 In searching for the latest and greatest science on vinegar, I came across this study on lime juice and vinegar injections as a cheap and natural alternative to control cots outbreaks. I was all intrigued until I realized cots stands for crown of thorn sea star, those crazy looking starfish. But just when I thought that was an unusual title, to pee or not to pee, a review on jellyfish invenomation and treatment. Due to an increase in jellyfish blooms, jellyfish invenomation has become an increasing public health problem, amounting to as many as 150 million jellyfish stings every year. But no research does not support the use of the most infamous sting treatment, urine. It is unclear exactly when the use of urine for jellyfish stings became popular, though certainly the scene from Friends didn't help. But it has become one of the most persistent myths in toxicology. What does help? The topical application of vinegar for 30 seconds may be effective. Any other conditions where topical vinegar may help? What about for eczema, also known as atopic dermatitis? Not only did dilute vinegar soaks yield no benefit, it caused substantial adverse effects, skin irritation, and the majority of subjects. Okay, scratch that. What about topical vinegar for uremic paritis, one of the most common disabling symptoms in patients with end-stage kidney disease? It's a chronic itching sensation that frequently accompanies chronic kidney disease. You could imagine how it could cause depression, insomnia, anxiety. So these researchers tried randomizing sufferers to try applying an oatmeal lotion or dilute vinegar about one tablespoon per cup of water versus taking antihistamine drug. The oatmeal lotion significantly reduced the intensity of itching, but not the frequency or surface area affected, whereas both the vinegar and the drug accomplished all three. What else? What about a randomized controlled trial on the effective topical apple cider vinegar on varicose veins? Between 25 and 50% of adults have varicose veins in their legs, which can be more than just an aesthetic concern. Varicose veins can cause pain, swelling, cramps, irritability, fatigue, itching, tingling, burning, a heavy feeling, bleeding, and even ulceration. What can we do about them? Apple cider vinegar, which is known to have legit healing properties, is stressed in many websites to help, but you don't know until you put it to the test. Patients were randomized to apply vinegar to the affected area of the leg. Now, here are the before and after symptoms in the vinegar group versus the control group. Those in the vinegar group appear to do better than the control group, but the whole point of having a control group is to directly compare the groups to each other, not to where they started. Before and after comparisons against baseline within randomized groups is a common statistical mistake that can be highly misleading, biased and invalid, so we really don't know if apple cider vinegar works better than nothing after all. And there are potential risks. A 14-year-old girl presented with two erosions on her nose. She found something on the internet about using vinegar to remove moles and removed part of her nose instead. I don't recommend applying undiluted vinegar to your skin and you should never drink it straight, which can land you in the emergency room vomiting blood with an esophagus that looks like this. The only time I'd consider using straight vinegar is in tiny doses up the nose. Intranasal vinegar as an effective treatment for persistent hiccups in a patient with advanced cancer undergoing palliative care. Persistent intractable hiccups are normally rare, however in patients with advanced cancer it can affect like 1 in 25. It's bad enough you're dying from cancer, but then to have unending hiccups keeping you awake or preventing you from connecting with your loved ones. So they tried a very small amount of vinegar and by very small we're talking two drops. This is what it looks like, just two little drops at the tip of a needle-less syringe and the patient's hiccups resolved within a few seconds. What they think is going on is the same nerve root that goes to the nose also goes to the hiccup area and the irritation is thought to then interrupt the hiccup reflex. In the past, non-pharmacological remedies such as vinegar were largely used for this kind of thing, but then they fell out of favor with the widespread use of drugs, which in this case were ineffective.