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Apple Cider Vinegar Baths

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Abstract

Nursing care and patient education are integral to compliance with dermatologic medical treatments. This column has been developed in partnership with caring nurses dedicated to optimizing patient care through practicum-based education and treatment. This article focuses on apple cider vinegar baths for atopic dermatitis.

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... 7,8 Acetic acid, particularly apple cider vinegar (ACV), is prominent among emerging natural remedies used by patients who seek therapies perceived as "safer" and "more natural" than prescriptions such as topical steroids. 9 Patients currently use ACV for skin infections and other maladies ranging from common warts to AD. 8,10 Even some dermatologists have recently started recommending ACV baths for AD. 9 ACV soaks are theoretically appealing given their antimicrobial activity and potential to acidify the skin. 11,12 However, little is known about the efficacy or safety of ACV on skin in AD, and reports of positive effects are often anecdotal. ...
... 9 Patients currently use ACV for skin infections and other maladies ranging from common warts to AD. 8,10 Even some dermatologists have recently started recommending ACV baths for AD. 9 ACV soaks are theoretically appealing given their antimicrobial activity and potential to acidify the skin. 11,12 However, little is known about the efficacy or safety of ACV on skin in AD, and reports of positive effects are often anecdotal. ...
... The concentration is notably nearly 10-fold above the 1:80 (0.06% acetic acid) ACV bath preparations recently recommended by Lee and Jacobs. 9 Other literature reports that concen- In conclusion, acetic acid, particularly apple cider vinegar, is prominent among emerging natural remedies used in AD. 9 Therefore, determining the safety of this commonly used product is crucial. This study used skin TEWL and pH in addition to reports of skin discomfort to evaluate the safety and efficacy of ACV for treating AD. ...
Article
Background/objectives: Atopic dermatitis (AD) is a common chronic inflammatory skin condition associated with high transepidermal water loss, high skin pH, and Staphylococcus aureus skin colonization. The treatment of AD with bath additives remains highly debated. Recent evidence suggests that dilute apple cider vinegar (ACV) may improve skin barrier integrity in AD, but its safety and efficacy are not well studied. This pilot split-arm study analyzed the effect of dilute apple cider vinegar soaks on skin barrier integrity in patients with atopic dermatitis as measured by skin transepidermal water loss and skin pH. Methods: A total of 22 subjects (11 AD and 11 healthy controls) were enrolled. Subjects soaked both of their forearms for 14 days, with one arm in dilute ACV (0.5% acetic acid) and the other in water 10 minutes daily. Transepidermal water loss and pH were measured pre- and post-treatment. Results: In both groups, transepidermal water loss increased and pH decreased at 0 minutes post-ACV treatment, but these effects were not sustained at 60 minutes. In total, 72.7% (16/22) of subjects reported mild side effects from ACV with improvement after discontinuing the soaks. Conclusions: Dilute ACV soaks have no significant effect on skin barrier integrity but caused skin irritation in a majority of subjects. Study limitations include analysis of a single brand, dilution, and application of ACV. Future studies are needed to explore whether lower concentrations of ACV soaks or other applications such as a leave-on acidic ointment could improve skin barrier integrity in a safe, nonirritating way.
... The concentration we chose of 0.5% AA is nearly 10-fold above the 1:80 (0.06% AA) ACV bath preparations recently recommended by Lee and Jacobs [53]. 0.5% AA is comparable to the MIC of 0.312% AA against methicillin-sensitive S. aureus (MSSA) and 0.625% AA against methicillin-resistant S. aureus (MRSA) [32]. ...
... In conclusion, apple cider vinegar is prominent among emerging natural remedies used in AD in spite of sparse evidence [53]. Our results show that even though daily soaks in 0.5% ACV do not change skin bacterial microbiomes significantly compared to water and are not likely a useful agent to affect skin-colonizing S. aureus, they may cause AD skin microbiome to become more similar to controls. ...
Article
Full-text available
Introduction Atopic dermatitis is a common skin disease characterized by altered cutaneous immunity in which patients often exhibit lower skin microbiota diversity compared to healthy skin and are prone to colonization by Staphylococcus aureus . Apple cider vinegar has been shown to have antibacterial effects; however, its effects on the skin microbiome have not previously been well-described. Objectives We aimed to examine the effects of topical dilute apple cider vinegar soaks on Staphylococcus aureus abundance, skin bacterial microbiome composition, and skin bacterial microbiome diversity in atopic dermatitis participants compared to healthy skin. Methods Eleven subjects with atopic dermatitis and 11 healthy controls were enrolled in this randomized, non-blinded, single-institution, split-arm pilot study. Subjects soaked one forearm in dilute apple cider vinegar (0.5% acetic acid) and the other forearm in tap water for 10 minutes daily. Skin bacteria samples were collected from subjects’ volar forearms before and after 14 days of treatment. 16S sequencing was used to analyze Staphylococcus aureus abundance and skin bacterial microbiome composition, and alpha diversity of microbiota were determined using Shannon diversity index. Results There was no difference in skin bacterial microbiome in atopic dermatitis subjects after 2 weeks of daily water or apple cider vinegar treatments (p = 0.056 and p = 0.22, respectively), or in mean abundance of S . aureus on apple cider vinegar-treated forearms (p = 0.60). At 2 weeks, the skin bacterial microbiomes of healthy control subjects were not significantly different from the skin bacterial microbiome of atopic dermatitis subjects (p = 0.14, 0.21, 0.12, and 0.05). Conclusions Our results suggest that daily soaks in 0.5% apple cider vinegar are not an effective method of altering the skin bacterial microbiome in atopic dermatitis. Further studies are needed to explore the effects of different concentrations of apple cider vinegar on skin microflora and disease severity. Trial number UVA IRB-HSR #19906.
... • The expansion of the apple market through the production of value-added, specialty products such as hard ciders (Becot et al., 2016). • The study of the health benefits of cider and cider vinegars, including effects on: (1) weight management, visceral adiposity index, and lipid profile (Khezri et al., 2018), (2) melanocytic nevus (Ashchyan et al., 2018), (3) oxidative stress (Halima et al., 2018), (4) hypoglycemic and hypolipidemic effects (Halima et al., 2018), and (5) atopic dermatitis (Lee and Jacob, 2018). • The role of pectin and haze particles in membrane fouling, for the development of efficient, commercially viable, cold microfiltration processes for apple cider. ...
Chapter
Cider vinegar or apple cider vinegar is the vinegar produced by the acetous fermentation of apple cider, according to the Codex Alimentarius. In other words, the primal raw material is apple juice or concentrated apple juice that undergoes alcoholic fermentation, and after that, the produced cider is subjected to a fermentation with acetic acid bacteria, for the final production of the vinegar. Cider vinegar is consumed and produced in several countries around the world, mainly in the United States of America, the United Kingdom, and Switzerland.
Article
Full-text available
Atopic dermatitis is a form of dermatitis commonly seen in children and adults. Its pathophysiology is complex and is centered on the barrier function of the epidermis. An important aspect of the skin's barrier is pH, which in turn affects a number of parameters such as the skin flora, protease function, and mediators of inflammation and pruritus. Normal pH for non-neonatal skin is acidic and ranges from 4 to 6. Skin pH in atopic dermatitis patients is often increased into the neutral to basic range, and the resulting cascade of changes contributes to the phenotype of atopic dermatitis. Therefore, the maintenance of normal skin pH remains an important topic in understanding and treating atopic dermatitis. This article will review skin pH and its impact on normal barrier function, pathological pH changes in atopic dermatitis, and the therapeutic considerations related to restoring and maintaining pH balance.
Bleach or vinegar: A recipe for eczema
  • Cheryl Lee
Cheryl Lee, M. D. (2015). Bleach or vinegar: A recipe for eczema [online].
The authors declare no conflict of interest. Correspondence concerning this article should be addressed to Sharon E
  • W Kun
  • B A Lee
  • Affairs Veterans
  • Loma Hospital
  • C A Linda
  • E Sharon
  • Jacob
Kun W. Lee, BA, Veterans Affairs Hospital, Loma Linda, CA. Sharon E. Jacob, MD, Department of Dermatology, Loma Linda University, Loma Linda, CA. The authors declare no conflict of interest. Correspondence concerning this article should be addressed to Sharon E. Jacob, MD, Department of Dermatology, Loma Linda University,