It is generally stated that drinking plenty of water has a positive influence on skin condition. However, there is no published scientific study that has investigated this matter. The aim of our exploratory 'before-after' study was to evaluate the in vivo influence of drinking more than 2 L of mineral water or ordinary tap water per day on skin physiology. Ninety-three healthy subjects were included in our prospective study. After an initial run-in phase of 2 weeks to monitor individual drinking habits, subjects had to drink 2.25 L day(-1) of either mineral water (n = 53) or tap water (n = 40) for 4 weeks. Bioengineering in vivo measurements on the volar forearm included sonographic evaluation of skin thickness and density, determination of skin surface pH, assessment of skin surface morphology, and measurement of finger circumference. Eighty-six subjects completed the study. In the mineral water group measurements revealed a statistically significant decrease in skin density. Skin thickness increased slightly, albeit not at a statistically significant level. However, when separately analysing those individuals from the mineral water group, who had routinely drunken comparably little before the start of the study, their skin thickness increased at a statistically significant level. Skin surface pH remained almost unchanged in the physiologically optimal range. In the tap water group, skin density increased significantly, while skin thickness decreased significantly. Skin surface pH decreased at a statistically significant level. While in the mineral water group finger circumference decreased significantly, measurements in the tap water group revealed a statistically significant increase. Objective skin surface morphology did not change in any group. In summary, drinking more than 2 L of water per day can have a significant impact on skin physiology. The exact effects within the skin seem to differ depending on the nature of the water ingested. Randomized, controlled, double-blind follow-up trials are warranted to confirm the findings of our exploratory pilot study.