The Skin Benefits of Apple Cider Vinegar (ACV)

Can Using Apple Cider Vinegar Help Improve Your Complexion?

For many people, one immediate question is whether it’s beneficial to put apple cider vinegar right on your face and skin. And while a study noted that ACV may offer antifungal and antibacterial properties, 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 skin-care benefits of ACV (topically or orally), and it can be harmful,” she says. But she adds that it can help skin conditions if used cautiously and with supervision from a 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 like acne, rosacea, and chronic scalp rashes such as seborrheic dermatitis 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, says Abigail H. Waldman, MD, a dermatologist at Brigham and Women’s Hospital in Boston. “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.

RELATED: The Best Natural Remedies to Add to Your Anti-Acne Skincare Routine

Diluting Apple Cider Vinegar Is Key to Using It Safely

When it comes to using apple cider vinegar in a skin-care routine, experts do not recommend applying pure ACV to your skin, as the acids in it may cause chemical burns and irritation, according to case reports.

“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,” says Patricia Farris, MD, a dermatologist in Metairie, Louisiana, and a clinical associate professor at the Tulane University School of Medicine in New Orleans. “I advise patients against using this particular home remedy for this reason.”

For skin infections, Dr. 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.”

RELATED: Can Apple Cider Vinegar Alleviate Ulcerative Colitis Symptoms?

How Apple Cider Vinegar May Help Treat Skin Conditions

Experts have mixed opinions on the use of apple cider vinegar for skin conditions. Anecdotally, they’ve heard of both successes and bad reactions. Waldman doesn’t recommend that her patients use ACV, but she 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 be-all and end-all of products,” she says.

If you do use diluted apple cider vinegar for your skin, 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 soaps 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 ACV 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, Dr. Piliang says.

Acne

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 a similar 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 anti-acne washes or 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.

RELATED: What to Know Before Undergoing Laser Resurfacing for Better Skin

Eczema or Psoriasis

If you have psoriasis or eczema, you should be very careful about using ACV, because if you put apple cider vinegar on areas of your face or skin that are already 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.

RELATED: 10 Treatments to Soothe Psoriasis

Rosacea

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,” she says. “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.

Skin Infections

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 the nails, also known as chloronychia.

When evaluating skin-care products that contain apple cider vinegar, Waldman warns that you may not 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 skin-care treatment for specific conditions, it is currently being explored as a potential aid for skin and cosmetic benefits in clinical settings. A study suggested 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.

RELATED: Top 10 Tips for Healthy Winter Skin

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, 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.”