In the dark corners of the Internet apple cider vinegar is touted as an ancient remedy that has stood the test of time, golden nectar that’s as close to cure-all as you can get. Of course it can also cure acne, as documented by glowing user reports.
But is apple cider vinegar (ACV) such a panacea as it’s touted out to be? You know what they say about things that sound too good to be true…
In this post I try to live up to my reputation as the Myth Buster of the acne world and take a critical look at ACV. We’ll examine what, if any, health benefits you can expect from drinking it, and we’ll look at the possibility of using it topically.
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The mother of all cure-alls?
There’s seemingly no end to the health benefits of apple cider vinegar. It’s claimed to be effective in anything from curing cancer to resolving digestive problems. But I was never able to find any coherent discussion on how or why ACV could accomplish all this, not that evidence and logic has ever been the strong points of alternative medicine.
From what I could find, here are some reasons for the claimed health benefits of apple cider vinegar:
- Aids detoxification and gets rid of ‘toxins’ from your body
- Anti-bacterial and anti-viral
- Reduces insulin and blood sugar levels
- Supports digestions
- Nutritional powerhouse
- ‘Alkalizes’ your body and gets rid of excess acids
Let’s do something you won’t find from most other sites. Instead of blindly parroting these claims, let’s look at them with a critical eye. Let’s look at the evidence supporting them and whether these claims are even biologically plausible.
Reduces blood sugar and insulin levels
Insulin is the cornerstone in hormonal acne. It can increase the levels of other hormones linked to acne and make your skin more sensitive to them. That’s why I’ve written about the importance of reducing insulin so many times.
This is one of the more plausible claims made for apple cider vinegar. A handful of small studies have shown that vinegar indeed reduces post-meal blood sugar and insulin levels. A recently published study on women with PCOS showed daily ingestion of vinegar reduced insulin resistance and improved hormonal profile. In this study the women had 1 tablespoon of apple vinegar every day for 90 days. The effect on insulin resistance was quite small and didn’t reach statistical significance. Another study on diabetic patients showed 30% decrease in insulin resistance.
Oh, in case it’s not clear, decrease in insulin resistance means the cells respond better to insulin and this reduces overall insulin level.
The problem with all these studies is that they are very small, only 8 to 12 participants per study. As far as scientific evidence goes, this is very weak and you can’t make strong conclusions based on such small studies.
Furthermore, this blood sugar and insulin lowering effect is in no way limited to apple cider vinegar. IT applies to every type of vinegar. It seems acetic acid (the acid found in vinegar) can slow stomach emptying and interfere with enzymes that digest carbohydrates. As a result, carbohydrates eaten with vinegar enter the bloodstream more slowly and this reduces blood sugar and insulin spikes.
Bottom line: Vinegar may have mildly positive effect on blood sugar and insulin levels, but the effect is fairly small and applies to all forms of vinegar.
Anti-bacterial and anti-viral
Yes, vinegar is an acid and can kill bacteria and virus. But just because it can kill bacteria and virus in a test tube doesn’t mean drinking it would be helpful in preventing or curing infections.
Topically applied it can treat some infections, but it seems anything but a miracle cure:
Although investigations have demonstrated the effectiveness of diluted vinegar (2% acetic acid solution at pH 2) for the treatment of ear infections (otitis externa, otitis media, and granular myringitis),[17,18] the low pH of these solutions may irritate inflamed skin and damage cochlear outer hair cells.
In the popular media, vinegar is commonly recommended for treating nail fungus, head lice, and warts, yet scientific support for these treatment strategies is lacking. Takano-Lee and colleagues demonstrated that, of 7 home remedies tested, vinegar was the least effective for eliminating lice or inhibiting the hatching of eggs. Scattered reports suggest that the successive topical application of highly concentrated acetic acid solutions (up to 99%) alleviated warts,[25,26] presumably due to the mechanical destruction of wart tissue.
So yes, due to the fact that vinegar is an acid it can clear some topical infections, but it can also cause skin irritation, and even severe damage if not used properly (see the section on chemical burns below).
Apple cider vinegar is claimed to be a rich source of various vitamins and minerals, especially potassium. Yet, nutritional analysis shows it contains almost no nutrition. It’s claimed to be a good source of potassium, yet 1 tablespoon of ACV gives you only 11mg, a paltry 0.2% of the recommended daily intake.
Perhaps apple cider vinegar has other enzymes or nutrients, but the standard nutritional analysis shows it’s a poor source of just about anything.
Many sources claim ACV is an excellent digestive tonic. I’m not quite clear on where this claim originated as I couldn’t find any supporting scientific data. Vinegar is a fairly strong acid, so it’s not completely implausible that drinking it prior to a meal could be helpful in people with low stomach acid.
Vinegar is a product of bacterial fermentation, much like yogurt. It’s claimed that the ‘mother’ you see in unfiltered vinegars contains probiotic bacteria, though the bacteria are different than what lives in your gut.
Some people claim that ACV is a prebiotic, i.e. it supports the growth of healthy bacteria. This is probably true, but so are the apples the vinegar is made of.
Without reliable data it’s impossible to say whether apple cider vinegar has any effect on digestion.
Outright nonsensical claims
The proponents also make claims that are completely fictional.
Apple cider vinegar aids detoxification
Here’s a simple rule of thumb for you. Anytime you see claims like ‘detoxifies your body’, you can stop reading because what follows is pure fiction.
The alt-med proponents like to make everyone feel guilty by implying we have polluted our bodies with unhealthy lifestyles. The solution is to follow their detox protocols and get their detox kits.
While it’s true that many people eat horrible crap, and processed food contains substances that are harmful to your health, aside from healthy diet and lifestyle, there’s no need to additional detoxification therapies. Nor does your body need any detoxification support. Science-Based Life has a great article looking at The Great “Detox” Hoax.
Alkalizes your body and removes excess acids
People who should spend more time studying and less time writing stupid articles online claim that unhealthy diet and lifestyle causes acidosis – buildup of acids in the body. These acids reduce the pH of your blood and encourage bacterial growth.
Apple cider vinegar is said to alkalize your body, because it just makes perfect sense that adding acid makes things more alkaline.
The whole acid-alkaline theory of disease is just wrong. So badly wrong that the American Institute for Cancer Research says it’s “in stark contrast to everything we know about the chemistry of the human body”.
While proponents of this myth argue that avoiding certain foods and eating others can change the body’s pH level, these claims stand in stark contrast to everything we know about the chemistry of the human body. Acid-base balance is tightly regulated by several mechanisms, among them kidney and respiratory functions. Even slight changes to your body’s pH are life-threatening events.
Internal use summary
What it comes down to is that there’s no good evidence to show that drinking apple cider vinegar has any real health benefits. All vinegars may be somewhat helpful in maintaining blood sugar and insulin levels, but even there the evidence is really weak. I would also suggest using balsamic vinegar instead. Apple cider vinegar is disgusting and it makes you smell, whereas balsamic vinegar combined with olive oil makes for a nice salad dressing.
Apple cider vinegar toner
Some people like to use apple cider vinegar as toner instead of drinking it. They claim that wiping your face with diluted ACV is almost guaranteed to get rid of acne.
In contrast to drinking, I can see the rationale for using ACV topically. As an acid it does have keratolytic effects. It breaks the bonds between dead skin cells and keeps skin pores open. While it has never been tested in humans, it’s possible that topical ACV can control acne-causing bacteria on the skin.
That said it still wouldn’t be my treatment of choice – far from it. Let’s face it, the stuff just stinks. Badly. I wouldn’t want to apply on my face anything that stinks that much, especially since there are many, many, many other treatments that have the same effect. Why not just use some cream with salicylic acid or alpha hydroxy acids (AHA)?
I get it that buying a cream isn’t as appealing as using an ancient folk remedy, but at least with creams you know what you are putting on your face. The problem with ACV is that it’s a fairly strong acid and, if you are stupid about it, can cause chemical burns.
Consequences of being stupid
If there’s one thing that annoys me, it’s the natural fallacy, i.e. it’s natural, and therefore it’s safe. It’s called fallacy because it’s not true. Apple cider vinegar is natural, yet it can cause fairly severe injuries.
Chemical burn from topical application of apple cider vinegar
Interestingly, when I searched the medical literature for apple cider vinegar, the first thing I found were case reports of people getting chemical burn injuries following topical application of ACV. Here are some:
- A 25-days old infant developed burn injuries when his grandmother applied ACV on his chest in an effort to bring down fever.
- 8-year old boy developed burn injuries on his leg after his mother applied cotton balls soaked in apple cider vinegar in an effort to treat a viral infection.
- A 59-year old woman twisted her ankle while hiking. She treated it with a home-made poultice of 50:50 flour and rice vinegar (contains the same acid that ACV) and then applied a bandage over the area. Her feet got serious burn injuries (see the picture below).
Here’s a picture of the burn injury to the leg of the 8-year old boy.
And here’s the grisly damage the 59-year old woman inflicted on herself.
Now, I have to say that in all of these cases the acid was in contact with the skin for quite a while, between 2 and 8 hours. It’s highly unlikely that a short contact of 5 to 20 seconds causes any harm.
Please don’t do what some articles and videos suggest – leave the vinegar on your skin overnight.
Injury from apple cider vinegar supplements
Another case report talks of esophageal injury (the tube connecting your mouth to your stomach) following ingestion of apple cider vinegar capsules. The doctors then tested various ACV capsules and found that the pH-values ranged from 2.9 to 5.7. In fact, most tablets had only little bit of ACV and were mostly just citric acid.
This is one reason I’m not a big fan of supplements. Because of lax regulations you as a consumer have no way to know what’s in the pills.
A 15-year old Moroccan girl suffered bad dental erosion because she had a glass of apple cider vinegar mixed with water every day. She had heard it’s good for weight loss.
Apple cider vinegar is food – not medicine. There’s no good evidence to say it’s good for anything. All vinegars may be somewhat helpful in maintaining blood sugar and insulin levels, but this effect is not specific to apple cider vinegar. ACV might improve digestion, but there’s no evidence to say either way.
Used topically it may help to keep the skin pores open and control acne-causing bacteria. Yet, even here the smell and potential risk of chemical burns makes it a poor choice.
It’s always possible that apple cider vinegar works through some yet unknown mechanism, but based on currently available evidence I wouldn’t use it on anything.
- Vinegar: Medicinal Uses and Antiglycemic Effect.
- Intake of vinegar beverage is associated with restoration of ovulatory function in women with polycystic ovary syndrome.
- Vinegar Improves Insulin Sensitivity to a High-Carbohydrate Meal in Subjects With Insulin Resistance or Type 2 Diabetes.
- Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects.
- Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study.
- Altered profiles of intestinal microbiota and organic acids may be the origin of symptoms in irritable bowel syndrome.
- Unhealthy weight loss. Erosion by apple cider vinegar.
- Chemical burn from topical apple cider vinegar.
- Esophageal Injury by Apple Cider Vinegar Tablets and Subsequent Evaluation of Products.
- Chemical burn caused by topical vinegar application in a newborn infant.
- Chemical burn from acetic acid with deep ulceration.
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