Salicylic Acid for Treating Acne: Does it Work?

Salicylic acid is a beta hydroxy acid that’s commonly used as an ingredient in over-the-counter acne creams, gels and face washes.

Like many other ingredients used to treat acne, one of the ways salicylic acid works is by stripping away dead skin cells. It’s backed up by some impressive scientific research and is sold over the counter, making it a popular choice for treating acne.

Below, we’ve explained how salicylic acid works as an acne treatment. We’ve also looked at its potential side effects and explained what you should know if you’re planning to use salicylic acid to treat acne. 

Finally, we’ve listed some other treatments and medications for treating acne that you may also want to consider if you’re prone to acne breakouts. 

What Is Salicylic Acid?

Salicylic acid is in a class of medications called keratolytic agents, which are used specifically to soften and break down the outer layers of skin. It’s used as an ingredient in a variety of skincare products and medications, including certain products used to treat acne.

Like many other widely used medications, salicylic acid is listed as part of the List of Essential Medicines published by the World Health Organization.

Salicylic acid is a naturally-occurring chemical. It’s found in certain plants, where it plays a key role in growth, development and photosynthesis as an important plant hormone.

As a skincare ingredient, salicylic acid has two key benefits. First, it has direct anti-inflammatory activity. Second, it’s known to promote exfoliation. Finally, it works as a topical antibacterial that can inhibit or kill certain types of bacteria.

Like many other active ingredients in skincare products, salicylic acid is available in a range of different concentrations. Most over-the-counter salicylic acid creams, facial washes and other products contain between 0.5 percent and five percent salicylic acid.

Higher-strength salicylic acid products require a prescription. 

How Does Salicylic Acid Work for Acne?

To understand how salicylic acid works for acne, it’s important to know the basics of how acne develops in the first place. 

Whiteheads, blackheads, pimples and other types of acne form when the hair follicles (or pores) in your skin become blocked due to a buildup of sebum and/or dead skin cells on the surface of your skin.

Sebum is a type of natural oil that’s produced by your body to keep your skin hydrated, smooth and protected. Your body secretes sebum from your sebaceous glands — small exocrine glands that are located inside your pores. 

When your sebaceous glands secrete too much sebum, your skin can become too oily, causing the excess sebum to build up inside your pores. When a pore becomes filled with excess sebum, it can become “plugged,” resulting in the development of acne lesions.

In addition to sebum, dead skin cells can build up on the surface of your skin as a result of your body’s natural skin cell turnover cycle. These dead skin cells can mix with sebum and contribute to blocked pores and acne.

Finally, bacteria can contribute to and worsen acne. When certain types of bacteria get inside a blocked pore, they can multiply rapidly, causing inflammation and discomfort. This is why some acne lesions become red, swollen and painful.

The factors that contribute to acne are caused by a mix of factors, including your genetics, your levels of certain hormones and even your habits. We’ve discussed these factors more in our full guide to the causes of hormonal acne. 

With the causes of acne out of the way, it’s time to discuss how acne prevention ingredients like salicylic acid can help. Salicylic acid works to treat and prevent acne in several ways:

• First, by peeling away dead skin cells. Salicylic acid is an exfoliating agent, meaning it helps to strip away the stratum corneum, or outermost layer of the skin. This layer of the skin is where many of the dead skin cells that contribute to acne can be found.
  
  In fact, salicylic acid is also used to treat other skin conditions that involve an overgrowth of skin cells, such as psoriasis, dandruff, calluses and certain types of warts.
  
  
• Second, by unclogging pores. Because salicylic acid helps to strip away the outermost layer of the skin, it can cause blocked pores to become unplugged, making existing acne shrink in size and disappear.
  
  
• Third, by reducing inflammation. Salicylic acid helps to lower the swelling and redness that can make certain types of acne, such as inflamed papules and pustules, stand out on your skin.
  
  
• Fourth, by killing certain types of bacteria. Although salicylic acid is nowhere near as effective as prescription antibiotics, research shows that it has mild antibacterial effects that may help to treat and prevent infected, inflammatory acne.

Is Salicylic Acid Effective?

According to most research, yes. Salicylic acid’s effectiveness as an acne treatment is backed up by numerous placebo-controlled scientific studies that show a clear benefit to using it as an acne treatment. 

For example, one scientific review from 1992, which looked at four separate studies, found that treatment with salicylic acid pads reduced the total number of lesions on the skin of people with acne.

Another study from the 1990s concluded that people with acne who used a salicylic acid lotion experienced a reduction in both noninflamed and inflamed acne lesions over the course of 12 weeks of treatment.

A different study published in 2004 found that salicylic acid caused a reduction in inflammatory and noninflammatory acne lesions in people with acne over the course of 12 weeks.

An even more recent study from 2018, which included 24 adult women with mild-to-moderate acne, involved the use of a two percent salicylic acid cleaner and cream in combination with a rebalancing gel.

After eight weeks of treatment, the women experienced a significant reduction in several forms of acne, including inflamed acne such as papules and pustules, and noninflamed, comedonal acne such as blackheads and whiteheads.

The women also reported improved skin smoothness and skin tone evenness by the end of the study.

Put simply, there’s a significant amount of scientific evidence indicating that salicylic acid works well as a treatment for both inflamed and noninflamed acne. 

How to Use Salicylic Acid for Acne

Because it’s available over the counter, salicylic acid is one of the easiest science-backed acne treatments to buy and use.

You can generally find acne treatment products containing salicylic acid at your local drugstore, pharmacy, supermarket or makeup and beauty products store. Look for salicylic acid in the list of active ingredients. Products that may contain salicylic acid include:

• Cleansers
• Toners
• Creams
• Gels
• Facial Washes
• Facial Moisturizers
• Facial Masks
• Medicated Pads

Applying salicylic acid products is easy. Follow the instructions that come with your cleanser, toner, cream or other product containing salicylic acid. Make sure not to use the product too frequently or apply it too heavily, as this may increase your risk of experiencing side effects. 

It’s normal to experience some level of dryness and irritation in your skin when you first start using salicylic acid. If you’re worried about this, you can try:

• Applying a small amount of the salicylic acid product to an area of your body that isn’t highly visible, such as your arm or waist, for a few days at the beginning. Then, if you feel comfortable with the medication, you can apply it to your acne-prone skin.
  
  
• Starting with a low-strength salicylic acid product. Most over-the-counter salicylic acid acne treatments contain anywhere from 0.5 to 5 percent salicylic acid. Products with a lower amount of salicylic acid may be less likely to cause irritation or dry skin.

When you apply a product containing salicylic acid, make sure to keep it away from your eyes, nostrils and mouth. If you get salicylic acid in your eyes, flush your eyes with water for at least 15 minutes to ensure it’s completely washed out.

Make sure not to use salicylic acid products on any areas of skin that are red, irritated, broken, inflamed or swollen. It’s best to only ever use salicylic acid products on the parts of your body that are affected by acne.

Like other acne treatments, salicylic acid can require some time to start working. You may not notice any improvement for several weeks after you start using a salicylic acid treatment. You may even find that you have more acne during your first few weeks of salicylic acid use. 

Before giving up, try to use your salicylic acid product for at least eight weeks. Most studies of salicylic acid show that acne typically starts to disappear after eight to 12 weeks of continuous use.

Salicylic Acid Side Effects

Salicylic acid is safe and effective for most people. However, like with many other ingredients in acne treatments and other skincare products, it can cause certain side effects. Potential side effects of salicylic acid include:

• Skin irritation, including red and/or dry skin
• Soreness and stinging in the area where the salicylic acid is applied

Although rare, salicylic acid products can potentially cause more severe side effects. You should contact your healthcare provider immediately if you feel dizzy, confused, nauseous, tired, overly weak, or if you develop a headache, hearing loss or fast breathing after using salicylic acid. 

Finally, seek emergency medical help immediately if you develop hives, itching, itchiness in your throat, feelings of faintness, difficulty breathing or swelling that affects your eyes, lips, tongue or face after using salicylic acid.

Other Treatments and Medications for Acne

Facial washes, creams and other products containing salicylic acid can be a good choice if you have mild acne. However, other treatments may be more effective if your acne is severe or fails to go away after using salicylic acid. 

A large range of other treatments are available for acne, including over-the-counter treatments and medications that require a prescription. We’ve listed these below, along with information on how each treatment can help to get rid of acne.

Over-the-Counter Treatments

• Benzoyl peroxide. A type of topical antiseptic, benzoyl peroxide kills the bacteria that can contribute to acne. Like salicylic acid, benzoyl peroxide is a common ingredient in over-the-counter acne treatments.
  
  Benzoyl peroxide is typically used to treat mild to moderate acne. Some research has found that it’s particularly effective when used in combination with salicylic acid. Make sure to talk to your healthcare provider if you plan to use these treatments together.

Prescription Medications

• The combination birth control pill. Several different types of combination birth control can be used to treat acne. These work by regulating your body’s production of androgen hormones — the hormones that control your skin’s sebum production.
  
  Currently, the combination birth control pills Yaz, Estrostep and Ortho Tri-Cyclen (as well as their generic equivalents) are approved by the FDA for treating acne. We’ve provided more information about this treatment option in our guide to birth control and acne.

• Tretinoin. A topical retinoid, tretinoin stimulates the growth of new skin cells and helps to promote normal flows of sebum, allowing it to get rid of acne and reduce your risk of experiencing future acne breakouts.
  
  Tretinoin is one of several ingredients in our customizable acne cream. We’ve explained more about how it works, its side effects and more in our guide to using tretinoin to treat hormonal acne.

• Clindamycin. A topical antibiotic, clindamycin works by getting rid of the bacteria that can contribute to inflammatory acne. Like tretinoin, it’s one of several active ingredients in our customizable acne cream.
  
  We’ve explained more about how clindamycin works in our full guide to clindamycin for treating acne.

• Oral antibiotics. Sometimes, oral antibiotics are used to treat inflammatory acne that’s caused by bacteria. Oral antibiotics used to treat acne include tetracycline, doxycycline, minocycline and several others.

In Conclusion

Salicylic acid is widely used as an active ingredient in products for treating acne, from creams and toners to medicated pads, facial masks and more. 

Overall, studies show that salicylic acid is effective as a treatment for acne, with most research showing that it helps to reduce inflammatory and noninflammatory acne lesions over eight to 12 weeks of use.

If you have mild to moderate acne, using an acne treatment that contains salicylic acid could be a good choice. However, if you have more severe or persistent acne, it may be best to talk to a healthcare professional about using a personalized, prescription treatment for your acne. 

Learn More About Treating and Preventing Acne

Working out the best way to deal with acne breakouts can be confusing, with countless products all claiming to offer the best results and the fewest side effects. 

Our guide to science-backed acne treatments looks into the real scientific data behind a range of popular acne treatments to help you learn more about what works, what doesn’t and what’s best suited to your needs.