Apple cider vinegar (ACV) is a fermented apple product used for centuries as a traditional remedy and food ingredient. Drinking diluted ACV has recently gained popularity, driven by claims that it can improve various aspects of health, including clearing up acne. Examining whether ingesting ACV can directly treat or prevent acne requires looking at the theoretical internal mechanisms and the current clinical evidence.
Proposed Internal Pathways for Skin Health
The idea that drinking ACV improves skin health relies on its potential indirect effects within the body. Acne is an inflammatory condition influenced by systemic factors like diet and gut health.
Blood Sugar Regulation
One hypothesized pathway involves regulating blood sugar levels. Rapid spikes in blood glucose can trigger hormonal responses that lead to acne flare-ups. The acetic acid in ACV may help slow the rate at which food leaves the stomach, moderating the post-meal rise in blood sugar. This stabilizing effect on glucose metabolism is thought to reduce the insulin spikes that contribute to acne development.
Gut-Skin Axis
The relationship between the gut and the skin, known as the gut-skin axis, provides another theoretical link. Raw, unfiltered ACV contains “the mother,” a mix of bacteria and yeast that may possess probiotic properties. It is also believed to contain prebiotics that promote the growth of beneficial gut bacteria, leading to a more balanced gut microbiome. A healthier gut environment is associated with reduced systemic inflammation, which could indirectly benefit skin health and reduce acne severity.
Clinical Evidence Connecting Ingestion and Acne Reduction
Despite the theoretical pathways, high-quality clinical evidence specifically linking the ingestion of ACV to a reduction in acne lesions is currently absent. Most research on ACV focuses on blood glucose control, weight management, and cholesterol levels. While these studies confirm general health benefits, they do not track acne outcomes as a primary measure.
There is a significant lack of controlled human trials investigating whether adults with acne who drink ACV experience fewer breakouts. Any reported benefits are largely anecdotal or extrapolated from studies focusing on its general anti-inflammatory or blood sugar-lowering properties. Researchers have not established a direct cause-and-effect relationship between consuming ACV and a measurable clinical improvement in acne.
Tangential studies suggest that acetic acid possesses antimicrobial properties against acne-associated bacteria, but these effects are typically observed in laboratory settings or when applied topically. Without dedicated clinical research, the claim that drinking ACV is an effective acne treatment remains scientifically unsupported.
Safe Consumption Guidelines and Potential Side Effects
Individuals who choose to consume ACV for general health benefits must follow safe consumption guidelines to minimize risks. ACV is highly acidic and must always be diluted before drinking to protect the digestive tract and teeth. A common recommendation is to mix one tablespoon (about 15 milliliters) of ACV into at least eight ounces of water.
The high acidity poses a significant risk of eroding tooth enamel. To protect dental health, it is advised to drink the diluted solution through a straw and rinse the mouth thoroughly with plain water immediately afterward. Limit intake to a maximum of one or two tablespoons per day, as excessive consumption can lead to throat irritation and digestive upset.
Drinking ACV may interact with certain medications, particularly insulin and some diuretics, which can affect potassium levels. A rare side effect of long-term, high-dose consumption is the lowering of blood potassium levels. Individuals with pre-existing conditions or those taking prescription medications should consult a healthcare provider before incorporating ACV into their daily routine.
Understanding the Difference Between Drinking and Topical Use
The internal versus external use of ACV targets completely different biological mechanisms. Drinking ACV is intended to exert a systemic effect on internal factors like blood sugar and gut bacteria. The compounds must be absorbed and distributed throughout the body to influence acne.
Topical application relies on the direct contact of the vinegar’s acidic components with the skin’s surface. When applied, the acetic acid acts as an antimicrobial agent against acne-causing bacteria like P. acnes. The natural acids also function as chemical exfoliants that may help unclog pores.
Topical use carries the risk of skin irritation, burns, and contact dermatitis, especially if the vinegar is used undiluted. This article focuses on the limited evidence for ingesting ACV as an acne treatment.