From the Guidelines
Vinegar soaks are not recommended as a primary treatment for dermatitis, as there is limited evidence supporting their effectiveness and potential risks of irritation or worsening symptoms. When considering the management of dermatitis, it's essential to prioritize evidence-based treatments that have been proven to improve morbidity, mortality, and quality of life. According to the American Academy of Dermatology guidelines 1, the primary treatment for atopic dermatitis involves the use of emollients and prescription topical therapies, with phototherapy and systemic therapies considered for more severe or widespread cases.
For patients with dermatitis, the focus should be on using moisturizers and topical anti-inflammatory medications as first-line treatments, as recommended by the guidelines 1. While vinegar soaks may be considered as an adjunctive treatment in certain cases, such as when there's a concern about bacterial or fungal overgrowth, they should not replace established treatments. It's crucial to weigh the potential benefits of vinegar soaks against the risks of irritation or worsening symptoms, and to discontinue their use if any adverse effects occur.
In terms of preparing a vinegar soak, if a patient still wishes to try this approach, they can mix 1 tablespoon of white vinegar with 1 cup of lukewarm water and apply it to the affected area for 5-10 minutes, 2-3 times daily. However, this should be done under the guidance of a healthcare provider and in conjunction with established treatments. The use of vinegar soaks should be carefully monitored, and patients should be advised to discontinue their use if they experience any increased irritation, burning, or worsening of symptoms. Ultimately, the decision to use vinegar soaks should be made on a case-by-case basis, taking into account the individual patient's needs and medical history, and with a focus on prioritizing evidence-based treatments that have been proven to improve outcomes.
From the Research
Vinegar Soaks for Dermatitis
- Vinegar has been used as a home remedy for various skin problems, including dermatitis, due to its antimicrobial and antioxidant properties 2.
- A study on apple cider vinegar soaks (0.5% acetic acid) found that they did not improve skin barrier integrity in patients with atopic dermatitis, and caused skin irritation in a majority of subjects 3.
- Another study found that apple cider vinegar soaks did not alter the skin bacterial microbiome in atopic dermatitis, and had no significant effect on Staphylococcus aureus abundance 4.
Treatment Options for Dermatitis
- Emollients and topical corticosteroids are commonly used to manage atopic dermatitis, while antihistamines, antibiotics, and calcineurin inhibitors may also be helpful in certain cases 5.
- Targeted molecular therapies, such as dupilumab, are emerging as promising treatments for severe atopic dermatitis 5.
- Antihistamines have been used to treat pruritus in atopic dermatitis, but their efficacy is still a topic of debate 6.