Salicylic acid is one of the many effective modalities available for acne treatment. Understanding why salicylic acid is an effective treatment for acne requires some understanding of the pathophysiology of acne. Acne commonly presents in areas of the body with the greatest population of oil, or sebaceous, glands, including the face, chest and back. It usually occurs during adolescence when there are surges in circulating androgens, which increase both the size and sebum secretion of the glands.
Acne lesions may take the form of non-inflamed comedones (whiteheads and blackheads), or red and swollen papules, pustules and nodules (the stereotypical pimples and zits). These lesions are generally due to obstruction of hair follicles and sebaceous glands by sebum and skin cells that have shed from the walls of hair follicles. The obstruction of the sebaceous glands causes the proliferation of bacteria called Propionibacterium acnes, which produce substances that promote an inflammatory reaction.
Acne treatments target the important factors involved in the condition's pathophysiology. Medications and procedures given by dermatologists act to unclog pores by suppressing oil production by the sebaceous glands and reducing the amount of skin cells shed, as well as eradicating populations of Propionibacterium acnes.
Salicylic acid is a beta-hydroxy acid obtained from the bark of the willow tree. Aside from being used to treat muscle aches, inflammation and fever in the form of aspirin or acetylsalicylic acid, the topical forms of salicylic acid are also common products used for acne treatment, because they are available over the counter and they have few side effects.
When applied topically to affected areas, salicylic acid penetrates the sebaceous glands and follicles to exfoliate dead skin cells. By keeping pores clear of cellular debris, salicylic acid can reduce acne breakouts, and prevent further comedones and pimples from appearing. Salicylic acid also exposes younger and healthier skin cells located deep in the skin.
Over-the-counter preparations of salicylic acid come in 0.5 and 2 percent hydroalcoholic formulations. These products are typically in gel, cream or lotion forms that are applied topically to all affected areas, usually at a frequency of once a day. Salicylic acid is sometimes also integrated with facial scrubs and washes.
Remember that salicylic acid is not a spot pimple remover. It should not be applied just to individual comedones, zits and pimples, but rather to all acne-prone areas to best enjoy its benefits. Moreover, salicylic acid can dry the skin, so avoid combining different products that all contain salicylic acid. In using different antiacne products, it is best to combine products that have different mechanisms of action. Consult your dermatologist regarding these other options.
Since salicylic acid is an exfoliant, it can cause stinging and burning sensations, as well as skin redness, irritation and peeling. These side effects may be ameliorated by using gentle skin moisturizers and by using a good sunblock during any sun exposure. You may also reduce the frequency of application to every two days instead of daily. If symptoms remain persistent despite these measures, stop treatment and consult a dermatologist.