# Potential Possibilities of Using Peat, Humic Substances, and Sulfurous Waters in Cosmetology
## 4 Medicinal Waters
### Dermatological and Cosmetological Uses of Water
#### 4.4.2 Soriasis  
The effects of sulfurous medicinal water were tested both in murine dermatitis models and in psoriatic patients. To investigate the anti-inflammatory effect, paw dermatitis was induced by oxazolone in mice. Then, the mice were bathed in the tested and disinfected water for control purposes. The baths lasted 20 min a day and were performed for 2 weeks. Studies on mice showed a reduction in paw swelling after bathing in sulfurous medicinal water. Myeloperoxidase and TNF-\(\alpha\) (tumor necrosis factor-\(\alpha\)) levels were also analyzed and histological examinations of the skin were performed. The measured parameters did not change. Only an increase in somatostatin concentration in plasma was demonstrated. In a clinical study, 19 patients with psoriasis were bathed for 21 days (2 \(\times\) 25 min/day).  
\begin{table}
\begin{tabular}{c c c} \hline
**Activity** & **Mechanism of Action** & **References** \\ \hline Anti-acne activity & -reduction in the growth (65\%) of _C. acnes_ & [133] \\ \hline  & -reduction in paw swelling & \\  & -increases somatostatin concentration & \\  & -decreases PASI (Psoriasis Area and Severity Index) & [117] \\  & -increases migration of Langerhans cells from the dermis to & \\ Effect on psoriasis & the epidermis & \\  & -reduction in proliferation of keratinocytes, fibroblasts, & [134] \\  & and macrophages & \\  & -50\% reduction in the PASI score & \\ \hline  & -decreases IgE level & \\ Effect on atopic dermatitis & -inhibition of serum inflammatory cytokines (IL-1\(\beta\), IL-13, & \\  & and TNF-\(\alpha\)) & [118] \\  & -reduction in reactive oxygen species (ROS) and & \\  & malondialdehydedehyde (MDA) in serum & \\ \hline Effect on skin irritations & -reduction in the degree of skin barrier disruption & [119] \\ \hline Skin-regenerating effect & -increases the proliferation and migration of keratinocytes & [120] \\  & -modulating the regenerated collagen and elastic fibers & \\ \hline \end{tabular}
\end{table}
Table 6: Directions and general mechanisms of potential cosmetic application of sulfurous water.  
These studies showed that PASI (Psoriasis Area and Severity Index) decreased after the use of therapeutic baths. Additionally, an increase in somatostatin in plasma and a greater migration of Langerhans cells from the dermis to the epidermis were demonstrated. These studies showed that somatostatin released by H\({}_{2}\)S plays a role in the mechanism of action of sulfurous medicinal water (Table 6) [135].  
Portuguese Natural Mineral Water collected in Monfortinho Thermal Center (rich in silica) was tested to analyze its impact on skin cell homeostasis using two representative cell lines of the epidermis and dermis, keratinocytes and fibroblasts, as well as macrophages, respectively. Mouse skin fibroblasts, macrophages, and human keratinocytes were exposed to a culture medium prepared with Natural Mineral Water. Studies showed a reduction in cellular metabolism in all cell lines tested. The proliferation of keratinocytes, fibroblasts, and macrophages was reduced. This action can be used for hyperkeratotic conditions occurring, among others, in psoriasis or atopic dermatitis (Table 6) [134].  
A pilot study was carried out on the effect of sulfurous mineral waters' application on psoriatic lesions. The study lasted a month and a half and involved 39 patients who were divided into control and experimental groups. The patients applied the water on the affected areas of their skin at home by themselves using a spray. Assessment was performed by a physician and a psychologist trained with PASI and DLQI at days 1, 8, and 15 of the treatment. The research showed that in the study group 21% achieved a 50% reduction in the PASI score (PASI 50) and in the control group, about 17% (Table 6) [117].