Does Apple Cider Vinegar for Acne Actually Make It Worse?

Tagged in: Skin Health

by Dr. Bryan Do, D.O. Last Updated: July 08, 2019

Does Apple Cider Vinegar Help Acne?

Over the years, apple cider vinegar has become increasingly popular for its health benefits. While some people take it orally, others apply it topically for skin conditions such as acne. In addition to some favorable anecdotes claiming that apple cider vinegar is good for acne, there is some research to suggest that it has acne-bacteria killing properties.

Let’s take a closer look at how the use of apple cider vinegar is used for acne and whether or not apple cider vinegar is good for acne.

Causes of Acne

Acne is caused by a number of factors, including diet, inflammation, poor hygiene, hormonal imbalance, and zinc deficiency. Knowing more about the 5 causes of acne is essential to figuring out how apple cider vinegar may work for acne.

How Is Apple Cider Vinegar Used for Acne?

Users of apple cider vinegar for acne claim that applying apple cider vinegar to the skin as a toner is helpful for acne. To prevent chemical burns, they recommend diluting the vinegar to make it less powerful.

Apple cider vinegar's main ingredient is acetic acid. The way it could help with acne is if this acid is able to kill the acne-causing P. acnes bacteria.

Acetic acid is a carboxylic acid. A prescription drug for acne featuring carboxylic acids is azelaic acid. Azelaic acid has antimicrobial, comedolytic, and mild anti-inflammatory properties. Azelaic acid and vinegar are similar in that they both feature carboxylic acids in their chemical structure.

Not many studies exist regarding the topical application of apple cider vinegar for acne, but here are the risks of applying acetic acid to the skin:

Reason #1 Not to Use: Chemical Burns

Apple cider vinegar contains acetic acid. Application of undiluted acetic acid may cause chemical burns.¹ If you use apple cider vinegar or acetic acid for acne, be sure to dilute it.

Reason #2 Not to Use: Skin Irritation

Undiluted apple cider vinegar may cause irritation. Skin irritation has been known to worsen acne. Increased irritation may cause inflammation, which may lead to hyperpigmentation or darkening of acne scars.²

acv for acne

Does Apple Cider Vinegar Work for Acne?

Reason to Use #1: Apple Cider Vinegar Kills Acne Causing Bacteria

Vinegar is known to inhibit the growth of bacteria, such as Proteus vulgaris, Acinetobacter baumannii and Pseudomonas aeruginosa even at the low concentration of 3%.⁵ There are no studies on the effects of acetic acid on P. acnes but based on the effects of acetic acid on other bacteria, it is plausible that it works for acne.

Does Drinking Apple Cider Vinegar Help Acne?

Reason to Use #2: Apple Cider Vinegar Helps Blood Sugar

Since topical application of ACV for acne is questionable, does drinking apple cider vinegar help acne? Studies on vinegar do show that it may help with stomach ailments and that it possesses potential anti-glycemic properties.⁸ Studies linking diet and acne have found that diets high in glycemic load may contribute to the pathogenesis of acne. Eating foods that have a high glycemic index stimulate the secretion of hormones that worsen acne such as insulin-like growth factor 1 (IGF-1).⁹

Considering these two ideas together, ingesting ACV for acne may have potential. However, more research is necessary to determine if there is any connection between drinking apple cider vinegar and acne reduction, and if so, what the mechanisms of action may be.

Products You Can Use Instead of Apple Cider Vinegar for Acne

Until research proves that the active ingredient of apple cider vinegar is able to inhibit the growth of P. acnes, we recommend the use of proven topical antibiotics like clindamycin or over-the-counter benzoyl peroxide for acne.

Benzoyl Peroxide

Benzoyl peroxide works by actively eliminating acne-causing bacteria while also preventing clogged pores by eliminating dead skin cells.⁶ However, it can come with some side effects, most notably peeling, redness, and irritation. It also has a bleaching effect on both skin and fabrics, resulting in lighter skin and white spots on pillowcases and clothes. In order to keep these potential side effects to a minimum, use a 2.5% benzoyl peroxide. While it can be found in concentrations up to 10%, most studies show that 2.5% benzoyl peroxide is just as effective, with significantly less irritation.⁷

Even with some time for your skin to adjust, you may not be able to handle benzoyl peroxide, especially if you have sensitive skin. Irritation from benzoyl peroxide can resemble the same side effects of ACV for acne, resulting in potentially more acne. Thankfully, there are a variety of other over-the-counter topical alternatives to apple cider vinegar for acne. You can also try salicylic acid and/or glycolic acid for acne. These other acids may not kill P. acnes but have been shown to exfoliate the skin and prevent the clogging of pores.⁴

Salicyclic Acid

Salicylic acid is more gentle than benzoyl peroxide and works in a similar way. Studies show that it is antimicrobial and anti-inflammatory and acts as a peeling agent to remove dead skin and dissolve the debris responsible for clogging pores.¹⁰ Similar to benzoyl peroxide and apple cider vinegar for back acne, salicylic acid may cause initial irritation, including dry, peeling skin. Concentrations generally only go as high as 2%. If you are not used to salicylic acid, apply a light layer to your skin once every two or three days before gradually increasing application frequency as much as twice per day.

Toner

If you prefer using a toner to help with acne, try one with anti-inflammatory properties. Toners work to remove excess dirt, oil, makeup, and any cleanser that you may have missed, while providing hydration and correcting skin’s pH.¹² Popular toners include:

Calendula Toner
Willow Bark Toner
Chamomile Toner
Green Tea Toner
Witch Hazel Toner

If you do use any of these over-the-counter topical acne treatments, make sure that you cleanse your skin using a simple, fragrance-free cleanser prior to application. After applying the treatment, use a face moisturizer and sunscreen. Moisturizer can help to reduce any irritation and redness from these treatments while nourishing your face.

Benzoyl peroxide, salicylic acid, and other alternatives to ACV for acne tend to make your skin more sensitive to UV radiation, which is why sunscreen is a necessity. Aside from preventing skin cancer, sunscreen will prevent skin damage and inflammation that could cause further breakouts and blemishes.

While apple cider vinegar has some potential to treat acne and prevent acne scars, any potential apple cider vinegar benefits for acne require further clinical studies. Consider using more proven acne treatments before using apple cider vinegar for acne.

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About the Author:

Dr. Bryan Do, D.O.

Dr. Bryan Do, D.O. is an osteopathic physician whose research interests include gastroenterology, immunology, and dermatology. He is particularly interested in the role of probiotics in the gut-brain-skin axis and has written many articles on the topic. He graduated from University of California, Los Angeles (UCLA) before graduating from Marian University College of Osteopathic Medicine in Indianapolis, Indiana and becoming a Doctor of Osteopathic Medicine. Osteopathic physicians are taught to take a holistic approach to medicine and to consider mind, body, and spirit when treating a patient. Osteopathic physicians receive training in Osteopathic Manipulative Medicine (OMM) in addition to the standard rigorous medical school curriculum. Both physicians with a Doctor of Osteopathic Medicine (D.O.) degree as well as a Doctor of Medicine (M.D.) can practice medicine.

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