Salicylic acid is a common ingredient in skin care products that people use to treat acne. It works to unblock clogged pores and exfoliate the skin. Salicylic acid also helps decrease sebum production in the skin.
This article describes what salicylic acid is, how it works to treat acne, and whether it is safe and effective. We also outline how to use salicyclic acid, and describe some of the other acne treatments available.
Salicylic acid (SA) is a beta hydroxy acid that occurs naturally in plants such as willow bark. Salicylic acid has anti-inflammatory and antibacterial properties, and also works as an exfoliant to remove dead skin cells.
Many face washes or skin care products for acne contain SA in varying strengths.
The American Academy of Dermatology (AAD) recommend using a skin care product containing SA to treat certain types of acne, including:
- Pustules: Pus-filled pimples.
- Papules: Small, hard bumps which may give a rough or textured feel to the skin.
- Blackheads: A small bump with a black surface. Blackheads develop as a result of a blockage within a hair follicle.
- Whiteheads: A completely blocked follicle.
Acne forms when excess oil and dead skin cells block pores within the skin. Bacteria can also become trapped inside the pore, causing inflammation and pus-filled pimples.
Salicylic acid works to treat acne by unclogging blocked pores. It does this by
Salicylic acid also decreases the skin’s sebum production, leading to fewer breakouts.
The following table offers general guidelines for using different forms and concentrations of SA. People should always follow the instructions on individual product labels, or the advice of their doctor or dermatologist.
| Forms of salicylic acid | Concentration | How to use |
| Over-the-counter topical treatments | 0.5% to 2% | Follow the product instructions, which will state whether to wash off or leave on for a set time. Initially apply once a day, then gradually increase applications to 2-3 times a day. If excessive dryness or peeling occurs, reduce applications to every other day. |
| Chemical peels | Only a trained dermatologist should carry out the procedure. |
Salicylic acid works as an exfoliant to slough off dead skin cells. Practitioners may use chemical peels containing up to
- papules
- whiteheads
- blackheads
- post-acne erythema
- hyperpigmentation
Salicylic acid may cause some side effects. These may vary depending on a person’s skin type or the form or concentration of SA they are using. Side effects may include:
- mild burning
- mild stinging
- peeling skin
- mild irritation
- dryness
The
- Patch test any product containing SA on a small area of skin before applying the product more liberally. Do not use the product if a reaction develops at the site of the patch test.
- Follow the instructions on the product label carefully.
- Avoid using more than the recommended amount of product.
- Avoid applying the product in higher doses or at a greater frequency than stated on the label.
- Avoid using SA products on babies and children.
- Always protect the skin from the sun when using SA products.
People should also take the following precautions when using an SA product:
- Avoid contact with the eyes, mouth, or any mucous membranes, such as those inside the nose.
- Stop using the product if there are excessive side effects, and contact a doctor for further advice. Examples of side effects include:
- skin peeling
- stinging
- irritation
- If a person accidentally swallows a SA solution, seek medical help straight away.
- Avoid using air-tight or water-tight dressings, or petroleum-based ointments, on top of SA as these may cause excessive exposure to SA.
- Avoid any other medications containing SA while using SA products. Examples of such medications include aspirin and certain sports injury lotions.
Salicylic acid may not be safe for everyone. Some examples are outlined below:
Pre-existing conditions
Salicylic acid products may not be safe for people who have a kidney or liver condition. Anyone who has such a condition should talk to their doctor before considering using products containing SA.
Allergies
If people have an allergic reaction to SA, they should stop using the product immediately and seek medical attention.
Pregnancy and breastfeeding
Topical use of SA in pregnancy and lactation is not problematic due to limited systemic absorption.
If a person wants more information about using salicylic acid during pregnancy or lactation they should get in touch with their doctor.
Benzoyl peroxide (BP) is another topical agent that may help treat acne. It is an antiseptic that kills acne-causing bacteria. People may use BP alone or in combination with SA. Both are available without a prescription.
Benzoyl peroxide may not be suitable for people with sensitive skin or eczema. People with pre-existing skin conditions may want to consult with a doctor or dermatologist to see if BP will be safe for them to use.
When using BP, people may want to start with a concentration of 2.5%. Higher doses may cause irritation and dryness.
Benzoyl peroxide can stain fabrics. People may want to avoid using BP before exercising or before going to bed to avoid staining clothing or bedding.
An over-the-counter (OTC) retinoid may also help to unclog pores. Adapalene is an example of a non-prescription retinoid.
When using topical acne treatments, people may have to wait 6–8 weeks to start seeing results. If people do not notice any improvement after this time, they may want to consult a dermatologist for further treatment options. Such treatments may include:
- extractions to unblock pores
- prescription acne medications, such as:
- azelaic acid
- topical or oral antibiotics
- the contraceptive pill, for the treatment of hormonal acne in females
- topical dapsone
- sprinolactone
- isotretinoin
The AAD recommends the following skin care tips for managing acne:
- washing the face twice a day, and after sweating
- washing the face with lukewarm water
- using the fingertips to gently cleanse the face with a non-abrasive face wash
- avoiding scrubbing the skin
- avoiding touching the face with unwashed hands
- protecting skin from the sun, and avoiding tanning beds
The following people may need to consult their doctor before using SA products:
- people who have a pre-existing health condition that affects their liver or kidneys
- people who are allergic or sensitive to SA or any of the additional ingredients listed on the product label
- people who are taking medication or are about to undergo laboratory tests
- women who are pregnant or breastfeeding
If a person does not experience any improvement in their acne after using an SA product for 6–8 weeks, they should see a dermatologist to discuss further treatment options.
Anyone who experiences side effects while using SA should stop using the product and contact their doctor. If a person develops symptoms of an allergic reaction or salicylic toxicity, they should seek immediate medical attention.
Salicylic acid can be an effective ingredient in skin care products to help treat acne. Salicylic acid can help unclog blocked pores by breaking down and removing dead skin cells and oil.
Salicylic acid may produce mild side effects, such as skin irritation or peeling. If people experience more severe side effects, they should stop using the product and contact their doctor.
When using salicylic acid or other acne treatments, it may take 6-8 weeks to start noticing results. Anyone who does not see an improvement in their acne after this time may wish to contact a doctor or dermatologist for advice on alternative treatment options.