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What does salicylic acid do for acne?

Salicylic acid is the second most important medical ingredient for the treatment of acne

Salicylic acid is the second of the most valuable medical ingredients for acne treatment—second only to the gold standard, benzoyl peroxide. When formulated in the right concentration and with the correct PH, salicylic acid is a highly potent and effective acne-fighting ingredient, which is why it is often found in medicated acne cleansers, treatment creams, and spot treatments. Salicylic Acid (SA) is a Beta-Hydroxy Acid that the FDA recognizes as safe and effective in treating acne. It removes excess oil and dead cells from the skin's surface to keep the pores clear and dry out pimples. As a hydroxy acid, SA also acts as a chemical exfoliator, dissolving connections between skin cells so the skin may more easily shed them.

What is salicylic acid?

Salicylic acid is a natural compound originally derived from the bark and leaves of the willow tree. Its name originates from the word Salix, the Latin name for willow trees. Its close relative, Acetylsalicylic acid (commonly known as Aspirin), is one of the most popular pain-relieving and anti-inflammatory drugs on the market. Topical salicylic acid is anti-inflammatory, keratolytic (helps exfoliate dead skin cells), anti-fungal, and anti-bacterial. In addition, as it is lipophilic (i.e., loves fat), it easily penetrates the skin's pores to soften and loosen comedones (blackheads and whiteheads) to treat and prevent acne breakouts.

How does salicylic acid work on acne?

Woman treating acne with medicated salicylic acid cleanser and treatment cream from MDacne

Salicylic acid dissolves in fat. When applied to the skin, it penetrates deep into openings of the oil glands and breaks down fatty compounds—such as the oily sebum —and unclogs pores, resulting in deep skin cleaning.

Salicylic acid also has a mild exfoliating effect, increasing cell turnover and enhancing collagen production, ultimately providing a healthier glow to the skin. This exfoliation is achieved gently without damaging the protective layers of the skin or the risk of rupturing pores or breaking tiny blood vessels, which frequently occurs with physical exfoliating from scrubs or electric cleansing brushes. By removing melanin-containing dead skin cells from the skin's upper surface, salicylic acid also gently helps fade post-acne dark spots (i.e., hyperpigmentation) over time.

Its ability to gently exfoliate the skin and clean the pores makes salicylic acid a perfect treatment for comedones (blackheads and whiteheads) and mild to moderate acne. It's also an anti-inflammatory, which can help calm inflamed acne.

How does salicylic acid (BHA) compare to glycolic acid (AHA)?

Salicylic acid is the only beta-hydroxy acid used in skincare. As salicylic acid is more potent than glycolic acid (an alpha-hydroxy acid), it provides the same level of exfoliation in a much lower concentration. For example, salicylic acid concentrations of 0.5% to 2% have similar efficacy, with considerably less irritation than glycolic acid 30%.

This difference is due to the different chemical structures of the types of compounds. For example, salicylic acid is a beta hydroxy acid, which means the hydroxy part of the molecule is separated from the acid part by two carbon atoms instead of an alpha hydroxy acid, separated by one carbon atom. That's probably more chemistry than you wanted to know. Still, the important thing to understand is that this chemical difference makes salicylic acid more oil-soluble to penetrate the skin's pores much better than glycolic acid.

How do salicylic acid cleansers work?

Cleansers containing salicylic acid are the best option for people who have acne. The salicylic acid will work to unclog the pores and prepare the skin for acne treatment cream to penetrate the skin better. In contrast to harsher acne cleansers, a salicylic acid cleanser is mild, non-irritating, and suitable for even the most sensitive skin when used in the right concentration. For the best results, cleansers with salicylic acid should be massaged gently into the entire face (avoiding the eyes), creating a nice lather for around 20-seconds, then rinsed off with tepid water.

MDacne's Salicylic acid 2% customized acne treatment cream

What are the best products with salicylic acid for acne?

The best way to effectively treat acne is to use the right ingredients in the proper concentrations for your unique skin. With salicylic acid, the percentage of the ingredients should be customized to the skin and acne severity. The best option for people with sensitive and normal skin types is typically a concentration of salicylic acid between 0.5%—gentle enough to reduce irritation but still potent enough to tackle and prevent breakouts. For people with more oily skin, a concentration of 2% salicylic acid is typically preferred.

Salicylic acid can be even more effective and less irritating when combined with certain plant-based botanicals, which have a synergistic effect and add additional anti-inflammatory and anti-oxidative effects. The MDacne cleansers and treatment creams with salicylic acid also contain plant-based compounds such as vitamin C, aloe, witch hazel, and others for even better results.

Is salicylic acid safe to use for acne treatment?

Salicylic acid is extremely safe for acne treatment when used in the right concentrations and combined with the right ingredients. Some dryness and mild peeling are possible—and totally normal—when starting an acne treatment with salicylic acid. This effect is temporary, and the skin will usually adjust to the treatment within a couple of weeks. To prevent over-drying of the skin, it is best to avoid using additional toner and other astringents (alcohol-based) products while using salicylic acid.

Is salicylic acid safe to use during pregnancy?

Many studies have been published in which researchers have examined the outcomes of women who had taken low-dose oral acetylsalicylic acid during pregnancy. The results? There was no increase in the baseline risk of adverse events (ex., major malformations, preterm birth, or low birth weight). That being said, no major studies have examined the topical use of salicylic acid in pregnant women. However, as such a small proportion of salicylic acid is absorbed through the skin, it is unlikely to pose any risk to a developing baby. Read more about a study on the safety of skincare products during pregnancy here.


Zander E, et al. Clin Ther . Mar-Apr 1992;14( 2):247-53.
Lu J, et al. Exp Dermatol . 2019 Jul;28( 7):786-794.

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