Bathing in a 0.5% apple cider vinegar solution isn’t a useful treatment for atopic dermatitis, and it can be irritating to the skin, researchers report in a study published in the September/October issue of Pediatric Dermatology.
Skin barrier dysfunction in people with atopic dermatitis, or eczema, often results in high transepidermal water loss, alkaline skin pH and Staphylococcus aureus colonization. Topical apple cider vinegar is a popular, emerging option that patients and parents think is safer or more natural than prescriptions like topical steroids. And while there is some evidence that dilute apple cider vinegar might improve skin barrier integrity in atopic dermatitis, there isn’t strong safety and efficacy data to support its use in atopic dermatitis, according to the paper.
Researchers studied 11 atopic dermatitis patients and 11 healthy controls. Subjects who were 12 years and older and included Caucasians, African Americans and Asians with mild-to-severe disease soaked both forearms ten minutes each day for 14 days. One forearm was soaked in 0.5% acetic acid, or apple cider vinegar, and the other in water. Researchers measured transepidermal water loss and skin pH on day one before, and up to one hour after the first soak and 24 hours after completing the two weeks of daily soaks.
Researchers found transepidermal water loss increased and pH decreased right after apple cider vinegar treatment, but those effects were not evident at 60 minutes post treatment. More than 70% of subjects — 16 of the 22 — reported mostly mild side effects from apple cider vinegar soaks. The side effects, including forearm skin discomfort and, in one patient, severe pruritus, improved after patients discontinued the soaks.
The study suggests several things to dermatologists who recommend or are thinking about recommending apple cider vinegar to their atopic dermatitis patients, as well as to patients who might be considering it as a treatment option, according to study author Richard H. Flowers, M.D., assistant professor of Dermatology at the University of Virginia in Charlottesville, Va.
Luu, LA, Flowers, RH, Kellams, AL, et al. Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity. Pediatr Dermatol. 2019; 36: 634– 639. https://doi.org/10.1111/pde.13888