Stephanie Feldstein, MD; Maryam Afshar, MD; Andrew C. Krakowski, MD
Rady Children’s Hospital, San Diego, California; University of San Diego, California
Disclosure: The authors report no relevant conflicts of interest.
Abstract
“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. (J Clin Aesthet Dermatol. 2015;8(6):50.)
A 14-year-old girl presented to the authors’ pediatric dermatology clinic for evaluation of two erosions on her nose. She had intentionally researched a protocol on the Internet utilizing apple cider vinegar as a “natural remedy” to chemically remove unwanted “ugly moles.” She subsequently applied several drops of apple cider vinegar daily for three days straight to the nevi on her nose, occluding the area with bandages. By the second day, significant erythema and irritation were noted at the application site, and her nevi “peeled off a couple of days later.” When her mother noticed the subsequent erosions, she immediately removed the vinegar from the patient’s possession and brought her for evaluation.
Physical examination revealed noninflammatory, poorly defined erosions on the left nasal ala and left nasal alar crease (Figure 1). The patient screened negative for depression and for suicidal/homicidal ideation. She was advised that many “home remedies” are ineffective and potentially dangerous, resulting in scarring, postinflammatory hyperpigmentation, and even possible malignant transformation. She was prescribed mupirocin 2% ointment twice a day for several weeks and liberal use of zinc oxide sunscreen to the erosions and surrounding skin.
Numerous “how-to” guides for vinegar removal of nevi may be found through Internet searches, and several websites suggest the use of vinegar as treatment for other dermatologic maladies, such as warts, lice, and molluscum. Common vinegars are weak acids that contain 4 to 8 percent acetic acid, which can erode the skin and cause significant chemical burns, especially when applied under occlusion.[1–3]
The Internet is a rapidly growing first-line resource for at-home healthcare, and self-removal of nevi is a popular topic on online forums. Providers should be aware of this phenomenon and better prepare themselves to educate patients on the potential adverse effects of self-treatment.
references
1. Korkmaz A, Sahiner U, Yurdakok M. Chemical burn caused by topical vinegar application in a newborn infant. Pediatr Dermatol. 2000;17:34–36. 2. Kuniyuki S, Oonishi H. Chemical burn from acetic acid with deep ulceration. Contact Dermatitis. 1997;36:169. 3. Buniick CG, Lott JP, Warren CB, et al. Chemical burn from topical apple cider vinegar. J Am Acad Dermatol. 2012:67(4) e143–e144.