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A Complete Guide to Salicylic Acid

A Complete Guide to Salicylic Acid featured image
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Whether you’re prone to full-blown breakouts or a few pesky pimples, chances are you’ve probably used a product containing salicylic acid. Considered to be one of the top acne-fighting ingredients in dermatology, salicylic acid is a tried-and-true active, but not so self-explanatory. Here’s what the pros want you to know.

What is salicylic acid?

Commonly used in dermatology to treat a variety of skin conditions and diseases (both over-the-counter and prescription medication), “salicylic acid is an organic compound that is a plant hormone found naturally in the bark of white willow and wintergreen leaves,” says Bloomfield Hills, MI dermatologist Linda C. Honet, MD. “It is one of the oldest, most ubiquitous and most accessible topical medications in dermatology, and it can be found in a variety of skin-care products, cleansers, peeling agents, and prescription compounds, to name a few. It has several important properties and clinical applications, where it can function as an exfoliant, a keratolytic—it can dissolve skin flakes and scales—and an anti-inflammatory, making it a very useful treatment for a variety of skin conditions.”

However, you probably know it best as a betahydroxy acid. “Salicylic acid is the classic example of a betahydroxy acid (BHA), as opposed to alphahydroxy acids like glycolic acid or lactic acid,” explains Campbell, CA dermatologist Amelia K. Hausauer, MD. “This means there is an extra carbon in its backbone structure that separates the hydroxy portion from the acid portion. The difference in structure means BHAs tend to be more oil-soluble than AHAs, so salicylic acid can penetrate through the lipid layers of the skin to get to a deeper level.” Nanuet, NY dermatologist Heidi A. Waldorf, MD adds that not only is salicylic acid “lipophilic—attracted to fat and oil—but also comedolytic, meaning it helps unplug whiteheads and blackheads so it’s attracted to the sebaceous follicles (pores) where it’s needed.”

What can it be used to treat?

“The fact that salicylic acid can get deeper into the skin and pass through the lipid layer means it is helpful in targeting clogged pores involved in acne,” Dr. Hausauer explains. “It works to dissolve or unglue skin debris that congests pores, and it has anti-inflammatory properties that can also help minimize inflamed red pimples and pustules, allowing for faster resolution and clearing. Three major factors contribute to acne: abnormal sloughing of skin cells forming a plug, excessive oiliness and actions of P. acnes bacteria. Salicylic acid targets the first mechanism by dissolving the keratin plug and better regulating cell interactions. Thus, it works most effectively for treating blackheads and whiteheads.”

“The fact that it can break down skin cell connections also makes it an exfoliator,” adds Dr. Hausauer. “It is also good for seborrheic dermatitis or dandruff: T/Sal is an example of a shampoo-scalp treatment that can help slough off that flaky skin.” Other skin conditions that can be treated with the salicylic acid include warts, calluses, keratosis pilaris, and even psoriasis, but always consult a doctor before experimenting at home.

At higher doses, Dr. Honet says salicylic acid can also be used in-office as a deep chemical peel to treat precancerous lesions called actinic keratoses (a rough, scaly patch on the skin that develops from years of sun exposure). Dr. Hausauer uses salicylic acid chemical peels to treat her acne-prone patients as well.  

What skin types is it best for?

According to Dr. Honet, salicylic acid is very well tolerated by the majority of skin types, and only the very sensitive or very dry may have difficulty. “Not only is it quite gentle at low concentrations, but the percentage can also be varied from very low to quite high to take advantage of its various properties and penetrability,” she explains. “The other valuable aspect of salicylic acid is that it is often combined and compounded with other medications to amplify specific therapeutic properties of the active ingredients.” Dr. Waldorf says it’s also safe for all skin colors and unlikely to cause hyperpigmentation. (“It also has the advantage over benzoyl peroxide of not bleaching clothing or towels.”)

Are there any ingredients you shouldn’t mix with it, or any side effects?

The most common side effects are dryness, redness and irritation, and Dr. Honet points out that though salicylic acid is typically gentle, if used in conjunction with other active ingredients that cause the same effects, they may be amplified, and the skin may become overly irritated. “However, and interestingly, some of the most popular skin-care products combine both an alphahydroxy acid, like glycolic acid, and salicylic acid in one, to more effectively exfoliate, improve skin texture, and improve blackheads, whiteheads and pores.”

If you’re pregnant, Dr. Hausauer says that although between 0.5 percent and 2 percent is sold over the counter and generally probably safe in pregnancy, it is not recommended in high doses or over large areas. “When used in large amounts, it can also potentially interact with blood thinners, and don’t apply a layer over the full body—just acne-prone areas—to minimize the risk of enough systemic absorption to salicylate poisoning.”

Can it be used as a spot-treatment and all over the skin?

Salicylic acid is effective for the spot-treatment of acne pimples and oily T-zones; Dr. Honet says it is also used in spot-treating warts and calluses, and is found as the active ingredient in over-the-counter foot-care products. “For all-over face and body treatment, it can be found as the active ingredient in cleansers, shampoos, lotions, gels, and exfoliators to treat skin conditions like dandruff, keratosis pilaris (chicken skin), rough patches on knees and elbows, and cracked skin on heels,” she explains.

However, Dr. Hausauer cautions users to watch the area being treated versus the strength of the medication. “It’s fine to apply to the body—like the back or chest if these are areas that break out—but for bigger areas, consider selecting a lower-strength formulation.”

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Face Reality Sal-C Toner ($29)

This antioxidant-rich toner exfoliates and balances irritated skin. Plus, we love the price point for such a high-quality formulation. “I like the combination of salicylic acid to clean the pores and vitamin C to help brighten any discoloration, making this a great product for acne-prone skin,” says board-certified Scottsdale, AZ dermatologist Brooke Jeffy, MD.

 

Type

Toner

Size

6 oz

Best for

Acne

2 / 18

Differin Acne Prone Skin Patches ($10)

These fact-acting pimple patches are a skin-saving hero to keep on hand. They’ll help to flatten and soothe the impacted skin quickly and effectively. “Unlike the typical hydrocolloid patches, these pimple patches contain salicylic acid to help exfoliate and shrink early-stage blemishes,” says New York dermatologist Connie Yang, MD.

differin patches

Type

Patch

Size

36 count

Best For

Acne

3 / 18

Paula’s Choice Skin Perfecting 2% BHA Liquid Exfoliant ($35)

Looking for an exfoliator that acts as an acne-fighting treatment? This Paula’s Choice Exfoliant has been a beauty-insider fave for years. Start slowly, integrating it into your routine every other day to see how your skin responds. “This two percent salicylic acid eliminates the buildup of dead skin cells and unclogs pores to reduce blackheads and improve the overall appearance of skin tone and texture,” says New York dermatologist Marisa Garshick, MD. “It’s a great way to add gently exfoliating salicylic acid to your skin-care routine,” adds Pasadena, CA dermatologist Courtney Rubin, MD.

paulas choice bha liquid exfoliator

Type

Exfoliator

Size

4 oz

Best For

Acne, Uneven Texture

4 / 18

Charlotte Tilbury Super Radiance Resurfacing Facial ($70)

This exfoliating mask is a triple threat—unclogging pores, hydrating dry skin, and smoothing the appearance of fine lines. “It features a blend of three hydroxyl acids: AHA (glycolic acid), BHA (salicylic acid) and PHA (bio agave acid) that work together to gently exfoliate and remove skin cells, revealing clearer, brighter and smoother skin,” explains Dallas dermatologist Rebecca Marcus, MD. “Polyglutamic acid hydrates and improves skin’s radiance,” she adds.

charlotte tilbury resurfacing facial

type

Mask

Size

1.6 oz

best for

Uneven Texture, Fine Lines, Dull Skin

5 / 18

Murad Clarifying Water Gel Moisturizer ($49)

Finding a moisturizer that provides necessary hydration for oily skin but doesn’t clog pores can be a challenge. “I think this lightweight gel moisturizer with salicylic acid is ideal for oily, congested and acne-prone skin,” says Dr. Rubin. It cleanses and exfoliates while moisturizing.

murad water gel moisturizer

type

Moisturizer

Size

2 oz

best for

Oily skin

6 / 18

Dr. Dennis Gross Alpha Beta Extra Strength Daily Peel Pads ($92)

The simplest of at-home treatments, this product contains two steps—though both are as easy as wiping a pre-dosed pad across the skin. “This at-home peel contains both alpha and beta hydroxy acids to exfoliate the skin, even skin tone, refine pores, and clear blemishes,” explains Dr. Yang.

TYPE

Exfoliating wipes

Size

30 count

Best for

Acne, Uneven Texture, Fine Lines

7 / 18

Andalou Naturals Clear Skin Blemish Vanishing Gel ($15)

“This is a great option for someone with oily or blemish-prone skin as it helps to reduce oil and brighten the skin,” says Dr. Garshick. “Containing fruit stem cell complex, argan stem cells, willow bark and salicylic acid, the gel helps to reduce inflammation, improving the overall appearance of the skin,” she explains.

andalou gel

type

Spot treatment

Size

0.6 count

Best for

Acne

8 / 18

Epionce Lytic Plus Tx ($56)

A hard-hitting moisturizing treatment for that tricky combo of acne, hyperpigmentation and dry skin, this clinically-proven lotion calms skin and improves overall texture. “It’s a great lotion for someone looking to incorporate the benefits of salicylic acid but who tends to have more dry skin,” says Dr. Jeffy.

epionce lytic

type

Skin-correcting treatment

Size

1.4 oz

best for

Acne, Hyperpigmentation, Aging Skin

9 / 18

Beauty Pie AcidEnzyme Exfoliating Face and Body Cleanser ($60)

A rare two-in-one face and body cleanser that actually gets both jobs done, the ingredients in this cleanser are gentle enough for the face while strong enough for the body. “This cleanser gently exfoliates the face and body with salicylic acid to break up oil and remove dead skin cells. Plus, papaya enzymes smooth and exfoliate skin without dryness or irritation,” says Dr. Marcus.

type

Face + Body Cleanser

size

13.42 oz

best for

Acne, Clogged Pores, Dull Skin

10 / 18

Neutrogena T/Sal Therapeutic Shampoo ($7)

Our scalps can benefit from salicylic acid too! The same ingredient that unclogs pores and clears acne on the face can break up buildup on the scalp and prevent flakes. “This shampoo helps exfoliate an itchy, flaky scalp with three percent salicylic acid. For those with psoriasis or dandruff, it can help clear out buildup and allow better penetration of prescription treatments,” explains Dr. Yang.

neutrogena shampoo

type

Shampoo

size

4.5 oz

best for

Scalp Buildup

11 / 18

CeraVe Acne Control Gel ($12)

This acne treatment gel is safe for use on the full face, as opposed to just being a spot treatment. In addition to clearing existing acne, it’ll help prevent future breakouts. “This treatment combines salicylic acid (a beta hydroxy acid) with glycolic and lactic acids (alpha hydroxy acids) for well-rounded exfoliation that will resurface dull skin and clear out pores,” explains Dr. Rubin. Plus, it won’t dry out the skin. Dr. Marcus adds, “Niacinamide and ceramides help to calm and hydrate while supporting the skin barrier.”

type

Treatment Gel

size

1.35 oz

best for

Acne

12 / 18

SkinCeuticals Blemish and Age Defense ($110)

This highly potent serum, filled with a luxurious and powerful mix of active ingredients, targets both acne and signs of aging. “It’s a splurge-worthy serum,” says Dr. Garshick. “It incorporates salicylic acid to help with oil and breakouts as well as dioic acid, glycolic acid, LHA and citric acid to help exfoliate and address breakouts and signs of aging while also reducing the appearance of pores,” she explains.

skinceuticals blemish and age defense

type

Serum

Size

1 oz

best for

Acne, Fine Lines, Uneven Texture

13 / 18

La Roche-Posay Effaclar Acne Treatment Serum ($43)

Give this serum several weeks of consistent use, and you’ll be sure to notice a difference in acne and reduced pore size. “It’s a great leave-on treatment for oily and acne-prone skin that is easy to find and combines salicylic acid with glycolic acid to gently exfoliate and improve pore appearance,” says Dr. Jeffy.

 

la roche-posay effaclar serum

type

Serum

size

1 oz

best for

Acne

14 / 18

Neutrogena Oil-Free Acne Wash ($10)

This is an affordably priced daily cleanser that’s gentle enough for sensitive skin and effective at addressing acne concerns. “This cleanser is a classic,” says Dr. Rubin. “It’s great at getting everything off the skin to clear away all the gunk that has built up over the day,” she says.

type

Cleanser

size

9.1 oz

best for

Acne

15 / 18

Mario Badescu Drying Lotion ($18)

We couldn’t complete this list without shouting out the OG acne spot treatment found in thousands of medicine cabinets and beauty #shelfies. The Mario Badescu Drying Lotion is a cult favorite for a reason—salicylic acid exfoliates skin and unclogs pores while calamine calms and soothes with a cooling sensation for visible and quick results.

8. Mario Badescu

type

Spot Treatment

size

1 oz

best for

Acne

type

Spot treatment

Size

1 oz

Best for

Acne

16 / 18

SkinCeuticals Silymarin CF ($182)

An advanced vitamin C serum that goes far beyond brightening skin, this formula stops oil overproduction in its tracks, preventing breakouts and visible signs of aging. “It’s a great vitamin C serum for acne-prone skin given its added ingredients like salicylic acid and silymarin,” explains Dr. Yang.

skinceuticals blemish and age defense

type

Serum

Size

1 oz

Best for

Acne, Oily Skin, Anti-Aging

17 / 18

iS Clinical Cleansing Complex ($46)

This cleanser from iS Clinical is a personal favorite from my skin hero, Denver, CO aesthetician Jessica Clarke Higgins, LE. At a recent appointment, when I was experiencing unusual breakouts around the chin and forehead, she recommended the Cleansing Complex. I’ve been using it for several weeks, and I’m noticing improved skin texture, less acne, and smaller pores.

is clinical cleansing complex

type

Cleanser

Size

6 oz

best for

Acne, Uneven Texture, Clogged Pores

18 / 18

CeraVe Acne Control Cleanser ($15)

This accessible everyday cleanser is beloved by derms, beauty insiders, and the masses alike. “It’s a uniquely inexpensive cleanser that uses salicylic acid and clay to clean pores and also focuses on skin-barrier hydration,” says Dr. Jeffy. “It contains two percent salicylic acid to help reduce breakouts and gently exfoliate the skin. Also formulated with niacinamide and ceramides, it won’t leave the skin feeling dry or irritated,” adds Dr. Garshick.

type

Cleanser

Size

8 oz

best for

Acne, Clogged Pores

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