From avocado facials to honey scrubs, reaching into your kitchen cabinet in hopes of attaining clearer, smoother skin is nothing new. But does apple cider vinegar (ACV), another superfood ingredient, deserve a spot on your bathroom vanity?
If you’ve considered using this pantry staple to help treat acne or another skin condition such as eczema, psoriasis, or rosacea, that isn’t surprising. The popularity of ACV has only grown in recent years, thanks to its reputation for healing common infections and wounds, or lowering blood sugar in people with type 2 diabetes, as some research shows. You should know that all those benefits haven’t been proved; long-term randomized controlled trials on the potential effects of ACV in humans are lacking, notes Harvard Medical School. (And, as UChicago Medicine points out, despite what you may have read online, ACV won’t cure cancer.)
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When it comes to helping you achieve a healthier complexion, some of the components in ACV may help, but experts are cautious about the ingredient’s use orally or infused in beauty products. Below we explore the possible benefits and risks.
What’s in Apple Cider Vinegar That May Offer Health Benefits?
“Apple cider vinegar is the new ‘it’ girl,” says Patricia Farris, MD, a clinical associate professor at the Tulane University School of Medicine in New Orleans and a founder of Sanova Dermatology in Metairie, Louisiana. The vinegar, Dr. Farris says, is “being touted for medical benefits including controlling blood sugar, weight loss, and lowering blood pressure.”
Farris adds that vinegar has polyphenolic antioxidants, which may offer health benefits. ACV is high in pectin, a polysaccharide that occurs naturally in apples and may play a role in improving the skin’s barrier, according to a study published in January 2014 in Biomolecules & Therapeutics.
While human research on the potential benefits of ACV is limited, some people have experienced health benefits from the vinegar. According to UChicago, probiotics, nutrients, and the chemical compound acetic acid are the potentially beneficial parts of this rosy-hued vinegar. In ACV, the probiotic is the “mother” formed from the yeast and bacteria during fermentation. Probiotics are “good” bacteria that are also in foods such as yogurt, sauerkraut, and kimchi, according to the Mayo Clinic.
Still, not just any bottle of ACV will boost your gut health. Abigail Waldman, MD, a dermatologist at Brigham and Women’s Hospital in Boston, says that most ACV has the bacteria filtered out of it. And even when you can buy unfiltered or unpasteurized ACV that contains bacteria, there’s no guarantee that these bacteria contribute to healthy gut flora the way the aforementioned fermented foods might.
“ACV, like most fruits and vegetables, may serve as a prebiotic, providing the food for your gut flora to consume,” says Dr. Waldman, who is also an instructor of dermatology at Harvard Medical School.
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How May Using Apple Cider Vinegar Help Improve Your Complexion?
A study published December 2017 in Natural Product Research suggests that ACV offers antifungal and antibacterial properties, but the research on how it may affect your complexion is lacking, says Melissa Piliang, MD, a dermatologist at the Cleveland Clinic. “There is really no good scientific evidence proving the [skincare] benefits of ACV [topically or orally], and it can be harmful,” she says, adding that it can help skin conditions if used cautiously and with supervision from a board-certified dermatologist.
There are a few things in ACV that may boost the appearance and health of your skin.
Acetic acid Research has shown this acid is antifungal and antimicrobial. When used topically, it clears bacteria that may be related to either infections or skin conditions such as acne, rosacea, seborrheic dermatitis (scalp eczema), and eczema.
Citric acid This is an alpha hydroxy acid (AHA). AHAs are used to increase skin cell turnover, and have been shown to decrease wrinkles and age spots.
Acetic acid and citric acid are found in higher levels in ACV, but they are also found in other types of vinegar. White vinegar probably works as well for skin conditions as ACV does, Waldman says. “Doctors have been using vinegar soaks forever. The theory is that ACV has more citric acid, which might be where the hype is coming from, but a lot of the effects are overblown,” she says.
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Can Drinking Apple Cider Vinegar Improve Your Health?
Drinking ACV has become popular as a way to improve gut health, but Dr. Piliang says that this benefit isn’t a sure thing. “Data suggests it, but we’re a ways from saying it will magically change your microbiome in a positive way. There are so many factors in what is in your microbiome and your gut,” she says.
So if you want to try it, manage your expectations. Farris recommends diluting it in water (1 tablespoon per cup of water) and drinking it as part of your daily routine.
To help mask the taste of ACV, a cup of tea, juice, or other nonalcoholic beverage can substitute for water for a flavorful alternative. The important thing is to avoid drinking ACV by itself, because in its pure form it has been associated with burns to the mouth and esophagus, and it can eat away at tooth enamel, according to a Dutch study published in December 2012.
Piliang says she’s seen reports of people having inflamed mucosa in their mouth, stomach, and esophagus from drinking ACV. “A tablespoon in a glass of water once a day is probably not going to do anything bad or good, but some people take things to the extreme,” she says.
Neither Waldman nor Piliang has heard of patients drinking ACV and successfully treating a skin condition.
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Diluting Apple Cider Vinegar Is Key to Using It Safely
While Farris notes the potential benefits of consuming diluted ACV orally, she does not recommend applying pure ACV to your skin, as the acids in it may cause chemical burns and irritation, according to a June 2015 article in the Journal of Clinical and Aesthetic Dermatology. “Putting it on the skin straight up is highly irritating, and I have seen many patients who have irritated and burned their skin by repeated use of apple cider vinegar. I advise patients against using this particular home remedy for this reason.”
For skin infections, Waldman advises making a dilution of 1 tablespoon of ACV per 1 cup of water. There’s a wide range of recommended concentrations, but it’s generally advisable to start there and see how much you can tolerate.
“The higher the concentration, the more likely it’s going to irritate your skin,” Waldman says. “But it probably also works better because of the higher levels of acetic and citric acid. It’s a balance. You never want to use ACV in its concentrated form.”
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How Apple Cider Vinegar May Help Treat Skin Conditions
Experts have mixed opinions on the use of ACV as a treatment for skin conditions. Anecdotally, they’ve heard both of successes and bad reactions. Waldman doesn’t recommend that her patients use ACV but doesn’t dissuade those who are using it successfully. “If you have a mild condition, it might help, but for more severe cases, it’s probably not going to be the end all, be all of products,” she says.
Some basics to keep in mind: Your skin has an outer layer, the epidermis. “That layer is essentially like a brick wall. When you pull it apart, water gets out and irritants can come in,” Waldman says. “A lot of face washes, toners, and bar soap are just too harsh and strip that layer.”
The pH of skin is slightly acidic, and so is ACV, so if you have dry skin, you can generally use it without stripping the epidermis. You want to keep everything where it belongs — the lipid layer in place, to keep the irritants from penetrating into the skin, Piliang says.
Acne forms when keratin, the main protein in your skin, builds up in a pore and forms a plug (a blackhead or a whitehead). AHAs, like citric acid, dissolve the keratin so the pore can open up and drain, and it helps make pores appear smaller and improve the appearance of acne. Retinoids and benzoyl peroxide have the same effect.
“We know that breaking down keratin can help acne, and ACV does contain AHAs, so the potential is there, but there just aren’t good studies to show that,” Piliang says.
If you already use an anti-acne wash or acne treatments, those tend to be irritating to the skin, causing dryness and peeling, and you could be stripping the epidermis if you add ACV to your routine.
“It defeats the purpose when you let all the water out and everything outside — chemicals in the air, irritants, bacteria — in,” Waldman says. “Everyone is a little different, and oily skin probably has a higher tolerance for applying more acidic products. Sensitive, dry skin, has a much lower threshold. There isn’t a one-size-fits-all recommendation.”
For teens with oily skin and acne, using ACV is less risky because their skin is more resistant to irritation. The oil protects the outer layer of skin, and it comes back faster in a younger person than an older adult with drier skin, Piliang says.
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Eczema or Psoriasis
If you have psoriasis or eczema, you should be very careful about using ACV, because if you put it on skin that’s broken down, fissured, or bleeding, it’s going to burn like crazy and be very uncomfortable, Piliang says.
When you have eczema, your skin doesn’t have a good barrier, so it’s vulnerable to bacteria, fungus, and other organisms and you’re at high risk for infection. Using diluted ACV may help get rid of the bacteria, and therefore prevent infection, Waldman says.
Waldman says she’s seen cases where ACV has improved psoriasis, but “mechanically it doesn’t quite make sense.” She has seen that ACV helps with seborrheic dermatitis, when you have a scaly scalp (like with psoriasis), and greasy, thick pink scales on the face. It’s thought to be due to the skin’s reaction to fungus and bacteria, which is why a diluted vinegar soak may help.
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People with rosacea should be very cautious about using ACV, since their skin is already very sensitive and the outer layer is already damaged, Piliang says. Waldman doesn’t recommend using ACV because rosacea is multifactorial and could be a reaction to your normal skin organisms, the sun, spicy food, coffee, and even an irritating cream.
“Rosacea can be inflamed from a lot of irritating conditions, meaning ACV could make it better, but it could very easily make it worse if used inappropriately, meaning if it’s not diluted enough or if the person is just particularly sensitive to any sort of irritant on their skin,” she says.
Waldman has seen patients successfully use vinegar soaks for chronic or acute local skin infections such as fungal infections like athlete’s foot and paronychia (infection around the fingernails). Vinegar soaks are particularly effective for treating toenail infections caused by a type of bacteria called pseudomonas, according to the American Osteopathic College of Dermatology. This type of toenail infection comes with greenish discoloration of thenails, also known as chloronychia.
“That’s where I see ACV being used in the most effective way,” she says. “I have had acne patients who swear by ACV applied as a toner after they wash their face. It’s not something I would generally prescribe, but certainly in that population, they say it works well.”
If you’re looking at skin-care products that contain ACV, Waldman warns that you don’t know the concentration of ACV you’re getting. Instead, look for products with acetic acid, citric acid or other AHAs, or make your own toner with 1 tablespoon of organic ACV in 1 cup of water. “Otherwise you’re probably just paying for labeling,” she says.
Though medical research doesn’t yet support using apple cider vinegar as an external treatment to treat skin conditions, it is currently being explored as a potential treatment for skin and cosmetic benefits in clinical settings. A study published in January 2016 in Evidence-Based Complementary and Alternative Medicine suggests that a topical application of apple cider vinegar may improve the impact of treatments of varicose veins in terms of both pain levels and cosmetic appearance.
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How to Tell if Apple Cider Vinegar Isn’t Helping Your Skin Condition
While it’s generally deemed safe to ingest diluted ACV or apply it to your skin, when it comes to your skin, don’t overdo it, or else you’ll risk irritating your skin. If you’ve been struggling with a skin issue for a while and are using ACV in your skin-care routine, Waldman recommends going to see your primary care physician or a dermatologist.
It’s possible that ACV may be helping you, but it could be masking another condition. She’s had patients come in who think they have acne, but actually have rosacea, and patients who thought they had brown spots but had very early melanomas.
“I know everyone wants an alternative treatment, but sometimes you do need to seek medical care for things that aren’t going away,” she says. “An outside, expert opinion can at least reassure you that everything is normal or if you need to seek other input.”
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