People with psoriasis have several treatment options, including biologic drugs, topicals, and light therapy. But many individuals who have the autoimmune condition turn to natural remedies as an alternative or a complement to pharmaceuticals. Of the natural solutions to promote health, apple cider vinegar has become one of the more popular ones.

“I have a number of patients who take apple cider vinegar for weight loss and for gut health and digestive problems,” says Pooja DeWilde, DO, a family medicine physician at Northwestern Medicine Regional Medical Group in Huntley, Illinois. “I have heard of people using it as a topical solution for mosquito bites, beestings, and toenail fungus. I don’t know the exact mechanism for how it might work, but I think it may have some antimicrobial, immune-boosting properties.”

An Ancient Treatment for Wounds

The idea of applying vinegar to the skin as a soothing agent dates back to 420 B.C., when the Greek physician Hippocrates recommended it for healing wounds.

RELATED: All About Apple Cider Vinegar

The National Psoriasis Foundation (NPF) specifically endorses apple cider vinegar as a treatment to help stop scalp itch related to psoriasis. Vinegar gets its name from the French vin meaning “wine” and aigre meaning “sour.” The sourness comes from acetic acid in the vinegar, which can provide relief by killing bacteria. The acid also acts as an exfoliant, removing dead layers of skin so the psoriasis is less scaly.

Murky, brown, unfiltered apple vinegar is thought to pack an especially healthy punch because it typically contains the mother culture. The “mother” is a collection of bacteria that changes the alcohol in fermenting apple juice into acetic acid. (The mother is said to be similar to the SCOBY, symbiotic culture of bacteria and yeast, in the fermented tea known as kombucha.)

Dilution With Water Avoids Risk of Burns

The NPF recommends creating a one-to-one-part solution of organic vinegar and water because straight-up vinegar can cause an unpleasant burning sensation.

“People can do a lot of damage with apple cider vinegar if they’re not careful,” says Matthew Lewis, MD, a dermatologist with Stanford Health Care. “The pH [measure of acidic concentration] is around three, which is similar to lemon juice. If you leave it on your skin for too long, you can just burn — like a chemical burn. We definitely see those sorts of things in the office frequently — it just destroys the skin.”

Instead, Dr. Lewis directs patients to salicylic acid, which is a commonly available product used to help shed dead skin cells. Coal tar can also help by slowing the rapid growth of skin cells and ridding the body of dead skin.

If using a vinegar solution, the NPF advises rinsing the skin after applying it and to avoid using it if the skin is cracked or bleeding.

Beyond using vinegar on the scalp, a dilution of vinegar may be applied in a compress to soothe inflamed or weepy skin (a sign of infection), according to John Anthony, MD, a dermatologist with the Cleveland Clinic.

Does Consuming Vinegar Offer Benefits?

It may be counterintuitive, but some alternative health proponents suggest that apple cider vinegar becomes less acidic or more alkaline once inside the body. Vinegar fans believe that it improves overall gut health and the acid-alkaline balance, which may in turn help reduce inflammation.

So far, no scientific investigations have validated this. One animal study found that apple cider vinegar was ineffective as an anti-inflammatory agent. On the other hand, there is evidence the vinegar intake can have some health benefits. A study published in May 2018 in the Journal of Evidence-Based Integrative Medicine indicated that vinegar may help control blood sugar, possibly lowering diabetes risk, and a study published in August 2009 in the journal Bioscience, Biotechnology, and Biochemistry showed that vinegar may reduce body weight and fat mass in obese people.

“There’s just not a lot of medical literature on the topic — more study is needed,” says Dr. Anthony.

If you do try drinking vinegar, do not take it undiluted. Potential health risks include damage to tooth enamel, burning of the lining of the esophagus, and upset to the stomach.

Other Potential Natural and Alternative Remedies

Complementary and alternative therapies sometimes used to improve symptoms of psoriasis range from mineral water baths, acupuncture, yoga, and meditation.

Although most of these approaches are safe, you should talk to your doctor before trying any new treatment or technique.

Anthony stresses that the mainstay topical solution is not “natural” but a steroid medication.

“For whatever reason, however, some people don’t want to take medication,” he says. “I think people want options. From my standpoint, there is no danger in using apple cider vinegar, so I never advise people not to use it.”