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Acetic acid and the skin: a review of vinegar in dermatology
Abstract
Vinegar is commonly used as a home remedy for many skin problems. It is important for dermatologists to understand the evidence supporting its use in skin disease, as well as potential adverse effects, so they can properly counsel patients on the safe use of this widely available treatment. Vinegar possesses antimicrobial and antioxidant properties that provide utility in wound care as well as bacterial and fungal infections. There is also evidence to support its use in pruritus, head lice removal, and treatment of striae gravidarum. While generally safe, inappropriate use can result in damage to the skin. In this review, we discuss the evidence supporting vinegar as a treatment for skin disease, as well as adverse events reported from misuse, to provide dermatologists the knowledge to counsel patients on the safe and appropriate use of vinegar.
... Bacterial and fungal infections are commonly treated with acetic acid due to the presence of antimicrobial and antioxidant functions. The same goes for its ascendency in treating skin conditions like pruritus and striae gravidarum and removing head lice [75]. ...
... Glucose, fructose, sucrose Moisturisation[60][61][62] Humectant[60][61][62] Biomolecules from Palmyra palm fruit pulp Anti-microbe[75] Topical treatment for pruritus, striae gravidarum, head lice[75] Biomoleculesfrom Palmyra palm syrup Anti-microbe [76] Topical treatment for Escherichia coli, Mycobacterium smegmatis, Staphylococcus simulans [76] Biomolecules from Palmyra palm leaf secretion Anti-microbe [4] Topical treatment for Vibrio mimicus [4] Biomolecules from male flower extract Anti-microbe [70] Topical treatment for Cutibacterium acnes [70] Biomolecules from Palmyra palm sugar Anti-inflammation [42], anti-microbe [71] Topical treatment for methicillin-resistant Staphylococcus aureus [71], prickly heat, boils, redness [42] Biomolecules from toddy Anti-fungal [42] Topical treatment Biomolecules from Palmyra palm extracts Anti-inflammation, wound healing, anti-microbe Topical treatment for Staphylococcus aureus [73], scabies, sores, burns, secondary syphilis, leprosy [27] ...
... Glucose, fructose, sucrose Moisturisation[60][61][62] Humectant[60][61][62] Biomolecules from Palmyra palm fruit pulp Anti-microbe[75] Topical treatment for pruritus, striae gravidarum, head lice[75] Biomoleculesfrom Palmyra palm syrup Anti-microbe [76] Topical treatment for Escherichia coli, Mycobacterium smegmatis, Staphylococcus simulans [76] Biomolecules from Palmyra palm leaf secretion Anti-microbe [4] Topical treatment for Vibrio mimicus [4] Biomolecules from male flower extract Anti-microbe [70] Topical treatment for Cutibacterium acnes [70] Biomolecules from Palmyra palm sugar Anti-inflammation [42], anti-microbe [71] Topical treatment for methicillin-resistant Staphylococcus aureus [71], prickly heat, boils, redness [42] Biomolecules from toddy Anti-fungal [42] Topical treatment Biomolecules from Palmyra palm extracts Anti-inflammation, wound healing, anti-microbe Topical treatment for Staphylococcus aureus [73], scabies, sores, burns, secondary syphilis, leprosy [27] ...
Palmyra palm is a resourceful plant species that can be put to use in superabundance. Its extensive range of use stretches in all directions—making it useful for consumption in countless forms, and the cosmetic industry is not a deviation from this. In accordance with the beneficial molecules generated in it, such as polyphenols, flavonoids, carotenoids and others, the addition of Palmyra raises incentives like reduction and microbe prevention when developed into therapeutic products. Therefore, the virtues of Palmyra fruit, sap, leaves, pulp, bark, haustoria and other parts are being diversely exploited in the beauty and health industry at present. To summarise the compass of Palmyra palm and its products in cosmetology and dermatology, an overview is drafted exploring the extant literature on the topic. Following the description of the available molecules, their adoption into skincare products and in vivo effects was analysed in this study. Aiming to highlight the prospects of Palmyra in skin and personal care formulations, this article discusses the span of its potential in light of its physicochemical attributes.
... Vinegar, aside from its culinary utility, is also renowned for its antimicrobial properties and is produced through a twostep fermentation process involving yeast and Acetobacter, which converts sugars to ethanol and then acetic acid, re-sulting in a solution of acetic acid and water. 66,67 Historically, its dermatological applications date back to 420 BC when Hippocrates used it to treat wounds. Over the years, numerous clinical trials have explored its benefits in dermatology. ...
... Over the years, numerous clinical trials have explored its benefits in dermatology. 66 In one such trial, Nakhaee et al studied 23 hemodialysis patients suffering from uremic pruritus, dividing them into three groups. The first group applied Avena sativa lotion twice daily for two weeks; the second group used diluted vinegar (30 mL synthetic white vinegar 5% in 500 ml of water); and the third group was treated with hydroxyzine tablets over the same period. ...
Background
Pruritus is one of the most common symptoms experienced by patients and can be a significant burden in daily life. A wide variety of topical treatment options are available for itch.
Objective
This review aims to provide a comprehensive summary of integrative/alternative topical treatment options for pruritus.
Methods
A comprehensive review of the literature regarding integrative topical treatments for itch was conducted using PubMed and PubMed Central.
Results
Some of the most commonly utilized integrative topical treatments for pruritus include oatmeal baths, urea cream, various herbal and botanical dressings/oils, cannabinoids, topical vitamin B12 and vitamin E, and honey.
Conclusion
Pruritus remains a challenging symptom to manage, despite the availability of a wide
range of both conventional and unconventional treatment options. Utilizing an
integrative approach may help decrease symptom severity and improve quality of life for patients with pruritus.
... It is known to have antibacterial, antifungal, and antioxidant properties. [3] The uses of vinegar are summarized in Table 1. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The adverse effects include burns, (especially in children) and contact dermatitis to nickel, as vinegar increases the leaching of nickel storage containers leading to a higher nickel content. ...
... [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The adverse effects include burns, (especially in children) and contact dermatitis to nickel, as vinegar increases the leaching of nickel storage containers leading to a higher nickel content. [3] ...
This article describes evidence-based usage of common household items to treat dermatological diseases. We have compiled the rationale of their usage from various studies and practical ways to use items like household vinegar, bleach, and common salt, in diseases such as pseudomonas nail infections, other bacterial and fungal infections, pyogenic granuloma, etc.
... The burning sensation after the application of permethrin is probably due to the product, as burning sensations have been reported (14). On a similar note, the burning sensation related to the Shega solution might be due to the presence of salt or vinegar in the solution and its adherence to the scalp because of the presence of glycerin (15). ...
Background
Head lice infestation among schoolchildren leads to social stigmatization, psychological distress, superinfection, and lack of concentration because of sleeplessness. Head lice infestation is universal and not found solely in privileged populations. Although there are modern medicines for the treatment of head lice, most communities are unable to access them due to high prices, limited supply in remote areas, or lack of willingness to use them because of the negative attitudes towards head lice infestation amongst children and the community. Therefore, this study assessed the effectiveness of a homemade remedy (“Shega solution”) made with easily available ingredients at a low cost as compared to the standard Permethrin 1% lotion.
Method
The study was conducted in the Amhara region of Ethiopia in five schools in Gondar city and the surrounding district. The selected school children were randomly assigned to intervention (Shega) and control (Permethrin) groups. The study was designed as a non-inferiority trial, with the hypothesis that Shega would, at worst, be only marginally inferior to standard treatment, by a margin (=delta) not exceeding 30 percentage points. A theatre play was created and performed in front of the whole school community to familiarize the school children with the study and to remove stigmatization about head lice infestation.
Results
Three hundred and eighty-four schoolchildren were included in the study. About 67.7% of participants were cured in the intervention group compared to 83.3% in the control group. The difference of 15.6 points of percentage is within the set acceptable range, with a 95% CI difference in the proportion of success of 7.2–24.1 for the difference in success rates. The theatrical event was noted as useful in breaking the social stigma and familiarizing the children with the research project.
Conclusion
The study has shown that the homemade remedy, Shega solution, has the potential to treat a fair proportion of head lice infestations as compared to the standard treatment, permethrin. The theatre performed in front of the school children has the potential to help the implementation of such projects at community levels. This study also indicates the level of effectiveness of permethrin lotion in Ethiopia for the first time.
Clinical Trial Registration
https://pactr.samrc.ac.za/Search.aspx, identifier (PACTR202208887378021).
... The role of topical vinegar in the resolution of the disease is unknown. While the main component acetic acid has potent antibacterial and antifungal effects [33], inappropriate application may result in skin damage [34]; therefore, it is not recommended for treating tinea corporis and cruris. On the other hand, it may have a role in treating fungal nail infections, via decreasing the pH locally, enhancing the activity of some topical antifungal preparations [35]. ...
Trichophyton indotineae is associated with difficult-to-treat, often extensive dermatophytosis and resistance to the commonly used antifungal agents. Successful therapy often necessitates higher than usual doses of systemic therapy for prolonged periods. The spread of this species has gained much attention lately, as several European and other Western hemisphere countries have recently reported their first respective cases or increasing numbers of them. Until recently, this species was not described in Hungary. Here, we report a case caused by this species in a patient with a travel history to an endemic region. The isolate was identified preliminarily by MALDI-TOF mass spectrometry and confirmed by DNA sequencing; furthermore, it was subject to phenotypic antifungal susceptibility testing by broth microdilution to fluconazole, voriconazole, posaconazole, itraconazole, and terbinafine. According to the susceptibility results, the isolate was wild type to all tested agents, including terbinafine which was in line with the sequencing data, and with the uncommon excellent therapeutic response to topical allylamine treatment. This case also further confirms the applicability of the MSI-2 database for the rapid identification of T. indotineae in routine clinical microbiology laboratories as a cost-effective and simple method.
... Other studies showed that the use of a solution of garlic oil with apple cider vinegar can produce a beneficial effect in the treatment of alopecia areata as an adjunct to minoxidil treatment [37] or a mix of lemon juice and vinegar can inhibit the growth of fungi responsible for the formation of dandruff [39]. Other scientific sources indicate that there is no evidence to support its use in pruritus, removal of head lice, and treatment of pregnancy stretch marks [38]. Also, in the trend of conscious hair care in recent years, apple cider vinegar, due to its low pH, has gained great popularity, as a means of closing the hair cuticle and thus improving the appearance of the hair [40]. ...
Introduction and Aim of the Study: Apple cider vinegar (ACV) has been used for centuries in various cultural and medical contexts globally. This study seeks to explore ACV's traditional and contemporary applications, evaluating scientific evidence for its efficacy and safety. Material and Methods: This review synthesizes information from PubMed, Google Scholar, and other scientific sources. Key search terms included "apple cider vinegar," "apple cider vinegar medical use," "apple cider vinegar antimicrobial effect," "apple cider vinegar lipid profile," "apple cider vinegar glucose level," "apple cider vinegar preparation," and "apple cider vinegar historical use." Results: Research supports ACV's traditional role as a disinfectant, demonstrating effectiveness against a range of bacteria and fungi. Both animal and human studies suggest ACV may help lower cholesterol and triglyceride levels while boosting HDL cholesterol. Evidence indicates ACV can enhance insulin sensitivity and reduce blood glucose levels, offering benefits for type 2 diabetes management. ACV shows antioxidant properties, potential for lowering blood pressure, and use in certain skin diseases, though further research is needed to confirm these effects. Conclusions: The historical use of ACV in traditional medicine finds partial support in modern scientific research. Its antimicrobial, lipid-modulating, and glucose-regulating properties are documented, suggesting potential benefits for cardiovascular health, weight management, and metabolic regulation. Nonetheless, the evidence for its cosmetic applications and impact on muscle cramps remains less definitive. Additional research involving larger, diverse populations is necessary to fully validate ACV's benefits and establish safe usage guidelines.
... These aromatic compounds exhibit various biological properties such as antibacterial, antifungal, anti-yeast, antioxidant, and wound healing activities. [48][49][50] In addition, the anti-tyrosinase activity and dermal care effect of acetic acid and furfural [51,52] may also explain the use of C. hartmannianum and T. laxiflora in Sudanese traditional cosmetology and therapy. ...
The smoke from Combretum hartmannianum and Terminalia laxiflora sapwood and fermented
heartwood (nikhra) are used in body smoke baths and homemade skincare products in
Sudan, which are believed to have various health benefits. In this study, the volatiles of
sapwood and nikhra were collected using two extraction techniques: a Mono-TrapTM sampling
technique (at low temperature) and a smoke trapping system (at high temperature). After
GC-MS analysis, the chromatogram of each sample revealed numerous peaks. The detected
peaks were identified using the DIST08 mass spectral library database, resulting in known and
unknown compounds. The results showed that 1,2,4,5-tetrachloro-3,6-dimethoxybenzene was
the major compound in the Mono-Trap and smoke extracts from nikhra samples of C.
hartmannianum and T. laxiflora. In contrast, the dominant compounds in the Mono-Trap
extracts of C. hartmannianum and T. laxiflora sapwoods were acetonyldimethylcarbinol and
cadina-1(10),4-diene, respectively. The largest peaks in the chromatograms of the sapwood
smoke extracts of both species corresponded to unknown compounds. Some of the detected
compounds are known for their aromatic and pharmaceutical properties. Identifying these
aromatic compounds in nikhra and not in sapwood might prove the traditional Sudanese
beliefs, and it could potentially improve the manufacturing of health products.
... It also contains small amounts of other organic acids, such as lactic acid, citric acid, and malic acid, as well as flavor compounds, such as aldehydes, ketones, and esters. [8,9] Gentamicin is an aminoglycoside antibiotic used in the treatment of several Gram-negative infections. It should be indicated based on patient age, symptoms, signs at presentation, and local antimicrobial resistance patterns to enhance the probability of successful treatment in bacterial septicemia, meningitis, UTIs, gastrointestinal tract infections, and soft tissue infections. ...
A bstract
Background
Antibiotic resistance in Escherichia coli (E. coli) has become a worrying issue been increasingly observed worldwide in recent decades. E. coli intrinsically has a great capacity to accumulate resistance, making them difficult to treat with standard therapies. So, using alternative strategies to treat it is urgent.
Material and Methods
The bacteria were isolated from urinary tracts and wounds, and then cultured in three media (blood agar, MacConkey agar, and eosin methylene blue agar). They were incubated for 24 h at a temperature of 37 o C to grow. The well diffusion method was used to evaluate the activity of vinegar, and the disk diffusion method was used for antibiotic sensitivity test of gentamicin as a control agent after overnight incubation. Statistical analysis was done by using SPSS 26 software.
Results
Out of the 24 participants in the study, 66.6% were women, while 33.4% were men with significant differences ( P < 0.05). Isolated E. coli (75%) were sensitive to vinegar, while 70.80% of isolates were sensitive to gentamycin. The mean inhibition zone for vinegar was 13 ± 6.04 mm compared to 15 ± 6.43 mm for gentamicin with no significant differences ( P = 0.27).
Conclusions
Vinegar shows 75% sensitivity to clinically isolated E. coli , and thus it can be a promising treatment option. Gentamicin with high rate of sensitivity can be used as an empirical treatment for E. coli infections. Vinegar has similar activity to gentamicin ( P > 0.05).
... Kandungan asam asetat dalam eco enzyme mampu berperan dalam menurunkan pH untuk menghambat pertumbuhan bakteri (Agrawal et al., 2017) dan telah terbukti mampu memusnahkan organisme (Nurlatifah et al., 2021). Penelitian yang dilaporkan oleh Elhage et al. (2021) menemukan bahwa asam asetat terbukti memiliki sifat dan efek antimikrob, antijamur, dan antioksidan yang memberikan kegunaan dalam perawatan luka serta infeksi bakteri dan jamur, serta berguna dalam pengobatan beberapa kondisi kulit termasuk pruritus. ...
Atopic dermatitis is one of the most common diseases in dogs that is multifactorial and usually attacks dogs aged between 6-36 months. This study was aimed to determine the histopathological appearance of the skin of dogs suffering from atopic dermatitis after treated with eco enzyme. Eco enzyme is a liquid product resulting from the fermentation of organic kitchen waste product such as fruit and vegetable dregs, molasses, and water. This study used five dogs suffering from atopic dermatitis which were divided into two groups. Group A: three dogs samples were bathed with 10% eco enzyme liquid every three days for 28 days. In Group B: two samples of dogs were bathed with 10% eco enzyme every three days until the 9th day, followed by a 2% eco enzyme bath once a week (13th, 20th, 27th day). Both treatment groups started from day 0 until day 28. Skin samples were taken using the biopsy method and histopathological changes were observed by making histopathological skin preparations stained with Hematoxylin and Eosin. Observations of the preparations were carried out using a light microscope. Data were analyzed using the Analysis of Variance test followed by the Duncan multiple range test and the Kruskall Wallis test followed by the Mann-Whitney test, then the data was explained descriptively. The results of the Anova test showed that the thickness of the dogs epidermis treated with 2% and 10% eco enzyme was significantly different (P<0.05). The Kruskall Wallis test for scoring inflammatory cell infiltration and degeneration showed that there was a significant difference (P<0.05) in the administration of 2% and 10% eco enzyme. Eco enzyme liquid is able to reduce atopic dermatitis lesions in dogs. Giving eco enzyme at a concentration of 10% and followed by a concentration of 2% with an extended application time can return the histological structure of the dog’s skin to normal, especially the thickness of the epidermis, reduce inflammatory cell infiltration, and reduce degeneration.
... Tetrahydrofuran (THF) is known as a solvent, but its derivates also demonstrated potential as human immunodeficiency (HIV) protease inhibitors 8,9 . Acetic acid (AA) is used in the food industry as a preservative and acidity regulator, has antioxidant and antimicrobial effects, and is present in vinegar in concentrations between 4 and 8% 10 . Diethylethanolamine (DEEA) often serves as a chemical precursor in industry, has anti-corrosive properties, and potently absorbs CO 2 11,12 . ...
Products containing chemicals with eye irritation potential need to be labeled with the respective hazard symbol. To avoid the testing of numerous dilutions of chemicals on animals, their labeling is directed by a theoretical approach. In this report, a previously described in vitro tissue model of the cornea based on human epithelial cells was used for eye irritation testing of dilutions. As a sensitive and non-destructive method to analyze the barrier function of the epithelium, impedance spectroscopy was applied. Moreover, the morphology and viability of the epithelial models were assessed. We tested four chemicals that, neatly, cause severe damage to the eye: tetrahydrofuran, acetic acid, diethylethanolamine, and benzalkonium chloride. With our test method, we were able to determine the concentrations of the chemicals which are critical for the integrity of the cornea. The threshold was < 0.1% for the most and > 5% for the least toxic substance. The described test system is not only an alternative for animal models but also for the theoretical examination of the hazard potential of diluted chemicals. By using the advantages of tissue engineering and non-destructive analysis tools, we can achieve more precise and safer labeling of the eye irritation potential of products.
... Another recent study showed that diluted apple cider vinegar did not affect skin barrier integrity but caused skin irritation in most subjects [89]. Anyway, the acetic acid effects may depend on the type of vinegar applied and, for its antimicrobial effects, on the type of microorganism involved [90]. Future studies are needed to explore the benefits of vinegar on skin barrier integrity and its use in a safe way. ...
Atopic dermatitis is a chronic inflammatory skin disease. The treatment plays an important role in influencing the patients’ quality of life. The basic management consists of appropriate skin cleansing, including bathing and eventually using bathing additives. Recommendations regarding frequency and duration of bathing, water temperature and usefulness of bathing additives are widely different, often leading to confusion among patients. This review aims to give insights into the best bathing practices and the use of bathing additives in atopic dermatitis in children. Several bathing additives, including bleach baths, commercial baby cleansers, bath baby oils and bath salt, appear to be promising adjunctive therapies for atopic dermatitis due to their anti-inflammatory, anti-bacterial, anti-pruritus and skin barrier repair properties through different mechanisms of action. However, their efficacy and safety are not fully understood in some cases. The usefulness of other bath additives, such as acidic and more natural substances (green tea extracts, pine tar, sodium bicarbonate), is still under investigation. Further studies are needed to determine their optimal use to achieve clinical benefit safely.
... The antifungal capabilities and phenol chemicals are also extensively used in the treatment of historical glassware and mineral specimens (Adgaba et al., 2020). Alternate treatments for lichens included carboxylic acids, sodium chloride combined with acetic acid, and sodium chloride alone (Elhage et al., 2022). ...
Secondary metabolites are a class of outwardly directed differentiation products of regular cellular metabolism that can operate as chemical messengers across organisms and species. They are molecules largely engaged in the maintenance/homeostasis of the organism. Secondary metabolites influence health-maintenance functions. Utilizing secondary metabolites has proven to be particularly successful in detecting some of the most prevalent food-spoilage fungus, including Penicillium species, Aspergillus species, and Fusarium species. Secondary products are uncommon, low-molecular-weight molecules that are structurally like primary metabolites but have a more restricted distribution than primary metabolites. Lichens are the natural result of a partnership between fungi (the Mycobionts’ partner) and algae (the host of the association). The stability of the secondary metabolites of lichens separates them from other species. Lichens can be both beneficial and hazardous to humans, depending on the location. They assist humanity in numerous ways, including feed and food, medicine, and industrial applications. In France, several lichens are used to make chocolates and pastries, while others are used medicinally. Curry powder made from Parmelia species can be found in Indian cuisine, while Endocarpon miniatum is used as a vegetable in Japan and Evernia prunastri is used to make bread in Egypt. The presence of lichenin, a polysaccharide, in Ramalina fraxinea, R. fastigiata, Evernia prunastri, and Lobaria pulmonaria lichens enables their use as animal feed. Parmelia saxatilis and Parmelia perlata are employed in the treatment of dyspepsia and epilepsy, respectively. Cladonia pyxidata is used to cure whooping cough, Xanthoria parietina is used to treat jaundice, and Pertusaria, Cladonia, and Cetraria are used to treat a variety of conditions. Ochrolechia androgyna and Ochrolechia tartaria are two plants that yield red and purple colors, respectively. Species of Ramalina and Evernia are used to extract the essential oils used to produce cosmetic soap. Some lichens, such as Amphiloma and Cladonia, parasitize mosses and, if left unchecked, can entirely decimate moss colonies. Some secondary compounds produced by lichens, such as anthraquinone pigments, are commonly present in both lichens and free-living fungi. The low levels of bacterial production allow for rapid mutation, selection of resistant strains, and horizontal transmission of resistance genes. Extracts of Usnea ghattensis, Parmotrem pseudotinctorum, Hypogymnia physodes, Lasallia pustulosa, and Parmelia caperata exhibited antioxidant activity. The majority of lichen species are terrestrial, whereas only a handful are found in the ocean
... The use of alternative therapies has increased over time due to the commercial availability of ACV and its antimicrobial properties. 2 ACV is known for having antimicrobial, antifungal, and antioxidant properties. 2 One clinical trial in atopic dermatitis showed ACV had some antimicrobial effect, but it did not improve skin barrier function, led to irritation, and ACV use was not statically significant compared to placebo. The next case report, an 8-year-old boy with molluscum contagiosum whose parent used ACV as at home remedy, caused a chemical burn that showed epidermal necrosis, neutrophil invasion, and fibrinoid changes on skin biopsy. ...
... Although irritation occurs in the topical applications of vinegar, it is a good sign indicating that vinegar disinfectant compounds are actively fighting against bacteria or viruses and destroying dead lesion tissue. [21,22] In addition, there is a report on the use of chopped P. ovata leaves to improve poisoning. [23] It is also used to relieve itching and inflammation of the skin and is used as a dressing to heal herpes, lesions, and abscess. ...
Background:
The present study aimed at investigating the topical effect of the combination of Plantago ovata and vinegar on the improvement of rural cutaneous leishmaniasis lesions.
Materials and methods:
The present randomized double-blind controlled clinical trial was performed on 42 patients with rural skin leishmaniasis. In the case group, in addition to injecting glucantime into the lesion according to the latest national instructions, a combination of P. ovata and vinegar was applied topically twice a day for 8 weeks. In the control group, only glucantime injection into the lesion was performed for 8 weeks according to the latest national guidelines. At the end of the 1st, 2nd, 3rd, 4th, 8th, and 12th weeks after the intervention, the lesion area and improvement were evaluated and recorded.
Results:
The results of the present study indicated the lesion area in the case group with the mean of 0.35 ± 0.39 cm and 0.18 ± 0.27 cm in the 8th and 12th weeks, respectively was significantly less than that of the control group with the mean of 0.64 ± 0.78 cm and 0.56 ± 0.44, respectively (P < 0.05). Twelve weeks after the intervention, 84.1% of the lesions in the case group and 65.9% of the lesions in the control group were completely improved (P < 0.05).
Conclusion:
According to the results of the present study, the improvement of leishmaniasis lesion with the topical application of the combination of P. ovata and vinegar was significantly more than that of the control group in the 8th and 12th weeks after the intervention.
... 1 Acetic acid Alleviating the inflammatory response, the wound, and atopic dermatitis [28,29] 2 Alanine Inhibition of apoptosis; stimulation of lymphocyte proliferation [30] 3 Aucubin Inhibition of inflammatory response, protection against oxidative stress, and improvement of transepidermal water loss and skin hydration [26,31] 4 ...
Background:
Ceramides are essential lipids in stratum corneum for skin permeability barrier function in that they retain the skin moisture and protect from the invasion of foreign pathogens. Previously, we demonstrated that ferment lysates of Lacticaseibacillus rhamnosus IDCC 3201 enhanced ceramide production in human epidermal keratinocytes. Furthermore, for comprehensive knowledge of this effect, in vitro experiments and multi-omics analysis were conducted to explore the underlying mechanisms.
Aims:
This study was designed to identify whether a cosmetic sample (i.e., Cera-Glow) containing the lysates improves the skin barrier function in clinical trials.
Patients/methods:
Twenty-four female participants (45.46 ± 9.78 years) had been enrolled in the transepidermal water loss (TEWL) measurement for 5 days and 21 female participants (50.33 ± 5.74 years) had undergone a skin hydration evaluation for 4 weeks. TEWL and skin hydration were evaluated using a Tewameter and the Epsilon Permittivity Imaging System, respectively. After applying the Cera-Glow sample, all participants recorded a satisfaction survey questionnaire (e.g., satisfaction, efficacy, and adverse reactions).
Results:
Application of Cera-Glow significantly improved transepidermal water loss induced by 1% (w/v) sodium lauryl sulfate (p < 0.05-0.01) and increased skin hydration (p < 0.01). Metabolic analysis suggested that Cera-Glow should contain beneficial gradients for skin barrier function. According to the questionnaire, most of participants were satisfied with the skin hydration improvement and efficacy of Cera-Glow.
Conclusions:
Cera-Glow, ferment lysates of Lacticaseibacillus rhamnosus IDCC 3201, can significantly improve skin barrier function.
... Peningkatan konsentrasi asam asetat berpotensi toksik pada kulit. Asam asetat pada cuka diketahui dapat menyebabkan resiko kulit terbakar dan eritema terutama penggunaan oleh anak-anak(Elhage et al., 2021). 2. Kurva regresi linier antara konsentrasi cuka nanas dengan log jumlah koloni jamur M. furfur.Tabel 3. Hasil perhitungan rerata ± standar deviasi (SD) log koloni jamur M. furfur setelah Hasil uji KBM kontrol obat ketokonazol, diketahui bahwa ketokonazol mulai membunuh M. furfur pada konsentrasi terendah 2 µg/mL (Tabel 3). ...
ABSTRAK Malassezia furfur merupakan flora normal yang terdapat pada kulit manusia, namun dapat menjadi patogen pada pasien imunosupresi. Di Indonesia, penyakit kulit pityriasis versicolor (hampir 50% penyakit kulit) disebabkan oleh M. furfur. Ketokonazol merupakan obat yang paling umum digunakan untuk pengobatan infeksi M. furfur, namun diketahui memiliki efek samping kerusakan hati. Oleh sebab itu perlu dilakukan pengembangan antijamur yang lebih aman. Cuka nanas mempunyai potensi sebagai antijamur karena mengandung senyawa saponin dan tanin. Penelitian ini melakukan uji kadar hambat minimal (KHM) cuka nanas dengan metode two-fold dilution pewarnaan Resazurin Microplate Assay (REMA). Konsentrasi cuka nanas yang digunakan berada pada rentang 62.5- 4000 µg/mL. Analisis regresi digunakan untuk menilai hubungan antara konsentrasi cuka nanas dengan pertumbuhan jamur M. furfur. Hasil penelitian menunjukkan bahwa konsentrasi cuka nanas 4000 µg/mL belum dapat menghambat pertumbuhan jamur M. furfur. Namun, berdasarkan hasil uji regresi linier sederhana, diketahui terdapat hubungan antara peningkatan konsentrasi cuka nanas terhadap pertumbuhan jamur dengan persamaan garis y = -0,000097x + 5,88 dan nilai korelasi determinasi (R2) 0,729 = 72,9 % (p=0,000). Peningkatan dosis uji cuka nanas mungkin dapat bermanfaat untuk menghambat pertumbuhan jamur M. furfur. Kata Kunci: Antijamur, Cuka Nanas, Malassezia Furfur, Resazurin Microplate Assay. ABSTRACT Malassezia furfur is normal flora found on human skin, but can be pathogenic in immunosuppressed patients. In tropical areas such as Indonesia, pityriasis versicolor skin disease (almost 50% of skin diseases) is caused by M. furfur.). Ketoconazole is commonly drug for the treatment of M. furfur infection, but it’s known to have hepatotoxic effects. Therefore, it’s necessary to develop safer antifungals. Pineapple vinegar has potential as an antifungal because it contains saponins and tannins. Minimum inhibitory concentration (MIC) of pineapple vinegar was carried out using two-fold dilution method and Resazurin Microplate Assay (REMA) staining. The concentration range of pineapple vinegar used is 62.5- 4000 g/mL. Regression analysis was used to assess the relationship between pineapple vinegar concentration and the growth of the M. furfur. The concentration of pineapple vinegar 4000 g/mL could not inhibit the growth of the M. furfur. However, based on a linear regression test, there is a relationship between increasing the concentration of pineapple vinegar on the growth of M. furfur, with regression line equation y = -0.000097x + 5.88 and (R2) 0.729 = 72.9% (p = 0.000). Increasing the dose of pineapple vinegar may be useful for inhibiting the growth of the M. furfur. Keywords: Antifungal, Malassezia furfur, pineapple vinegar, pytiriasis versicolor, resazurin microplate assay
... Vinegar is a well-known folk remedy employed as a rinse solution on the skin for cleaning off residual cnidocytes, but this recommendation is largely based on empirical knowledge [9,20]. While some research groups support the use of vinegar for cubozoans, hydrozoans, and scyphozoans [21], research aimed at clarifying its use in scyphozoan first-aid protocols warns against and contraindicates its use [22][23][24][25]. ...
Rhizostoma pulmo is a widely distributed scyphozoan in the Mediterranean Sea. Their stings result mainly in erythema, small vesicles, or/and pain, and cause a high number of bathers to seek assistance from first-aid services during the summer season. Despite the threat that jellyfish stings represent to public health, there is disagreement in the scientific community on first-aid protocols, with the dispute largely centered around the effectiveness of vinegar. In the present research, we investigated the effect of commonly used rinse solutions on nematocyst discharge in R. pulmo and the effect of vinegar on three more scyphozoans (Aurelia sp., Cassiopea sp., and Rhizostoma luteum). Scented ammonia, vinegar, and acetic acid triggered nematocyst discharge in R. pulmo. Vinegar also caused nematocyst discharge in Aurelia sp., Cassiopea sp., and R. luteum. In contrast, seawater, baking soda, freshwater, urine, and hydrogen peroxide were considered neutral solutions that did not induce nematocyst discharge. These results indicate that the use of vinegar, acetic acid, or commercial products based on these compounds is counterproductive. Their use can worsen pain and discomfort caused not only by R. pulmo stings but also by those of any scyphozoan. The use of seawater is recommended for cleaning the R. pulmo sting site until an inhibitor solution that irreversibly prevents nematocyst discharge is discovered.
Chronic wounds are a vital clinical challenge due to the infliction of prolonged suffering on patients, the economic burden on individuals and society, and the possibility of limb amputation, and there is a growing interest in developing effective therapeutic strategies for their management. The present research investigated the therapeutic effect of a new repairing gel on chronic wounds. Individuals who suffered from chronic wounds of various etiologies and whose wound conditions had not changed for at least 4 weeks under standard treatments were recruited. For three months, they received a repairing gel dressing, which is a cocktail of useful ingredients for wound healing. Participants had weekly follow-up visits, and their wound healing process was assessed. The healing rate and speed of wounds improved significantly after our new intervention relative to previous standard wound care (86.66% versus 13.33%). Additionally, after starting therapy, the amount of wound exudate, pain, and malodor decreased within a short period. Patients did not report any serious complications during the follow-up period. This novel repairing gel can be a safe, affordable, noninvasive, and effective therapy for chronic wounds.
Chemical inertness of pristine carbon nanotubes (CNTs) poses challenges on their biocompatibility. In this paper, surface modification of pristine (5, 5) single-walled carbon nanotube (SWCNT) was explored through substitutional Boron (B) and Nitrogen (N) doping forming a C38NB isomer. The electronic topology and binding mechanism of acetic acid adsorption on the isomer was then examined in the context of first-principles Density Functional Theory (DFT). Accordingly, high abundance of localized electrons between the substitutional doping sites indicates chemical binding of the substitutional atoms with the SWCNT. These are further supported by the calculated bond angles. When the acid was adsorbed on the C38NB isomer, spontaneous charge redistributions were observed which are attributed to the oxidation caused by the O atoms and the charge acceptance of the C atoms. Topological analyses revealed that the net charge transfers for all considered configurations were towards the acid. In addition, the Lowest Unoccupied Molecular Orbital (LUMO) and Highest Occupied Molecular Orbital (HOMO) revealed the nonuniform distribution of electronic charges near the Fermi level. Finally, calculations of the electron localization function (ELF) showed that there was no orbital hybridization between the acid and the isomer. Further, the absence of localized electrons between their interaction points implied a physical binding mechanism. The results of the study could be used for future opto-electronic experiments and electrochemical biosensing applications of CNTs.
El ácido acético presenta propiedades antimicrobianas, con nulos cambios perjudiciales en la matriz citoplasmática a determinadas concentraciones con posibilidad de recuperación celular y tisular. El objetivo de esta investigación fue evaluar eficacia, seguridad y posibles ventajas del ácido acético con una revisión detallada de su uso como antiséptico y cicatrizante en heridas abdominales. A través de un estudio observacional, descriptivo, se incluyeron 11 pacientes intervenidos quirúrgicamente con procesos infecciosos agregados en el postoperatorio y pacientes con abscesos localizados en tejidos blandos y úlceras por presión. En todos se realizaron aseos quirúrgicos, debridación de tejidos en etapas iniciales (36.4%), y curaciones con ácido acético al 2.5% en medio hospitalario y en el domicilio por un familiar capacitado. Como resultados se obtuvo la Resolución del proceso infeccioso y cicatrización en infecciones de sitio quirúrgico y no quirúrgico en 46.64 días en promedio con reducción del tiempo de cicatrización (media 11.36 días). Sólo el 27.3% presentó irritación leve con aplicación de ácido acético diluido al 1.25% de solución. Las principales Conclusiones son que el ácido acético es útil en el tratamiento de infecciones de tejidos blandos y en infecciones del sitio quirúrgico, con disminución del periodo de cicatrización y reducción de costos, sin embargo, se requieren más estudios para evaluar su eficacia en dicho proceso a diferentes concentraciones.
Herbal medicine is the use of plants or plant-based substances to treat various health conditions, including wounds. Wounds are injuries that damage the skin or other body tissues. Wound healing is a complex process that involves four phases: hemostasis, inflammation, prolifer-ation,andremodeling.Herbalmedicinecanenhancewoundhealingby providing anti-inflammatory, antimicrobial, antioxidant, and anal-gesic effects. Herbal medicine can also stimulate cellular regeneration and collagen production, which are essential for tissue repair. In this review, we introduce 50 herbs that have been reported to be effective for wound healing. These plants have a long history of use based on experience, but they have also been confirmed to be effective in wound healing by modern medical methods. However, herbal medi-cine should not replace conventional medical care for severe wounds. These plants can be a good source for researchers to design and make more effective drugs with less side effects for wound healing.2023, Vol9, No1Doi:10.22034/JATE.2023.88
In this paper, (5,5) single-walled carbon nanotube was doped by substitutional nitrogen (N) atom forming bridgehead C-N bonds in the resulting C39N armchair nanotube. It was then interacted with acetic acid to investigate its detection capability using first-principles calculations in the context of Density Functional Theory (DFT). As known, DFT is a very efficient and accurate method in calculating the properties of the atoms and molecules, and their interactions. Accordingly, the O-H bond of the acid has not undergone a heterolytic dissociation caused by the weak interaction of the materials. In the valence region of the C39N-acid, the O atoms (2p) are the main causes of additional states as shown in the projected density of states (pDOS). Calculations of the charge density difference revealed the occurrence of charge redistribution and nonuniform charge transfer between the acid and the sidewalls of the C39N. Further topological investigation of the system revealed no localized electrons between the interaction points indicating a physical binding mechanism. These electronic responses have shown the biosensing ability of C39N to detect and capture acetic acid.
Background:
Topical antimicrobials are recommended for first line treatment of surface and superficial infections in dogs. This is especially important given the increasing prevalence of antimicrobial resistant infections. Antimicrobial wipes have become popular, but there are a lack of controlled studies assessing their in vitro antimicrobial and in vivo residual activity. We aimed to assess the antimicrobial efficacy of two commercial antimicrobial wipes against frequently isolated pathogens. Ten clinical and one reference isolate each of meticillin-susceptible Staphylococcus pseudintermedius (MSSP), meticillin-resistant S. pseudintermedius (MRSP), Escherichia coli (EC), extended spectrum beta-lactamase (ESBL) producing E. coli (ESBL-EC), Pseudomonas aeruginosa (PA) and Malassezia pachydermatis (MP) were tested using a modified Kirby-Bauer technique. Each isolate was tested against 6 mm discs of chlorhexidine (CHX) and acetic acid/boric acid (AABA) wipes, and positive and negative controls either overnight (bacteria) or for 3 days (Malassezia). Healthy dogs were treated with the wipes and distilled water on a randomised flank (n = 5 each). Hair samples (1 cm; 0.1 g) taken at days 0, 1 and 3 were inoculated with an isolate of each organism. Zones of inhibition (ZI) were measured.
Results:
All isolates produced confluent growth with AABA and control wipes, except for the cleansing wipes and MP (median ZI 12 mm; 95% CI 8.2-15.8). The median (95% CI) CHX wipe ZIs (mm) were: MP 48.0 (47.0-49.0), MSSP 15.6 (14.2-17.0), MRSP 14.0 (13.6-14.4), EC 13.6 (12.0-15.2) and ESBL-EC 10.0 (9.4-10.6). PA showed confluent growth. The differences between the bacterial isolates was significant (Kruskal-Wallis p < 0.0001; post-tests MSSP = MRSP = EC > EBSL-EC > PA). Confluent growth was visible with all the hair samples.
Conclusion:
CHX but not AABA showed in vitro efficacy against MSSP, MRSP, EC and MP. ESBL-EC were less susceptible and there was no activity against PA. There was no residual activity on hair. Additional studies are required to determine efficacy of these products in clinically affected patients.
Topical treatment of wound infections is often a challenge due to limited drug availability at the site of infection. Topical drug delivery is an attractive option for reducing systemic side effects, provided that a more selective and sustained local drug delivery is achieved. In this study, a poorly water-soluble antibiotic, ciprofloxacin, was loaded on polyvinylpyrrolidone (PVP)-based foils and nanofiber mats using acetic acid as a solubilizer. Drug delivery kinetics, local toxicity, and antimicrobial activity were tested on an ex vivo wound model based on full-thickness human skin. Wounds of 5 mm in diameter were created on 1.5 × 1.5 cm skin blocks and treated with the investigated materials. While nanofiber mats reached the highest amount of delivered drug after 6 h, foils rapidly achieved a maximum drug concentration and maintained it over 24 h. The treatment had no effect on the overall skin metabolic activity but influenced the wound healing process, as observed using histological analysis. Both delivery systems were efficient in preventing the growth of Pseudomonas aeruginosa biofilms in ex vivo human skin. Interestingly, foils loaded with 500 µg of ciprofloxacin accomplished the complete eradication of biofilm infections with 1 × 109 bacteria/wound. We conclude that antimicrobial-loaded resorbable PVP foils and nanofiber mats are promising delivery systems for the prevention or topical treatment of infected wounds.
p class="abstract"> Background: Nodulocystic acne is a severe form of acne which can result in significant damage to the skin with great impact on quality of life. Oral isotretinoin is considered to be the best treatment for such cases. Although it has a high rate of success and its efficacy is well established in the treatment of nodulocystic acne, it may occasionally fail to meet expected degree of disease control. Known side-effects and long duration to achieve cumulative dose might lead to poor compliance and known contraindications sometimes as well limit its usage.
Methods: A prospective observational studies on 20 patients who presented themselves with facial nodulocystic acne on regular OPD basis and were poorly compliant to treatment with isotretinoin owing to its side-effects, the drug failed to meet patients’ expectations or due to any contraindication to isotretenoin usage were included. A peel containing black acetic acid, jasmonic acid, salicylic acid, potassium iodide (“black peel”, Theraderm) was used topically as an alternative treatment, for a course of 3 treatment sittings 2 weeks apart.
Results: Significant reduction of nodulocystic lesions was noted after 3 sittings of “black peel” 2 weeks apart. Among 20 patients 55% showed excellent response; 45% showed good response while none of the patients were non responsive. Post treatment ISGA score of 0.45 as opposed to pre-treatment score of 3.70 (p<0.0001) was observed.
Conclusions: Black peel can be used as promising and hopeful alternative treatment for difficult to treat nodulocystic acne.</p
There are many chemicals that can cause burns. Although they are generally acidic and basic in nature, there are more than one million known chemical compounds, of which 300 have been declared highly hazardous chemical substances by the National Fire Protection Society. Chemical burns account for approximately 10.7% of all burn injuries and 30% of deaths because of burns. Chemicals can be classified as acid, alkali, organic, and inorganic compounds. Acids act by denaturing and coagulating proteins. Alkaline burns cause deeper burns than acid burns.
Gram‐negative bacterial toe web infection (GNBTWI) caused by Pseudomonas Aeruginosa combined with fungal infection has variety of treatments. However, these treatments have been poorly described in the literature. Our retrospective study describes patients that had been treated in our medical center with acetic acid combined with local antifungal treatment, in order to evaluate evidences for the appropriateness of this treatment. Ten patients with evidence of GNBTWI caused by Pseudomonas Aeruginosa combined with local fungal infection which have been treated with acetic acid in Emek Medical Center were identified. Eight patients (80%) had a complete response while 2 patients (20%) showed only a partial response. Side effects were minimal and included temporary stinging sensation. Acetic acid is a relatively cheap ingredient with minimal side effect profile and highly effective outcomes as a treatment for GNBTWI caused by Pseudomonas Aeruginosa and should be considered as an adjuvant treatment.
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Toe nail onychomycosis (ONM) is a common problem in elderly patients. Treatment in diabetic patients with associated comorbidities such as congestive heart failure becomes a challenge. Oral antifungals are best avoided owing to most of them being contraindicated or unsafe due to comorbidities and/or risk of drug interactions stemming from polypharmacy. Topical agents alone are not effective. Unlike isolated ONM in healthy and younger patients, ONM involving multiple nails in geriatric and diabetic patients warrants treatment as it serves as a source of recurrent tinea of the feet and other sites, and even contributes to formation of diabetic foot ulcers. Long-pulsed Nd:YAG and fractional CO2 laser (in addition to antifungals) have been reported to provide gratifying results in toe nail ONM. But high treatment cost is a major limitation. Nail peeling with glycolic acid (GA) and low-concentration croton-oil free phenol (CFP) peels have been used in different nail conditions but not specifically for ONM. We report the successful use of Black peel (a superficial-to-medium depth peel used typically for anti-acne and cosmetic indications), a combination of 50% black acetic acid, 0.5% salicylic acid, 6% tetrahydrojasmonic acid, 10% bio sulphur, and 0.1% potassium iodide, in two difficult cases with ONM of multiple nails, the rationale of use being the additional anti-fungal effects of all the peel components.
Folk herbs are vital to the Japanese health care system, with some being used to treat fungal skin infections. We tested folk herbs used in traditional Japanese medicine for in vitro antifungal activity against Trichophyton rubrum, the most common pathogen in patients with superficial dermatitis. Acetone, ethanol, methanol, water, and acetic acid extracts from 15 species of Japanese folk herbs (Bi-wa, Aka-me-gashiwa, Ta-mushi-ba, Yomogi, Shi-so, Ku-ko, So-ba, Yama-momo, Kuro-mo-ji, Ichi-ji-ku, Kaki-no-ki, Kuwa-no-ki, Kusa-gi, Chimaki-zasa, and I-buki-jya-kou-sou) were evaluated for fungal growth inhibition, as measured by absorbance. Crude acetic acid extracts of Aka-me-gashiwa, Ta-mushi-ba, Yomogi, Ku-ko, Kaki-no-ki, and I buki-jya-kou-sou exhibited antifungal activity comparable to that of amphotericin B. Although the active compounds and underlying antifungal mechanisms are not known, the data contribute to the development of new and safe antifungal drugs, highlight new extraction methods for herbs, and support the traditional use of Japanese folk herbs against fungal infections.
Infection and inflammation account for approximately 25% of cancer-causing factors. Inflammation-related cancers are characterized by mutagenic DNA lesions, such as 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) and 8-nitroguanine. Our previous studies demonstrated the formation of 8-oxodG and 8-nitroguanine in the tissues of cancer and precancerous lesions due to infection (e.g., Opisthorchis viverrini-related cholangiocarcinoma, Schistosoma haematobium-associated bladder cancer, Helicobacter pylori-infected gastric cancer, human papillomavirus-related cervical cancer, Epstein-Barr virus-infected nasopharyngeal carcinoma) and pro-inflammatory factors (e.g., asbestos, nanomaterials, and inflammatory diseases such as Barrett’s esophagus and oral leukoplakia). Interestingly, several of our studies suggested that inflammation-associated DNA damage in cancer stem-like cells leads to cancer development with aggressive clinical features. Reactive oxygen/nitrogen species from inflammation damage not only DNA but also other biomacromolecules, such as proteins and lipids, resulting in their dysfunction. We identified oxidatively damaged proteins in cancer tissues by 2D Oxyblot followed by MALDI-TOF/TOF. As an example, oxidatively damaged transferrin released iron ion, which may mediate Fenton reactions and generate additional reactive oxygen species. Dysfunction of anti-oxidative proteins due to this damage might increase oxidative stress. Such damage in biomacromolecules may form a vicious cycle of oxidative stress, leading to cancer development. Epigenetic alterations such as DNA methylation and microRNA dysregulation play vital roles in carcinogenesis, especially in inflammation-related cancers. We examined epigenetic alterations, DNA methylation and microRNA dysregulation, in Epstein-Barr virus-related nasopharyngeal carcinoma in the endemic area of Southern China and found several differentially methylated tumor suppressor gene candidates by using a next-generation sequencer. Among these candidates, we revealed higher methylation rates of RAS-like estrogen-regulated growth inhibitor (RERG) in biopsy specimens of nasopharyngeal carcinoma more conveniently by using restriction enzyme-based real-time PCR. This result may help to improve cancer screening strategies. We profiled microRNAs of nasopharyngeal carcinoma tissues using microarrays. Quantitative RT-PCR analysis confirmed the concordant downregulation of miR-497 in cancer tissues and plasma, suggesting that plasma miR-497 could be used as a diagnostic biomarker for nasopharyngeal carcinoma. Chronic inflammation promotes genetic and epigenetic aberrations, with various pathogeneses. These changes may be useful biomarkers in liquid biopsy for early detection and prevention of cancer.
Introduction:
Onychomycosis is a fungal nail infection, frequently caused by dermatophytes, which occurs in 2-14% of Western adults. The present study was set up to evaluate the efficacy and safety of a water-based, peelable nail polish (daily application), which acidifies the nail environment, versus a 5% amorolfine nail lacquer (weekly application) for topical treatment of mild-to-moderate onychomycosis.
Methods:
One hundred two adults were randomized in this open, prospective, blinded trial. Clinical efficacy was evaluated at baseline and days 30, 60, 120, and 180, respectively. All patients underwent microbiological testing (at baseline and study end). The primary objective of this trial was the change in the percentage of healthy nail surface at day 180.
Results:
The percentage of healthy surface between baseline and day 180 increased with 11.8% in the test product group and 13.2% in the amorolfine group, which were statistically comparable. Other onychomycosis-related parameters (dystrophy, discolouration, thickening, and healthy aspect, respectively) showed significant (p < 0.05) improvement after 180 days (versus baseline) with both treatments. Clinical performance was further confirmed by the frequency of patients showing onychomycosis improvement or success at the end of the study: 96.0% (test product) versus 79.6% (amorolfine). Microbiological results and improved quality of life confirmed clinical performance. Both treatments were well tolerated and appreciated for their properties and efficacy.
Conclusion:
The present trial confirmed the clinical performance of daily acidification of the nail, as reflected by (1) a comparable increase of percentage of healthy nail surface following treatment with the test product versus amorolfine, (2) the overall improvement of other onychomycosis-related parameters, (3) user convenience, and (4) absence of side effects. These data indicate that daily application of an aqueous, acetic acid-based, peelable solution can be a convenient, safe, and equally effective alternative for the topical management of onychomycosis.
Trial registration:
ClinicalTrials.gov identifier; NCT03382717 FUNDING: Oystershell Laboratories.
Objective: Striae happen to 50–90% of pregnant women and never disappears completely. It is, therefore, a major aesthetic concern for most women, which can cause psychological distress and disturbed body image. This study was conducted to examine the effectiveness of the topical use of apple vinegar on striae gravidarum.Methods: This randomized controlled clinical trial study was conducted on 23 women referred to health centers in Gonabad city, selected according to inclusion criteria and systematic random method. The right half of the abdomen in each participant was considered as a trial group and the left half as the control. On the trial side, apple vinegar was massaged onto striae twice daily for 1 month. Data were collected using a demographic questionnaire, checklist of striae aesthetic change, a pair of calipers and a camera and analyzed in SPSS-20 using descriptive statistics, paired t, and Wilcoxon tests at significance level p<0.05.Results: No significant change was observed in mean length and width of striae in either trial or control sides after the intervention (p>0.05). However, on the trial side, the difference between striae length and width before and after the intervention was statistically significant (p<0.001). A significant difference was observed during intervention in the reduction in striae length and width on trial side (p<0.001).Conclusion: Topical application of apple vinegar effectively reduces the size of striae. Further and longer studies with larger sample size are recommended.
Background
Recently, natural moisturizing factors (NMFs) and corneocyte surface topography were suggested as biomarkers for irritant dermatitis.
Objectives
To investigate how exposure to different irritants influences corneocyte surface topography, NMF levels and the barrier function of human skin in vivo.
Methods
Eight healthy adult volunteers were exposed to aqueous solutions of 60% n‐propanol, 0.5% sodium lauryl sulfate (SLS), 0.15% sodium hydroxide, and 2.0% acetic acid, and distilled water, in a repeated irritation test over a period of 96 hours. Erythema, transepidermal water loss (TEWL), skin hydration, the dermal texture index (DTI) and NMF levels were measured at baseline, and after 24 and 96 hours.
Results
SLS and sodium hydroxide had the most pronounced effects on erythema and TEWL. Although n‐propanol caused only slight changes in TEWL and erythema, it showed pronounced effects on skin hydration, NMF levels, and the DTI. NMF was the only parameter that was significantly altered by all investigated irritants. The changes in the DTI were inversely associated with NMF levels and skin hydration.
Conclusion
Skin barrier impairment and the inflammatory response are irritant‐specific, emphasizing the need for a multiparametric approach to the study of skin irritation. NMF levels seem to be the most sensitive parameter in detecting irritant‐induced skin barrier alterations.
Background
Wounds have since long, contributed majorly to the health-care burden. Infected long-standing non-healing wounds place many demands on the treating surgeon and are devastating for the patients physically, nutritionally, vocationally, financially, psychologically and socially. Acetic acid has long been included among agents used in the treatment of infected wounds. In this study, we have evaluated the use of acetic acid for topical application in the treatment of infected wounds.
Materials and Methods
A total of 100 patients with infected wounds were treated with topical application of 1% acetic acid as dressing material after appropriate cleaning. A specimen of wound swab was collected before first application and further on days 3, 7, 10 and 14. Daily dressings of wounds were done similarly. Minimum inhibitory concentration (MIC) of acetic acid against various organisms isolated was determined.
Results
The patients treated ranged between 9 and 60 years, with the mean age 33 years. Nearly 70% of patients were male. Aetiologies of wounds: infective 35, diabetic 25, trauma 20, burns 10, venous ulcers 5 and infected graft donor site 5. Various microorganisms isolated include Pseudomonas aeruginosa (40%), Staphylococcus aureus (2%), Acinetobacter (12%), Escherichia Coli (5%), Proteus mirabilis (3%), Klebsiella (18%), methicillin-resistant S. aureus (10%), Streptococcus (2%) and Enterococcus (1%), Citrobacter (1%). Few wounds (6%) also isolated fungi. About 28%, 64% and 8% of patients isolated no growth on culture after 7, 14 and 21 days, respectively. MIC of all isolated organisms was ≤0.5%.
Conclusion
pH of the wound environment plays a pivotal role in wound healing. Acetic acid with concentration of 1% has shown to be efficacious against wide range of bacteria as well as fungi, simultaneously accelerating wound healing. Acetic acid is non-toxic, inexpensive, easily available and efficient topical agent for effective elimination of wound infections caused due to multi-drug resistant, large variety of bacteria and fungus.
The global escalation in antibiotic resistance cases means alternative antimicrobials are essential. The aim of this study was to investigate the antimicrobial capacity of apple cider vinegar (ACV) against E. coli, S. aureus and C. albicans. The minimum dilution of ACV required for growth inhibition varied for each microbial species. For C. albicans, a 1/2 ACV had the strongest effect, S. aureus, a 1/25 dilution ACV was required, whereas for E-coli cultures, a 1/50 ACV dilution was required (p < 0.05). Monocyte co-culture with microbes alongside ACV resulted in dose dependent downregulation of inflammatory cytokines (TNFα, IL-6). Results are expressed as percentage decreases in cytokine secretion comparing ACV treated with non-ACV treated monocytes cultured with E-coli (TNFα, 99.2%; IL-6, 98%), S. aureus (TNFα, 90%; IL-6, 83%) and C. albicans (TNFα, 83.3%; IL-6, 90.1%) respectively. Proteomic analyses of microbes demonstrated that ACV impaired cell integrity, organelles and protein expression. ACV treatment resulted in an absence in expression of DNA starvation protein, citrate synthase, isocitrate and malate dehydrogenases in E-coli; chaperone protein DNak and ftsz in S. aureus and pyruvate kinase, 6-phosphogluconate dehydrogenase, fructose bisphosphate were among the enzymes absent in C.albican cultures. The results demonstrate ACV has multiple antimicrobial potential with clinical therapeutic implications.
Background: Acne vulgaris is a very common skin disease and several modalities are used to manage the condition. Among those is Complementary Alternative Medicine (CAM). This study aims to evaluate the prevalence of CAM usage among acne vulgaris patients, and to determine possible factors associated with its adoption over the prescribed modern medicines.
Methods: A cross-sectional survey, conducted during an acne awareness campaign at King Abdulaziz University Hospital (KAUH), in Jeddah, Saudi Arabia. The survey was conducted between January 21st and 28th 2016.
Results: A total of 658 subjects were interviewed of which 68% were female and 32% were male; 72% reported a positive past-history of acne. The face was the most frequently affected site (90.7%). Among all acne sufferers, 77% admitted using CAM. Honey was the most common CAM type used by 53.4%, followed by yogurt (43.4%). Both gender and past history of side effects to medical treatment were associated with CAM use, but the levels of education was not.
Conclusions: CAM users were mainly middle-aged females: their high levels of education did not lower the CAM adoption rates. Their choices could have been driven by cultural beliefs and boundaries embedded in the community.
In this study, the antioxidant contents and the antimicrobial activities of 18 vinegar samples were investigated. For this purpose, total flavonoid contents (TFC) and total phenolic contents (TPC) of different vinegar samples were determined. In addition, total antioxidant capacities (TAC) of vinegars were analyzed using four different in vitro tests: ABTS, CUPRAC, DPPH, and FRAP, in parallel. Results obtained from antioxidant analyses showed that balsamic vinegar had the highest TFC (96 textpm 18 mg CE/100 mL) and TPC values (255 textpm 24 mg GAE/100 mL), as well as the highest TAC determined using CUPRAC (709 textpm 108 mg Trolox/100 mL) and FRAP (421 textpm 28 mg Trolox/100 mL) methods. The phenolic profiles of vinegar samples were identified by performing HPLC analysis. Among all vinegar samples studied, the most abundant phenolic compounds were determined to be gallic acid, protocatechuic acid, and p-hydroxybenzoic acid. Furthermore, antimicrobial activities of different vinegars, against Staphylococcus aureus, Salmonella Typhimurium, and Escherichia coli, were evaluated using disc diffusion method; the results of which were related to the acetic acid contents and the pH values of the vinegar samples. Balsamic vinegar was again determined to be the sample that had the highest antimicrobial activity, which showed a strong antibacterial activity against S. Typhimurium. Antibacterial activities of vinegars could partly be related to both their acetic acid contents and the pH values, and also to their phenolic contents.
Stings from the hydrozoan species in the genus Physalia cause intense, immediate skin pain and elicit serious systemic effects. There has been much scientific debate about the most appropriate first aid for these stings, particularly with regard to whether vinegar use is appropriate (most current recommendations recommend against vinegar). We found that only a small percentage (≤1.0%) of tentacle cnidae discharge during a sting event using an ex vivo tissue model which elicits spontaneous stinging from live cnidarian tentacles. We then tested a variety of rinse solutions on both Atlantic and Pacific Physalia species to determine if they elicit cnidae discharge, further investigating any that did not cause immediate significant discharge to determine if they are able to inhibit cnidae discharge in response to chemical and physical stimuli. We found commercially available vinegars, as well as the recently developed Sting No More ® Spray, were the most effective rinse solutions, as they irreversibly inhibited cnidae discharge. However, even slight dilution of vinegar reduced its protective effects. Alcohols and folk remedies, such as urine, baking soda and shaving cream, caused varying amounts of immediate cnidae discharge and failed to inhibit further discharge, and thus likely worsen stings.
Background
The acidic pH of the stratum corneum (SC) is important for epidermal permeability barrier homeostasis. Acidification of the skin surface has been suggested as a therapeutic strategy for skin disorders such as atopic dermatitis (AD).
Objective
We performed an animal study to evaluate the usefulness of acidification of SC for inhibition of AD lesions and to find out if the therapeutic effect of vinegar is attributable to its herbal contents, rather than its acidity.
Methods
Five groups of six oxazolone-treated (Ox)-AD mice were treated for three weeks with creams of different acidity: vehicle cream alone (pH 5.5), neutralized vinegar cream (pH 7.4), pH 5.0 vinegar cream, pH 3.5 vinegar cream, and pH 3.5 hydrogen chloride (HCl) cream. Also, we have compared two groups of Ox-AD mice treated with pH 5.5 vehicle cream or pH 5.5 vinegar cream.
Results
Ox-AD mice treated with acidic creams exhibited fewer AD-like lesions, had significantly lower eczema scores, decreased basal by transepidermal water loss (TEWL), and increased SC hydration compared to the groups given only vehicle and neutral cream. There was no significant difference between the acidic vinegar and HCl groups. Between the groups treated with vehicle and pH 5.5 vinegar cream, there was no difference in eczema score, basal TEWL and SC hydration.
Conclusion
Application of topical acids, regardless of their source materials, inhibits the development of AD lesions by maintenance of skin surface pH and skin barrier function in murine model.
There is a growing cause for concern on envenoming European species because of jellyfish blooms, climate change and globalization displacing species. Treatment of envenomation involves the prevention of further nematocyst release and relieving local and systemic symptoms. Many anecdotal treatments are available but species-specific first aid response is essential for effective treatment. However, species identification is difficult in most cases. There is evidence that oral analgesics, seawater, baking soda slurry and 42-45 °C hot water are effective against nematocyst inhibition and giving pain relief. The application of topical vinegar for 30 s is effective on stings of specific species. Treatments, which produce osmotic or pressure changes can exacerbate the initial sting and aggravate symptoms, common among many anecdotal treatments. Most available therapies are based on weak evidence and thus it is strongly recommended that randomized clinical trials are undertaken. We recommend a vital increase in directed research on the effect of environmental factors on envenoming mechanisms and to establish a species-specific treatment. Adequate signage on jellyfish stings and standardized first aid protocols with emphasis on protective equipment and avoidance of jellyfish to minimize cases should be implemented in areas at risk.
Introduction:
Localised infections, and burn wound sepsis are key concerns in the treatment of burns patients, and prevention of colonisation largely relies on biocides. Acetic acid has been shown to have good antibacterial activity against various planktonic organisms, however data is limited on efficacy, and few studies have been performed on biofilms.
Objectives:
We sought to investigate the antibacterial activity of acetic acid against important burn wound colonising organisms growing planktonically and as biofilms.
Methods:
Laboratory experiments were performed to test the ability of acetic acid to inhibit growth of pathogens, inhibit the formation of biofilms, and eradicate pre-formed biofilms.
Results:
Twenty-nine isolates of common wound-infecting pathogens were tested. Acetic acid was antibacterial against planktonic growth, with an minimum inhibitory concentration of 0.16-0.31% for all isolates, and was also able to prevent formation of biofilms (at 0.31%). Eradication of mature biofilms was observed for all isolates after three hours of exposure.
Conclusions:
This study provides evidence that acetic acid can inhibit growth of key burn wound pathogens when used at very dilute concentrations. Owing to current concerns of the reducing efficacy of systemic antibiotics, this novel biocide application offers great promise as a cheap and effective measure to treat infections in burns patients.
Uremic pruritus is a common complication in patients with chronic kidney disease. While its cause is not known for certain, different treatments are currently applied. This study aimed to compare the effects of Avena sativa, diluted vinegar, and hydroxyzine on the reduction of uremic pruritus.
In this crossover randomized clinical trial, 23 hemodialysis patients with uremic pruritus were randomly divided into 3 groups. The first group was treated with Avena sativa lotion, twice a day, for as long as 2 weeks; the second group received diluted vinegar; and the third group took hydroxyzine tablets for the same time span. After 3-day-long washout periods, the therapeutic methods were crossed over. The data were collected by a pruritus scale and a visual analogue scale, which were completed before and after the interventions.
Avena sativa lotion significantly decreased the mean scores of pruritus intensity, consequences, and the verbal descriptor, although it did not have a significant effect on the frequency of pruritus and the pruritic surface. Vinegar and hydroxyzine significantly decreased all of the scores. Conclusions. Avena sativa, vinegar, and hydroxyzine were effective in decreasing pruritus. Diluted vinegar and Avena sativa can be used as a complement to hydroxyzine, which is itself a common pharmaceutical therapy.
Antiseptics are widely used in wound management to prevent or treat wound infections due to their proven wound healing properties regardless of their cytotoxicity. The objective of this study was to determine the bactericidal effects of three antiseptics on pathogens known to cause wound infections.
The study was carried out at a tertiary care hospital and a university microbiology laboratory in Sri Lanka in 2013. The three acids (acetic acid, ascorbic acid and boric acid) in increasing concentration (0.5%, 0.75% and 1%) were tested against bacterial suspensions equivalent to 0.5 McFarland standard. The Bacteria isolates used were isolated from wound and standard strains of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa.
There were 33 (68.8%) Coliforms, 10 (20.8%) Pseudomonas species, and 5 (10.4%) strains of Staphylococcus aureus. Acetic acid at concentration of 0.5% inhibited growth of 37 (77%) and 42 (87.5%) of tested isolates when exposed for 30 and 60 minutes, respectively. However 100% inhibition was achieved at four hours. At a concentration of 0.75%, 40 (83.3%) and 44 (91.7%) were inhibited when exposed for 30 and 60 minutes, respectively, with 100% inhibition at 4 hours. At concentration of 1%, 46 (95.8%) inhibition was seen at 30 minutes and 100% inhibition at 60 minutes. Ascorbic acid, at 0.5% and 0.75 % concentrations, inhibited growth of 45(93.7%) and 47(97.9%) of isolates respectively when exposed for 30 minutes. At these two concentrations, 100% inhibition was achieved when exposed for one hour. At 1% concentration, 100% inhibition was achieved at 30 minutes. Boric acid did not show bactericidal effect at concentrations of 0.5%, 0.75 % and 1%. Pseudomonas species were inhibited at 30 minutes by 0.5% acetic acid. Bactericidal effect against all the standard strains was seen with three acids at each concentration tested from 30 minutes onwards
Ascorbic acid was bactericidal for all organisms tested within the shortest exposure time at the lowest concentration compared to other two acids. Despite promising bactericidal effects, further studies warrant, as ongoing debates on toxicity of acids on tissue epithelialisation. Application of antiseptics for a shorter duration could overcome this problem without losing bactericidal activity.
The authors have no conflict of interest and no funding was received for this study.
Marine stings are common but most are minor and do not require medical intervention. Severe and systemic marine envenom-ing is uncommon, but includes box jellyfish stings, Irukandji syndrome, major stingray trauma and blue-ringed octopus enven-oming. Almost all marine injuries are caused by jellyfish stings, and penetrating injuries from spiny fish, stingrays or sea urchins.
This article describes the presentation and management of marine envenomations and injuries that may occur in Australia.
First aid for jellyfish includes tentacle removal, application of vinegar for box jellyfish, and hot water immersion (45°C for 20 min) for bluebottle jellyfish stings. Basic life support is essential for severe marine envenomings that result in cardiac collapse or paralysis. Irukandji syndrome causes severe generalised pain, autonomic excess and minimal local pain, which may require large amounts of analgesia, and, uncommonly, myocardial depression and pulmonary oedema occur. Penetrating marine inju-ries can cause significant trauma depending on location of the injury. Large and unclean wounds may have delayed healing and secondary infection if not adequately irrigated, debrided and observed.
Green nails, also known as chloronychia or green nail syndrome, are characterized by green discoloration of the nail plate (greenish-yellow, greenish-brown, greenish-black), proximal chronic non-tender paronychia, and distolateral onycholysis. The cause is Pseudomonas aeruginosa infection of the nail plate in persons whose hands are constantly exposed to water, soaps, and detergents or are subject to mechanical trauma, especially in the elderly. Green or black coloration of the nails should raise suspicion for Pseudomonas infection and be treated with an oral quinolone (ciprofloxacin), particularly in aged patients. We present three cases of green nails in elderly persons.
Effective and economical mycobactericidal disinfectants are needed to kill both Mycobacterium tuberculosis and non-M. tuberculosis mycobacteria. We found that acetic acid (vinegar) efficiently kills M. tuberculosis after 30 min of exposure to a 6% acetic acid solution. The activity is not due to pH alone, and propionic acid also appears to be bactericidal. M. bolletii and M. massiliense nontuberculous mycobacteria were more resistant, although a 30-min exposure to 10% acetic acid resulted in at least a 6-log10 reduction of viable bacteria. Acetic acid (vinegar) is an effective mycobactericidal disinfectant that should also be active against most other bacteria. These findings are consistent with and extend the results of studies performed in the early and mid-20th century on the disinfectant capacity of organic acids.
IMPORTANCE Mycobacteria are best known for causing tuberculosis and leprosy, but infections with nontuberculous mycobacteria are an increasing problem after surgical or cosmetic procedures or in the lungs of cystic fibrosis and immunosuppressed patients. Killing mycobacteria is important because Mycobacterium tuberculosis strains can be multidrug resistant and therefore potentially fatal biohazards, and environmental mycobacteria must be thoroughly eliminated from surgical implements and respiratory equipment. Currently used mycobactericidal disinfectants can be toxic, unstable, and expensive. We fortuitously found that acetic acid kills mycobacteria and then showed that it is an effective mycobactericidal agent, even against the very resistant, clinically important Mycobacterium abscessus complex. Vinegar has been used for thousands of years as a common disinfectant, and if it can kill mycobacteria, the most disinfectant-resistant bacteria, it may prove to be a broadly effective, economical biocide with potential usefulness in health care settings and laboratories, especially in resource-poor countries.
A perceived recent increase in global jellyfish abundance has been
portrayed as a symptom of degraded oceans. This perception is
based primarily on a few case studies and anecdotal evidence, but
a formal analysis of global temporal trends in jellyfish populations
has been missing. Here, we analyze all available long-term datasets
on changes in jellyfish abundance across multiple coastal stations,
using linear and logistic mixed models and effect-size analysis to
showthat there is norobust evidence for a global increase in jellyfish.
Although there has been a small linear increase in jellyfish since the
1970s, this trend was unsubstantiated by effect-size analysis that
showed no difference in the proportion of increasing vs. decreasing
jellyfish populations over all time periods examined. Rather, the
strongest nonrandom trend indicated jellyfish populations undergo
larger, worldwide oscillations with an approximate 20-y periodicity,
including a rising phase during the 1990s that contributed to the perception
of a global increase in jellyfish abundance. Sustained monitoring
is required over the next decade to elucidate with statistical
confidence whether the weak increasing linear trend in jellyfish
after 1970 is an actual shift in the baseline or part of an oscillation.
Irrespective of the nature of increase, given the potential damage
posed by jellyfish blooms to fisheries, tourism, and other human
industries, our findings foretell recurrent phases of rise and fall in
jellyfish populations that society should be prepared to face.
Head louse infestation, or pediculosis capitis, caused by Pediculus humanus var. capitis, is a common health concern in pediatric age group. An itching of the scalp is the chief symptom, whereas presence of viable nits confirms the diagnosis of head louse infestation. Secondary bacterial infection with impetignization with cervical and occipital lymphadenopathy can complicate the clinical scenario with physician misdiagnosing pediculosis to a primary bacterial infection. Screening and treatment of all close contacts is necessary for an adequate management of pediculosis. Medical management of head louse infestation requires proper application of topical pediculicidal agents', chiefly permethrin lotion and wet combing with a fine toothcomb. Severe cases with high parasitic load justify the use of either oral cotrimoxazole or Ivermectin. Other described technique involves a single application of hot air for 30 minutes. Radical but culturally unacceptable method would be shaving of scalp in resistant cases. Environmental fogging with insecticides is neither necessary nor recommended.
Wound care is the cornerstone of treatment for patients with epidermolysis bullosa (EB); however, there are currently no guidelines to help practitioners care for these patients.
The objective of this study was to generate a list of recommendations that will enable practitioners to better care for patients with EB.
An expert panel generated a list of recommendations based on the best evidence available. The recommendations were translated into a survey, and sent to other EB experts to generate consensus using an online-based modified Delphi method. The list was refined and grouped into themes and specific recommendations.
There were 15 respondents (45% response rate), with significant experience in the EB field (>10 years [67%]). Respondents included physicians (67%), nurses (17%), and allied health professionals (7%). There was more than 85% agreement for all the proposed items. These were further refined and grouped into 5 main themes (assessment and management of factors that impair healing, patient-centered concerns, local wound care, development of an individualized care plan, and organizational support) and 17 specific recommendations.
There is a paucity of scientific evidence with most recommendations based on expert opinion.
These recommendations will provide practitioners with a framework for caring for these patients. Additional scientific research including effectiveness studies for everyday practice and expert consensus, may further refine these recommendations.
Background/objectives:
Epidermolysis bullosa (EB) comprises a group of inherited skin blistering diseases. There is currently no cure, and management includes skin protection and prevention of infection. To date, there has been no systematic investigation of home skin care practices among EB patients on a multicenter scale.
Methods:
This cross-sectional, observational study included data collected from patients with EB enrolled in the Epidermolysis Bullosa Characterization and Clinical Outcomes Database (EBCCOD) who provided answers to a patient-directed questionnaire between January 1, 2017, and December 31, 2017.
Results:
Of 202 respondents, 130 (64.4%) had dystrophic EB, 51 (25.2%) had EB simplex, 21 (7.4%) had junctional EB, 3 (1.5%) had Kindler syndrome, and 3 (1.5%) had an unspecified subtype. Seventy-eight patients reported cleansing in plain water only (39%). Of those who used an additive in their cleansing water, 75 (57%) added salt, 71 (54%) added bleach, 36 (27%) added vinegar, and 34 (26%) endorsed the use of an "other" additive (multiple additives possible). Reported concentrations of additives ranged widely from 0.002% sodium hypochlorite and 0.002% acetic acid solutions, which are thought to have negligible effects on microbes, to 0.09% sodium hypochlorite and 0.156% acetic acid, concentrations shown to be cytotoxic. One hundred eighty-eight patients answered questions regarding topical product use (93%). Of those, 131 reported topical antimicrobial use (70%). Mupirocin and bacitracin were the most commonly reported topical antibiotics (59, 58 [31.4%, 30.9%], respectively).
Conclusions:
These findings highlight the variety of skin care routines and frequent use of topical antimicrobials among EB patients and have potential implications for antibiotic resistance. The reported range of bleach and vinegar additives to cleansing water, including cytotoxic concentrations, emphasizes the need for clear and optimized skin cleansing recommendations.
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.
Background/Objectives
Skin infection is common in atopic dermatitis (AD), often necessitating treatment with systemic antibiotics. Topical adjunctive therapies such as dilute bleach baths are increasingly recommended, and topical dilute acetic acid (AA) has not been widely studied. The objective of this study was to evaluate whether various topical anti‐infective bathing recommendations were associated with decreased systemic antibiotic exposure in pediatric AD, as well as evaluate topical anti‐infective recommendations over time within our institution.
Methods
Clinical data were extracted from charts of pediatric patients from 1/1/2000 to 12/31/2005 and 1/1/2009 to 12/31/2014 who visited outpatient dermatology clinics at Mayo Clinic, Rochester, a tertiary referral center. Recommendations for topical anti‐infectives (dilute AA, dilute bleach, other, or none) at any time after patient had clinically proven or suspected AD superinfection were recorded as exposures to topical anti‐infective. Primary outcome was the number of systemic antibiotic courses in a 1‐year period.
Results
Of 1111 patients with AD, 753 met inclusion criteria (303 in 2000‐2005; 450 in 2009‐2014). Of these, 351 (46.6%) had culture‐proven or clinically suspected superinfection. Topical anti‐infective recommendations increased between the time periods (23.3% to 79.2%; P < 0.001) and number of courses of systemic antibiotics decreased (1.9 per year vs 1.5 per year, P = 0.010). Number of systemic antibiotic courses did not differ between those who received bathing recommendations and those who did not, nor between different anti‐infective groups (P = 0.398).
Conclusions
Practice behaviors have changed, and topical anti‐infectives are now commonly recommended. Neither dilute AA nor bleach baths were associated with fewer subsequent exposures to systemic antibiotics in the treatment of pediatric AD.
These are the days when one would go online first seeking home remedies before seeing a doctor. Apple cider vinegar (ACV) is one such popular yet scientifically under-validated remedy. Our results prove the unequivocal antimicrobial activity of ACV to be true at full strength concentrations. However, the activity cannot be generalised because although strong antibacterial activity was observed at 25% concentrations, in terms of antifungal activity, yeasts, especially Candida were found to be less susceptible. The antimicrobial/antioxidant properties are ascertained to the total phenolic contents of ACV, as confirmed by our characterisation of the bioactive compounds and antioxidant activity. When checking for its cytotoxicity, ACV exhibited toxicity even at concentrations as low as 0.7%. These results indicate that there is no question of generalising the idea of ACV usage, instead more in vitro and in vivo validations are necessary in order to precisely weigh the pros and cons of ACV.
In this proof of concept study, 50 lesions from 15 patients with multiple seborrheic keratoses (SKs) were treated with a novel aqueous solution containing nitric acid, zinc and copper salts, and organic acids (acetic, lactic, and oxalic acid). Treatment consisted in the application of an amount of the solution sufficient to obtain a whitening/yellowish reaction. Application of the nitric–zinc solution was performed every other week until clinical and dermoscopic clearance or crust formation, for a maximum of 4 applications. Efficacy evaluation was performed at 8 weeks (T1) and 6 months (T2). All subjects, who reported no or minimal discomfort during and after the application of the solution, completed the study. At T1, a complete clinical and dermoscopic resolution was observed in 37 lesions after an average of 3 applications/lesion (range 2–4). A partial response, with minimal persistent residual spots, was detected in the remaining 13 lesions. All patients with complete clearance showed no relapses at a 6-month follow-up (T2). The positive preliminary results indicate that this novel solution may represent a promising alternative option for SKs especially in patients not keen or eligible to undergo invasive tissue-destructive procedures.
Background:
In addition to the release of lead and cadmium from ceramic and glass vessels, (acceptable limits being set by the EU 84/500/EC Directive), other harmful metals can migrate, such as nickel and chromium. Permissible migration limits for these latter metals however have not yet been set in the EU legislation. Both the toxic properties of nickel and chromium and the measures taken by the European Commission Working Group on Food Contact Materials for verifying permissible migration limits for lead, cadmium and other metals from ceramics have acted as drivers for studies on nickel and chromium release from ceramic and glass tableware.
Objective:
To investigate the migration of nickel and chromium into food simulants from ceramic and glassware, available on the Polish market, which are intended for coming into contact with food. Potential consumer exposure can thereby be estimated from the release of these elements into food.
Materials and methods:
Tableware consisted of ceramics and glass vessels generally available on the domestic market, with inner surfaces being mainly coloured and with rim decorations. Migration of nickel and chromium studied from the ceramics was carried out in 4% acetic acid (24 ± 0.5 hrs at 22 ± 2°C), whilst that from glassware in 4% acetic acid (24 ± 0.5 hrs at 22 ± 2°C) and 0.5% citric acid (2 ± 0.1 hrs at 70 ± 2°C). The concentrations of metals which had migrated into the test solutions were measured by using flame atomic absorption spectrometry (FAAS). This analytical procedure had been previously validated by measuring nickel and chromium released into food simulants from ceramic and glass tableware where working ranges, detection limits, quantification limits, repeatability, accuracy, mean recovery and uncertainty were established.
Results:
Migration of nickel and chromium was measured from 172 ceramic and 52 and glass vessels samples, with all results being below the limits of quantification (LOQ = 0.02 mg/L), excepting one instance where a 0.04 mg/L concentration of nickel was found. The validated methods for measuring chromium achieved the following parameters; 0.02 to 0.80 mg/L operating range, 0.01 mg/L detection limit, 0.02 mg/L limit of quantification, 6% repeatability, 2.8% accuracy, 102% average recovery and 11% uncertainty. For the nickel method the corresponding parameters were 0.02 to 0.80 mg/L work- ing range, 0.02 mg/L limit of quantification, 0.01 mg/L detection limit, 5% repeatability, 6.5% accuracy, 101% average recovery and 12% uncertainty.
Conclusions:
The tested ceramics and glassware did not pose a threat to human health regarding migration of nickel and chromium, and thus any potential exposure to these metals released from these products into food will be small. However, due to the toxicity of these metals, the migration of nickel and chromium is still required for articles coming into contact with food, which includes metalware.
Key words:
ceramic tableware, ceramics, glassware, food contact articles, nickel, chromium leaching, migration.
Vinegars are liquid products produced from the alcoholic and subsequent acetous fermentation of carbohydrate sources. They have been used as remedies in many cultures and have been reported to provide beneficial health effects when consumed regularly. Such benefits are due to various types of polyphenols, micronutrients and other bioactive compounds found in vinegars that contribute to their pharmacological effects, among them, antimicrobial, antidiabetic, antioxidative, antiobesity and antihypertensive effects. There are many types of vinegars worldwide, including black vinegar, rice vinegar, balsamic vinegar and white wine vinegar. All these vinegars are produced using different raw materials, yeast strains and fermentation procedures, thus giving them their own unique tastes and flavours. The main volatile compound in vinegar is acetic acid, which gives vinegar its strong, sour aroma and flavour. Other volatile compounds present in vinegars are mainly alcohols, acids, esters, aldehydes and ketones. The diversity of vinegars allows extensive applications in food.
In brief: Millions of divers, swimmers, and other ocean-goers may encounter jellyfish. If they are stung, they may need either first aid if the case is mild, or extensive treatment if they suffer anaphylaxis, cardiorespiratory problems, or long-term reactions. Some severe cases may even be fatal. The author describes the mechanisms of envenomation and tissue reaction and discusses how to recognize and treat both the immediate and late sequelae.
Introduction:
Otitis externa is thought to affect 10% of people at some stage, and can present in acute, chronic, or necrotising forms. Otitis externa may be associated with eczema of the ear canal, and is more common in swimmers, humid environments, people with absence of ear wax or with narrow ear canals, hearing-aid users, and after mechanical trauma.
Methods and outcomes:
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of empirical and prophylactic treatments for otitis externa? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
Results:
We found nine systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
Conclusions:
In this systematic review we present information relating to the effectiveness and safety of the following interventions: oral antibiotics, specialist aural toilet, topical acetic acid drops or spray, topical aluminium acetate drops, topical antibacterials, topical antifungals, topical anti-infective agents, topical corticosteroids, and water exclusion.
In the United States, chronic ulcers - including decubitus, vascular, inflammatory, and rheumatologic subtypes - affect >6 million people, with increasing numbers anticipated in our growing elderly and diabetic populations. These wounds cause significant morbidity and mortality and lead to significant medical costs. Preventative and treatment measures include disease-specific approaches and the use of moisture retentive dressings and adjunctive topical therapies to promote healing. In this article, we discuss recent advances in wound care technology and current management guidelines for the treatment of wounds and ulcers.
Background
Fruit-derived organic compounds and detergents are relevant exposure factors for occupational contact dermatitis in the food industry. Although individuals with atopic dermatitis (AD) are at risk for development of occupational contact dermatitis, there have been no controlled studies on the effects of repeated exposure to multiple irritants, relevant for the food industry, in atopic skin.Objectives
The aim of the study was to investigate the outcomes of repeated exposure to a fruit-derived organic acid and a detergent in AD compared to healthy volunteers.Methods
The volunteers were exposed to 2.0% acetic acid (AcA) and/or 0.5% sodium lauryl sulfate (SLS) in controlled tandem repeated irritation test. The outcomes were assessed by measurements of erythema, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) levels.ResultsIn the AD volunteers, repeated AcA exposure led to barrier disruption and significant TEWL increase; no significant differences after the same exposure in the healthy controls were found. Repeated exposure to SLS and the irritant tandems enhanced the reactions and resulted in a significantly higher increase in TEWL in the AD compared to the control group. Cumulative irritant exposure reduced the NMF levels in both groups.Conclusions
Differences in the severity of irritant-induced barrier impairment in atopic individuals contribute to the risk for occupational contact dermatitis in result of multiple exposures to food-derived irritants and detergents.
"Natural home remedies" for nevi removal found on the Internet can be ineffective, or worse, dangerous. Children and teens, in particular, may be more likely to attempt self-treatment in order to avoid discussing their concerns with their parents. Here, the authors report a case of an adolescent who presented with a chemical burn after following an Internet-based protocol for nevi removal using apple cider vinegar.
• Three topical antibiotics and four antiseptics (1% povidone-iodine, 0.25% acetic acid, 3% hydrogen peroxide, and 0.5% sodium hypochlorite) were directly applied to cultured human fibroblasts to quantitatively assess their cytotoxicity. The four antiseptics were found to be cytotoxic; all of the cytotoxic agents except hydrogen peroxide were subsequently found to adversely affect wound healing in an animal model. Comparison of bactericidal and cytotoxic effects of serial dilutions of these four topical agents indicated the cellular toxicity of hydrogen peroxide and acetic acid exceeded their bactericidal potency. Bactericidal noncytotoxic dilutions of povidone-iodine and sodium hypochlorite were identified. These experiments provide evidence that 1% povidone-iodine, 3% hydrogen peroxide, 0.5% sodium hypochlorite, and 0.25% acetic acid are unsuitable for use in wound care. This sequence of experiments could be used to identify bactericidal, noncytotoxic agents prior to their clinical use.(Arch Surg 1985;120:267-270)
Vinegar contains about 5% acetic acid in water, varying amounts of fixed fruit acids, colouring matter, salts and a few other fermentation products which impart characteristic flavour and aroma to the product. Vinegar traditionally has been used as a food preservative. Vinegar production methods could range from traditional methods employing wooden casks (Orleans Process) and surface culture (Generator Process) to submerged fermentation. Vinegar is the product made from the conversion of ethyl alcohol to acetic acid by a genus of bacteria Acetobacter. Many technical devices have been developed to improve the industrial production of vinegar. Generally, these improvements increase the speed of the transformation of ethanol into acetic acid in the presence of acetic acid bacteria. In this review a detailed description on vinegar production, methods of production, different substrates and microorganisms used for its production, and the chemistry of vinegar is presented.
Inclusion criteria:
All patients with chronic wounds infected with P. aeruginosa.
Exclusion criteria:
Wounds due to massive burns, suspected malignancy, immunocompromised individuals and individuals with sepsis. A total of 32 patients enrolled in the study. Subjects were randomised equally to the 1% acetic acid group and saline dressing group. None of the patients received any systemic antibiotics during the study period and received twice daily dressings. The endpoint of the treatment was wounds free of P. aeruginosa. The duration of treatment required to eliminate the Pseudomonas from the wounds in the acetic acid group was on an average 7 days less than that required by the saline group. P value was <0·001. In the 1% acetic acid group irrespective of the sensitivity of the organism to antibiotics, Pseudomonas organisms were eliminated within the same time period - 4·5 days. In the saline group, susceptible organisms were eliminated within 11·5 days and multidrug-resistant organisms were eliminated by 15·5 days. 1% acetic acid is a simple, safe and effective topical antiseptic that can be used in the elimination of P. aeruginosa from chronic infected wounds.
This manuscript highlights and critically analyses clinical and forensic signs related to chemical burns. Signs that may lead to suspicion of a particular chemical are thoroughly discussed regarding its underlying mechanisms. Burns due to sulfuric, hydrofluoric, nitric, hydrochloric (muriatic) and acetic (including derivatives) acids, hydrogen sulphide, sodium (caustic soda) and calcium (cement) hydroxides, paraquat, burns after inflation and rupture of airbags, povidone–iodine, chlorhexidine/alcohol (in preterm infants), laxatives, and vesicants (warfare agents), will be reviewed since these are the most common agents found in daily practice, for which relevant and timed information may be helpful in formulating an emergency treatment protocols and toxicological analysis.
PurposeTo evaluate the in vitro antifungal activity of apple cider vinegar on Candida spp. involved in denture stomatitis.Material and Methods
The microdilution technique was used to determine the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of apple cider vinegar containing 4% maleic acid, and nystatin (control). Further tests of microbial kinetics and inhibition of adherence to acrylic resin were performed testing different concentrations (MIC, MICx2, MICx4) of the products at time intervals of 0, 30, 60, 120 and 180 minutes. A roughness meter was used to measure the changes in surface roughness; color change of the acrylic resin specimens exposed to the test products in different concentrations and time intervals were also evaluated.ResultsApple cider vinegar (4%) showed MIC of 2500 μg/ml and MFC of 2500, 5000, and 10,000 μg/ml depending on the strain tested. Nystatin showed MIC of 3.125 μg/ml and strain-dependent MFC values ranging from 3.125 to 12.5 μg/ml. The microbial kinetic assay showed a statistical difference between apple cider vinegar and nystatin (p < 0.0001). After 30 minutes of exposure, apple cider vinegar showed fungicidal effect at MICx4, whereas nystatin maintained its fungistatic effect. Apple cider vinegar showed greater inhibition of adherence (p < 0.001) compared to control. Apple cider vinegar did not significantly alter the surface roughness of the acrylic resin specimens compared to nystatin (p > 0.05), and both had no influence on their color.Conclusion
Apple cider vinegar showed antifungal properties against Candida spp., thus representing a possible therapeutic alternative for patients with denture stomatitis.
Toxicological studies show that oral doses of nickel and chromium can cause cutaneous adverse reactions such as dermatitis. Additional dietary sources, such as leaching from stainless steel cookware during food preparation, are not well characterized. This study examined stainless steel grades, cooking time, repetitive cooking cycles, and multiple types of tomato sauces for their effects on nickel and chromium leaching. Trials included three types of stainless steels and a stainless steel saucepan; cooking times of 2 to 20 hours, ten consecutive cooking cycles, and four commercial tomato sauces. After a simulated cooking process, samples were analyzed by ICP-MS for Ni and Cr. After six hours of cooking, Ni and Cr concentrations in tomato sauce increased up to 26- and 7-fold respectively, depending on the grade of stainless steel. Longer cooking durations resulted in additional increases in metal leaching, where Ni concentrations increased 34 fold and Cr increased approximately 35 fold from sauces cooked without stainless steel. Cooking with new stainless steel resulted in the largest increases. Metal leaching decreases with sequential cooking cycles and stabilized after the sixth cooking cycle, though significant metal contributions to foods were still observed. The tenth cooking cycle, resulted in an average of 88 µg of Ni and 86 µg of Cr leached per 126 g serving of tomato sauce. Stainless steel cookware can be an overlooked significant source of nickel and chromium, where the contribution is dependent on stainless steel grade, cooking time, and cookware usage.
Kurozu (Japanese black vinegar), a traditional product made from unpolished rice, contains beneficial organic materials and minerals. Improved manufacturing processes yielded a new vinegar, Izumi, that contains large amounts of these constituents. Because the antioxidative effects of Kurozu are well understood, we examined Izumi for its anticancer activity against the human squamous cell carcinoma (SCC) cell line HSC-5. HSC-5 cells were treated with Izumi or ordinary grain vinegar adjusted to 4.2% acidicity. MTT assay and the trypan blue dye exclusion test showed that Izumi significantly inhibited the proliferation of HSC-5 cells compared to ordinary grain vinegar. Propidium iodide (PI) flow cytometry and annexin V/PI staining revealed that among cells treated or untreated with Izumi or ordinary grain vinegar there was no difference in the number of apoptotic cells. A new form of necrosis, programmed necrosis or necroptosis, has been proposed. It is mediated by receptor-interacting serine-threonine kinase 3 (RIPK3), key signaling molecule, and results in the release of cellular danger-associated molecular patterns (DAMPs). When HSC-5 cells were treated with Izumi, the cellular level of RIPK3 protein and the amount of high-mobility group protein B1, one of the DAMPs, released into culture media were remarkably increased. These findings indicate that Izumi inhibits the proliferation of human SCC cells via programmed necrosis (necroptosis).
Notwithstanding the above advantages, the major concern is low specificity (a high false-positive rate), which means that many subjects must be recalled for colposcopy. The frequency of referral after VIA ranged from 3.1% to 38.7% in reported studies.11-16 It seems that the objectivity of the test can further be improved with adequate training of the providers and possibly by magnification. We believe that the low proportion of acetowhite cases in our study was due to 1) the prolonged training of our workers, 2) including colposcopy sessions in the training, and 3) scoring only those with distinct acetowhite areas on the cervix as positive and not including those with faint and suspicious whitish appearances. However, another explanation for the low proportion of acetopositivity is that the subjects in this study more or less resembled the general population as opposed to selected diseased populations attending the clinic-based studies. The proportion of acetopositive subjects was approximately 12-13% in 2 other studies,11, 14 indicating that the proportion recalled for further investigations and false-positives may be considerably reduced by technical refinements and in general populations. Despite this, it does seem likely that a higher proportion of subjects will require follow-up after VIA than with good quality cervical cytology. However, because the result of VIA is immediately available, colposcopy and treatment of preinvasive lesions could be performed during the same visit, which will certainly have favorable implications for the costs of screening. Alternatively, because treatment (cauterization or cryotherapy) may have a low risk of morbidity, treatment of a large number of false-positives may be judged as an acceptable price to pay for the effective control of cervical carcinoma.