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Apple Cider Vinegar

John Montgomery4 min read

Apple Cider Vinegar

Apple cider vinegar (ACV) is fermented apple juice containing acetic acid. It is used diluted as a bath, a forearm soak or a spray. The rationale is the Skin pH story: eczema skin tends to be less acidic, which favours Staphylococcus aureus and weakens the barrier. An acid rinse is supposed to restore the “acid mantle”, repair Skin Barrier Dysfunction and cut staph. Its University of Virginia investigators note that acetic acid, “particularly apple cider vinegar, is prominent among emerging natural remedies used in AD”. Patients and parents often see it as safer or more natural than Topical Corticosteroids (Dermatology Times 2019).

Apple Cider Vinegar [relates] Skin pH Apple Cider Vinegar [relates] Staphylococcus aureus Apple Cider Vinegar [part-of] Herbal and Home Remedies for Eczema

Evidence — skin barrier (Luu, Pediatr Dermatol 2019). Eleven people with eczema and 11 healthy controls, all aged 12 or older, soaked one forearm in 0.5% ACV and the other in tap water for 10 minutes daily for 14 days. Skin pH dropped after the vinegar soak, but only for about 15 minutes in eczema skin. Transepidermal Water Loss actually rose straight after soaking and was back to baseline within 30–60 minutes. There was no lasting improvement in barrier function. The authors concluded that acidification “by way of topical bathing in a 0.5% [ACV] solution… is not useful in AD treatment”.

Apple Cider Vinegar [worsens] Transepidermal Water Loss Apple Cider Vinegar [relates] Skin Barrier Dysfunction

Evidence — microbiome (Luu, PLoS One 2021). In the same split-arm design, daily 0.5% ACV soaks did not change the skin bacterial microbiome or S. aureus abundance compared with water (p=0.60 for S. aureus). The antibacterial claim is not supported on living skin. The same clinicians use dilute Bleach Baths, which have more data, far more often than ACV (Flowers, Dermatology Times).

Apple Cider Vinegar [relates] Skin Microbiome Apple Cider Vinegar [relates] Bleach Baths

Toddler safety. In the 2019 study, 16 of 22 participants (72.7%) had skin discomfort on the vinegar arm, mostly mild. One had severe itch. It settled after stopping. “We often consider natural treatments as harmless, but our study showed that this may not necessarily be true” (Flowers). Case reports document chemical burns from topical vinegar. These include a JAAD report of a burn from topical ACV (Bunick 2012), an adolescent following an internet mole-removal protocol (Feldstein 2015), and a newborn burned by vinegar applied to bring down a fever (Korkmaz 2000). Toddler skin is thinner, eczema skin is broken, and stronger home dilutions are common online, so the risk is likely higher than in the adult and teen studies. No trial has included children under 12.

Acid on broken toddler skin

Vinegar stings and can burn eroded or weeping eczema. Undiluted or strong home mixes have caused chemical burns, including in a newborn. ACV is not a substitute for prescribed treatment of Infected Eczema. Do not give ACV by mouth to toddlers as an eczema “cleanse”.

Apple Cider Vinegar [worsens] Itch-Scratch Cycle Apple Cider Vinegar [relates] Infected Eczema

What parents report (evidence: anecdotal). On r/eczema, adults post that diluted ACV sprays or soaks “decreased [itch] MAJORLY” or cleared patches. Some report a dry, worse-looking skin phase first, and others say ACV soaks “nothing really worked”. No toddler success stories turned up in the search. A Facebook “natural healing” group advised ACV baths for a 6-month-old with weeping facial eczema. One parent described a TikTok regimen for a 2-year-old that included ACV by mouth, a “parasite cleanse”, activated charcoal and shilajit. Usernames were removed from the saved sources.

Apple Cider Vinegar [relates] Manuka Honey

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