According to different internet sources, apple cider vinegar is being touted as an ancient remedy that has stood the test of time. Some say it’s a “golden nectar” that’s as close to a cure-all as you can get. It’s only reasonable that, as documented by glowing user reports, it can also treat acne.
But is apple cider vinegar (ACV) really the panacea it’s being promoted as?
In this post, we’ll examine what, if any, health benefits you can expect to receive from drinking ACV as well as applying it topically. Many people swear by ACV, saying that it really cleared their skin of acne. However, others say they got burned while trying it. Let take a deeper look at ACV and see what the science says about it.
Does apple cider vinegar help with acne?
Many of the purported benefits from apple cider vinegar come from either drinking it or applying it topically. However, as we delve into this supposed treatment option, there is not much research or concrete data to back up these claims.
There’s seemingly no end to the health benefits of apple cider vinegar. It’s claimed to be effective for anything, from curing cancer to resolving digestive problems. As such, there are many opinions on the topic.
From what I could find, there are several benefits regarding apple cider vinegar:
- Reduces blood sugar and insulin levels
- Acts as an antibacterial and antiviral agent
- Provides a source of nutrition
- Supports digestive health
- Aids detoxification and bodily toxin removal
- Alkalizes the body and removes excess acids
Let’s take a look at these claims and examine the evidence behind them.
Reduces blood sugar and insulin levels
Insulin is the cornerstone of hormonal acne. It can increase the levels of other hormones linked to acne and make your skin more sensitive to them. If you’ve been following this blog, I’ve written about the importance of reducing insulin levels 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 published study on women with PCOS showed that 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 a 30% decrease in insulin resistance.
In case it’s not clear, a decrease in insulin resistance means the cells respond better to insulin which, in turn, reduces the overall insulin level.
One problem with all these studies is that they are very small with only 8 to 12 participants per study. As far as scientific evidence goes, it may be hard to make strong conclusions based on such small studies.
Furthermore, this blood sugar and insulin lowering effect is not completely exclusive to apple cider vinegar. It applies to every type of vinegar. 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 which 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.
Acts as an antibacterial and antiviral agent
Yes, vinegar is an acid and can kill bacteria and virus. However, most of these antibacterial and antiviral actions were studied in a test tube. Therefore, drinking it might not be a practical way to prevent or cure all infections.
Topically applied, it may treat some infections. But there are still some nuanced points to consider:
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.
Vinegar: Medicinal Uses and Antiglycemic Effect – Medscape General Medicine
Bottom line: Vinegar is an acid which may 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).
Provides a source of nutrition
Apple cider vinegar is claimed to be a rich source of various vitamins and minerals, especially potassium. Yet, nutritional analysis shows the contrary. It’s claimed to be a good source of potassium where 1 tablespoon of ACV gives you 11 milligrams of potassium. If we look more closely, however, that is only 0.2% of the recommended daily intake.
Bottom line: Perhaps apple cider vinegar has other enzymes or nutrients. Some products claim they contain apple cider vinegar that is fortified, or combined with vitamins and minerals. Still, there is not enough scientific data to support its use. The standard nutritional analysis does not show any evidence for exceptional nutrition.
Supports digestive health
Many sources claim ACV is an excellent digestive tonic. It’s not clear where this claim originated as there is no supporting scientific data. Vinegar is an acid, so it’s not completely implausible that drinking it prior to a meal could be helpful for people with low stomach acid. That said, compared to the acids in your stomach, vinegar is a fairly weak acid and may have negligible benefits.
Vinegar is a product of fermentation, much like yogurt. Some sources claim that unfiltered vinegars contain probiotic bacteria. The Vinegar Institute, for example, says that the “Mother of Vinegar” is cellulose produced by acetobacter, an acidic strain of bacteria. One thing to note though is that this strain of bacteria is different from what resides in your gut. In other words, it’s unlikely that they have any probiotic effect.
Some people claim that ACV is a prebiotic, i.e. it supports the growth of healthy bacteria. This may be true, but apples are prebiotic sources in and of themselves. Eating one apple may actually provide more prebiotics than ACV.
Bottom line: Without reliable data, it’s hard to say whether apple cider vinegar has any effect on digestion.
Aids detoxification and bodily toxin removal
To preface this section, anytime you see claims like ‘detoxifies your body’, it’s important to differentiate between fact and fiction.
Many alt-med proponents believe that we are continually polluting our bodies with unhealthy lifestyles. Their solution is to buy detox kits and follow certain detox protocols.
It’s true that many people eat poorly, especially with processed foods that contain substances which are harmful to health. However, aside from healthy diet and lifestyle, there’s no evidence to support additional detoxification therapies nor does your body need any detoxification support. Science-Based Life has an interesting article looking at how detoxification may be a hoax.
Bottom line: There is no conclusive evidence to show that ACV exhibits detoxification properties or that detoxification is beneficial for overall health.
Alkalizes the body and removes excess acids
Some people claim that unhealthy diet and lifestyle cause acidosis – a buildup of acids in the body. It is believed that acids reduce the pH of your blood which may be harmful as it encourages bacterial growth. Further claims suggest that ACV reduces acid build up in the body and makes it more alkaline. How it does this is never entirely explained.
Bottom line: This acid-alkaline theory of disease contains flaws with limited supporting evidence. The American Institute for Cancer Research goes so far as to say it’s “in stark contrast to everything we know about the chemistry of the human body”.
Does drinking apple cider vinegar help with acne?
There is no concrete evidence to show that drinking apple cider vinegar has any real health benefits. Vinegars, in general, may be somewhat helpful in maintaining blood sugar and insulin levels. However, there is also a lack of evidence behind these claims. Many of the claimed benefits are anecdotal or reported from small sample studies.
Apple cider vinegar toner for acne
Some people like to use apple cider vinegar as a toner instead of drinking it. It has been recommended by big Hollywood stars, such as Scarlett Johansson and Hilary Duff, who swear by it. Proponents claim that wiping your face with diluted ACV is almost guaranteed to get rid of acne.
In contrast to drinking, there may be some 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, there is not enough evidence to consider it a treatment of choice. Although acetic acid, found in ACV, is classified as a weak acid, it is still too strong to be used on the skin.
How to dilute ACV for topical use
According to the University of Washington, Department of Chemistry, vinegar is ~5% acetic acid solution which is ~0.9 M. This means that its pH is approximately 2.4, almost the same as that of the stomach acid.
Most brands of apple cider vinegar in the market have a pH in the range of – 2 to 3. Therefore, it is critically important to dilute it before applying on the skin. Otherwise, it can cause severe irritation and burns at the site of application.
The following table gives a rough idea of how dilution will affect pH. Because the normal skin pH is below 5, even 1:4 dilution can cause problems in some individuals. If you have sensitive skin, consider diluting more.
Is it safe to use apple cider vinegar as an acne treatment?
As I have mentioned, ACV is a fairly strong acid and using it is not without risks.
Chemical burns from topical application of apple cider vinegar
Interestingly, if you search for medical literature on apple cider vinegar, one of the first things you’ll find are case reports of chemical burn injuries following topical application of ACV. Some of the case reports are as follows:
- A 25-day-old infant developed burn injuries when his grandmother applied ACV on his chest in an effort to bring down fever.
- An 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 14-year-old girl presented with two erosions on her nose after applying ACV to a nevi, or mole, to remove it. It was applied daily and covered with a bandage for three consecutive days.
- A 59-year-old woman twisted her ankle while hiking. She treated it with a homemade 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.
Here’s a picture of skin wounds after applying ACV to the nose per an internet-based protocol for nevi removal.
And here’s the grisly damage the 59-year old woman inflicted on herself.
Now, it must be said that, in all of these cases, the acid was in contact with the skin for quite a while, or between 2 and 8 hours. It’s highly unlikely that a short contact time of 5 to 20 seconds causes any harm. However, caution is advised.
Please don’t do what some articles and videos suggest – leave the vinegar on your skin overnight.
Esophageal injury from apple cider vinegar supplements
Another case study reported esophageal injury (the tube connecting your mouth to your stomach) following ingestion of apple cider vinegar capsules. Scientists tested various ACV capsules and found that the pH-values ranged from 2.9 to 5.7. In fact, most capsules had miniscule amounts of ACV and were mostly just citric acid.
This is one reason oral supplements may not be the best option. Because of lax regulations, you, as a consumer, have no way of truly knowing what’s inside the supplement.
Dental erosion from drinking apple cider vinegar
A 15-year old Moroccan girl suffered bad dental erosion after using apple cider vinegar. She reported hearing about potential benefits for weight loss. Her routine consisted of a glass of apple cider vinegar mixed with water every day.
There’s no substantial evidence to support some of the extensive health claims made for apple cider vinegar. After all, it is primarily known as a food ingredient, not a medicine. 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, again, there’s no strong evidence to support this claim.
Used topically, it may help to keep the skin pores open and control acne-causing bacteria. However, it should never be put directly on the skin. If used topically, it needs to be diluted first before being used as a spot treatment only.
Due to individual skin characteristics, everyone may react differently to ACV. Those with sensitive skin may need to take extra precautions when applying ACV. It is best to try it out on a smaller area, such as parts of the neck or on the earlobe. When applying ACV, it should never be left on for too long, especially overnight as some online sources suggest.
Overall, it’s always possible that apple cider vinegar works through some yet unknown mechanism. But based on current evidence, it’s difficult to completely recommend ACV as a sole treatment for different ailments and acne.
What is your experience with ACV? Have you tried it? If so, how did it go?