skin health and beauty.
Niacinamide has a long-standing history of benefits for human skin health. It is
well-established in its relationship in preventing the disease pellagra, which can cause
severe cases of dermatitis [20]. Supplementation of niacin assists the body in restoring
energy stores, minimizing oxidative stress, controlling the inflammatory response, and
enhancing the skin barrier while slowing the process of pigmentation [36]. Moreover,
niacinamide-containing moisturizers were found to improve stratum–corneum-barrier
function, which is correlated to lowering skin sensitivity [37]. Because of niacinamide’s role
in regulating the redox status of cells, it is thought to be useful as a cosmeceutical ingredient
that can slow skin aging and control pigmentation [36]. Supported by abovementioned
studies, niacinamide might also contribute to the skin-health-promoting effects of the äKwä
skincare products reported in the present study.
In summary, green-tea (Camellia sinensis) leaf water, green-tea extract, niacinamide,
humectants, and occlusives are among the main functional ingredients in äKwä skincare
products. Consistent with existing literature, it was expected that daily application of äKwä
skincare products could improve one’s facial-skin health. The current study provides direct
clinical evidence supporting the effectiveness of äKwä skincare system in improving facial-
skin health and beauty, specifically skin hydration, skin porphyrin count, red vasculature
count, and red-spot count.

5. Limitations
The study necessitated concurrent use of all products in the äKwä skincare system.
As such, it is not feasible to distinguish the impact of a specific ingredient or product on
the endpoints. The small sample size (15 in treatment, 11 in control) in the study was also
less than ideal, and might have affected the validity of the results, both significant and
non-significant. The variability in skin types and conditions might also have had an impact
on the results due to the small sample size. The instruments used in this study have only
been used in a limited number of studies [38–40], which might be seen as a disadvantage.
The data lack the skin measurements of the control group on day 0 and day 8, and therefore
direct comparisons with the treatment group on day 0 and day 8 were impossible. The
participants’ diets or lifestyles were not closely monitored, nor were the routine products
used in the control group, which could also have confounded the skin condition at baseline
and the end of study. The relatively short time frame may partially explain why significant
improvements in pores, skin texture, and wrinkles were not observed, as these parameters
typically require more time to be able to see any effects. Therefore, a longer-term study with
a bigger sample size and better controlled design is needed to be able to see any long-term
effects of the äKwä skincare system on one’s facial-skin health.

6. Conclusions
The formulas of individual products within the äKwä skincare system are extensive,
and therefore any significant positive effects must be attributed to the entire regimen,
instead of individual components or products. Though it has some limitations, the study
shows that the äKwä six-step skincare system used daily over a 30-day period may improve
various markers of facial-skin health and beauty, including skin moisture, skin porphyrin
count, red vasculature count, and red-spot count.
Cosmetics 2022, 9, 96 10 of 11

Author Contributions: Formal analysis, R.L. and X.H.; investigation, T.P., K.B. and D.V.; resources,
D.V.; data curation, R.L. and X.H.; writing—original draft preparation, R.L. and X.H.; writing—review
and editing, R.L., X.H. and D.V.; supervision, X.H.; project administration, T.P.; funding acquisition,
D.V. All authors have read and agreed to the published version of the manuscript.
Funding: This study was funded by 4Life Research, LLC, Sandy, UT, USA (Grant number: RSC-017-00).
Institutional Review Board Statement: The study was conducted according to the guidelines of the
Declaration of Helsinki, and approved by the Ethics Committee of 4Life Research (protocol code
RSC-017-00 and date of approval 1 March 2019).
Informed Consent Statement: Informed consent was obtained from all subjects involved in
the study.
Data Availability Statement: The data presented in this study are available on request from the
corresponding author.
Conflicts of Interest: The authors were employees of 4Life Research, LLC, Sandy, UT, USA.

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