A rundown on the benefits of salicylic acid in skincare
(this is not a substitution for real medical advice)
Section 1: Introduction
section 2: The Easy Read Rundown (use this if you just want an easy read of the whole article)
Section 3: Explanations
Section 4: Clinical Trials
Section 5: Personal Anecdotes
Section 6:Product Recommendations References
section 1: There are many skin care ingredients that have a good standing efficacy in regards to skin care but today we will focus on salicylic acid and a very specific application. Chances are you have heard of this product which is classified as a O-hydroxybenzoic not a BHA (beta-hydroxy acid) and the intended purpose for this ingredient is for the treatment of acne (3). So that’s what I’ll be focusing on but with a different application then what most people have tried. I want to note at the very start that this application is probably not for someone who is a complete novice at skin care. This is probably more for those who are at least intermediate at skin care. What I mean be intermediate is someone who understands PH in skin care, high and low quality ingredients, skin barrier function, and basic skin care applications. The application is to leave the product on the skin rather than wash it off. This article will include short simple answers, research, explanations, real world anecdotes, and product recommendations.
Section 2: The Easy Read Rundown
(Refer to the anecdotes for progress photos, applications, helpful advice, ect) If you want to just get to the point and move on with your day here are the main takeaways: Intended users: Those with acne vulgaris (the more common type of acne which consists of inflamed pustules) acne (closed comedones IE blackheads and whiteheads), those who produce a lot of sebum(oily skin), hyperpigmentation, psoriasis, eczema, folliculitis, acne scarring, and fungal acne. Warning: For those who have a damaged skin barrier this application may be problematic. If currently breast feeding you should probably avoid this product out of safety for child. Use a sunscreen! Benefits: With a longer topical skin exposure with salicylic acid, it may be beneficial for reducing acne, white heads, black heads, and clogged pores. Gently exfoliates the skin (keratolytic properties). Application: So like I said in the intro the main point here is to just leave the ingredient on all day.
Here I will lay out what you can do as an example for each product. No, don’t just use any product containing salicylic acid. There is a reason why I’ve picked the products that I have. First the concentration of salicylic acid that we are working with is 2%. Here I will provide an explanation for different concentrations and their uses. 0.5%–10% Acne, 3%–6% Hyperkeratotic disorders like psoriasis, ichthyoses, keratosis pilaris, 5%–40% Warts, corns 50% Actinic damage and pigmented lesions, 20%–30% Superficial chemical peeling of face (7).
Note: The PH of the product may or may not matter here. However I can’t find much recent data on this. I’ve seen reviews of those using products with a high PH containing salicylic acid and still report a positive outcome. This was the closest data I could find which stated this might not be relevant (5). Salicylic Acid Pads 2%- Preferably to be used at night. After cleansing the face apply the stridex pad to the face and neck for as long as you can tolerate it (preferably all day) or wash it off after 5-20 minutes. To be as cautious as possible you can try buffering the ingredient with a moisturizer before applying the pad. Lotions/Moisturizers containing salicylic acid 2%- Perform your normal skin care routine using some sort of cleanser beforehand and simply apply the moisturizer/lotion. The product recommendations I’ve provided seem to be safe for the face. (If you are using other products you may want to reconsider this application. Generally you don’t want to use too many active ingredients especially if you want to know if this application is working for you. But of course irritation is always something to consider. This is totally context dependent so if you don’t notice any problems you may not have to worry.
Product recommendations: (Note: Product review and break down in section 6.)
Stridex pads (recommended) - This is available at most Walmarts. Price- Around $4. https://www.amazon.com/Stridex-Strength-Medicated-Maximum-Count/dp/B000O1KP1O CeraVe SA
Moisturizing Cream for Rough & Bumpy Skin- Available at most targets, Around $14 https://www.amazon.com/CeraVe-Renewing-Lotion-Ounce-Salicylic/dp/B0071XPQQ2/ref=sr_1 _2?keywords=CeraVe+SA+Moisturizing+Cream+for+Rough+%26+Bumpy+Skin&qid=158016 4062&sr=8-2
Section 3: Explanations
Salicylic acid (O-hydroxybenzoic acid) has two main mechanisms that make it an efficacious treatment for acne and other subtypes of acne. The first mechanism is it has a keratolytic property so this means “ it can break down the follicular keratotic plugs through dissolving the intercellular cement holding the stratum corneum cells and promoting the desquamation of follicular epithelium”(1). The second mechanism is that it has comedolytic activities, so this means “it also has anti-inflammatory capabilities”(1). Now to understand why this is even relevant to acne and other subtypes let's look at potential causes. Acne is recognized as an inflammatory disorder of the hair follicle which it’s main cause is an overproduction of sebum (which can be caused be a number of things such as androgens or an impaired skin barrier), “follicular hyperkeratinisation, Propionibacterium acnes (P. acnes), and bacterial hypercolonisation, as well as inflammation, are the major pathogenetic factors for acne”(1). So outside of healing the skin barrier salicylic acid may be efficacious for addressing these mechanisms. Now that we have a surface level understanding of what causes acne and how salicylic acid can address these causes, lets go over the clinical trials.
Section 4: Clinical Trials
I couldn’t find any systematic reviews or meta analysis on salicylic acid in regards to this application however I do have a few clinical trials to reference here. I will provide a summary and a link to the reference at the bottom. If you would like full access to the paper you can use sci-hub. The benefit of 2% salicylic acid lotion in acne - a placebo-controlled study Main summary: “This study demonstrated that twice daily application of 2% salicylic acid lotion impregnated into pads was significantly better than placebo in mild to moderate acne. Significant benefit from the active therapy was evident at 4,8 and 12 weeks when total lesion counts were assessed. There was a significant benefit from the active therapy over placebo in noninflamed lesions at 8 and 12 weeks and inflamed lesions at 12 weeks. These results fit with the suggestion that salicylic acid has a primary effect on comedogenesis”(4).
Patient and Methods: At the start of the study, there were 86 males and 28 females with mild to mild-moderate facial acne. The therapy was used twice daily. The active treatment consisted of 2% salicylic acid lotion and the placebo was a 10% hydroalcoholic lotion (4). Composition of the lotion was Purified water, Alcohol SD 408, Salicylic acid, Isoceteth-20 (Arlasolve 200), Aloe VeraGel liq 1:l, Triethanolamine 99%, Perfume 4-7837, Disodium EDTA dihydrate, Denatonium benzoate(4). Treatment of Acne Vulgaris With Salicylic Acid Pads Abstract: “Most cases of acne vulgaris are either mild or moderate in severity and well-suited for treatment with nonprescription agents that are safe, effective, and convenient to use.
A review of four clinical studies and a comedolytic assay attests to the efficacy and safety of 0.5% and 2% solutions of salicylic acid for the treatment of acne vulgaris. In three placebo-controlled studies and a comedolytic assay, salicylic acid pads reduced the number of primary lesions and thereby the number and severity of all lesions associated with acne. Comparative studies of salicylic acid have shown it to be superior to benzoyl peroxide in reducing the total number of acne lesions. Adverse reactions to salicylic acid are generally limited to mild, local irritation occurring in a minority of patients”(6).
Section 5: Personal Anecdotes
Here are a few testimonies using this application.
Testimonial #1 Here a user named silverscreenquotes from reddit posted her progress using stridex pads with a before and after picture a month apart. Here is her routine: “Morning: cerave hydrating cleanser then cetaphil lotion. Night: cerave hydrating cleanser then stridex in the red box then after a few minutes cerave cream. I also apply aquaphor to my lip and eye area right before bed.” “...I try to allow for as much time as possible, but since my dry skin drinks up any product ~five minutes does the trick.”
Here you can access her before and after photo: https://imgur.com/a/ms0db Link to her post: https://www.reddit.com/r/SkincareAddiction/comments/3z6sfr/acne_progress_pictures_after_add ing_stridex_to_my/
Testimonial #2 Here another user from reddit oxymorons who had a bad case of clogged pores and oily T zones. They also used the stridex pads. Their routine was “I used them every other day after cleansing at night. I would wait about 15 minutes after using the pad before moisturizing.... I did this for five weeks or more (I know it was at least five weeks though)”. “I typically wait anywhere from 15 to 25 minutes before I apply moisturizer. My face is so soft now!”. They had some trouble at first but with continued use they saw noticeable improvement in the texture and appearance of their pores. Unfortunately they didn’t have any before or after progress photos.
Link to their post: https://www.reddit.com/r/SkincareAddiction/comments/1hpnw6/i_used_stridex_pads_5_weeks_before_i_saw_results/
Testimonial #3 Personally tried this application and found it effective. I’m still looking for pads that have better ingredients but for now this will do. What I do: I will cleanse my face and neck with a Vanicream Gentle Facial Cleanser and then apply the stridex pad around the same areas and let it sit till it dries. Around 5-10 minutes later I will apply a Cerave PM Facial Moisturizing Lotion. Note: I use the pads at night.
Section 6: Product recommendations
Stridex Pads- https://www.amazon.com/Stridex-Strength-Medicated-Maximum-Count/dp/B000O1KP1O
Active Ingredient: Salicylic Acid 2.0% Inactive Ingredients: Ammonium Lauryl Sulfate , Ammonium Xylenesulfonate, Citric Acid, DMDM Hydantoin, Fragrance, Menthol, PPG-5-Ceteth-20, Purified Water, Simethicone, Sodium Borate, Tetrasodium EDTA.
Summary: The inactive ingredients here aren’t exactly necessary IMO except for maybe DMDM Hydantoin (Preservative). The only downside is the first two inactive ingredients are surfactants and that it has added fragrance which is not ideal for your skin. However the product is very cost efficient with the highest price I’ve seen being $4 for a pack of 110 at Walmart.
Protocol: Salicylic Acid Pads 2%- Preferably to be used at night. After cleansing the face apply the stridex pad to the face and neck for as long as you can tolerate it (preferably all day) or wash it off after 5-20 minutes. To be as cautious as possible you can try buffering the ingredient with a moisturizer before applying the pad. Use a sunscreen!
CeraVe SA Lotion for Rough & Bumpy Skin- https://www.amazon.com/CeraVe-Renewing-Lotion-Ounce-Salicylic/dp/B0071XPQQ2
Ingredients: Aqua / Water / Eau, Glycerin, Paraffinum Liquiadum / Mineral Oil / Huile Minerale, Triethanolamine, Salicylic Acid, Glyceryl Stearate, Ammonium Lactate, Peg-100 Stearate, Cetearyl Alcohol, Cetyl Alcohol, Zea Mays Oil / Corn Oil, Ceramide Np, Ceramide Ap, Ceramide Eop, Carbomer, Behentrimonium Methosulfate, , Dimethicone, Methylparaben, Sodium Lauroyl Lactylate, Cholecalciferol, Cholesterol, Disodium Edta, Propylparaben, Hydrolyzed Hyaluronic Acid, Phytosphingosine, Xanthan Gum.
Summary: This product has salicylic acid as well as lactic acid. Just for your info lactic acid is just an AHA that is very mild yet effective exfoliating agent. Some people will see that this has mineral oil and think that this is somehow a negative but there really isn’t anything to worry about. If anything it is a neat occlusive. Worst case scenario if you find that the stridex pad ingredients are problematic you can opt for this product.
Protocol: Lotions/Moisturizers containing salicylic acid 2%- Perform your normal skin care routine and simply apply the moisturizer/lotion. If you are using other active ingredients you may want to reconsider this application. Generally you don’t want to use too many active ingredients especially if you want to know if this application is working for you. But of course irritation is always something to consider. This is totally context dependent so if you don’t notice any problems you may not have to worry. Use a sunscreen!
Dylan Armbruster
Turncoat Mag
