Salicylic acid for skin: how does it work?

Acne is a common skin problem that can (literally) break out at any time. It can be frustrating, but know you’re not alone––acne affects 40–50 million people in the United States (AAD, n.d.). 

If you’re looking for a remedy for whiteheads, blackheads, or other acne blemishes, salicylic acid is one of the most widely used topical medications. It’s also a common ingredient used in chemical peels and wart remover. Read on to learn more about what salicylic acid does and how to use it.

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If you’re not familiar with salicylic acid, is an active ingredient in many topical (applied to the skin) medications for skin and foot care products like pimple-fighting face wash and wart remover.

Despite limited clinical evidence of its effectiveness, salicylic acid is a popular over-the-counter acne treatment (Tan, 2018).

Salicylic acid works by unclogging pores, promoting exfoliation of dead skin cells, and decreasing skin oil (sebum) production. 

It’s classified as a beta-hydroxy acid (BHA), which is oil-soluble––meaning it dissolves in oil as opposed to water. This characteristic allows BHAs to penetrate deep into oil-clogged skin pores, making salicylic acid a potentially powerful ingredient for fighting acne (Arif, 2015). 

Additionally, salicylic acid is very similar to aspirin, an anti-inflammatory medicine used to treat pain and fever. Like aspirin, salicylic acid helps reduce inflammation (Tan, 2018; Arif, 2015).

Lower strengths of salicylic acid are mainly used to treat acne. Higher strengths are used to remove or loosen thick areas of skin. Here are the most common salicylic acid uses and strengths (Arif, 2015).

Because of the limited evidence of this ingredient’s effectiveness, experts typically recommend other topical acne medications. Top choices for treating acne include (Tan, 2018): 

• Benzoyl peroxide 

• Topical antibiotics like clindamycin

• Retinoids like tretinoin and adapalene  

But salicylic acid is a good choice for treating mild acne, especially for those who can’t tolerate retinoids like tretinoin (brand name Retin-A). If you don’t see clearer skin within a few months of use or if your acne becomes more severe, see a healthcare provider or dermatologist for medical advice (Graber, 2022).

Common side effects of salicylic acid include skin irritation and stinging at application areas. It’s recommended to start out with a low concentration and only apply it every other day (MedlinePlus, 2016).

To prevent an allergic reaction, test new skincare products on a small area for the first few days. If you develop a rash, swelling, itching, or other signs of an allergic reaction, wash it off and seek medical attention right away. 

While rare, salicylic acid toxicity (salicylism) can occur from swallowing or applying too much topical product containing the ingredient. Rare side effects include (Arif; 2015; MedlinePlus, 2016): 

• Confusion 

• Dizziness 

• Fatigue 

• Headache

• Rapid breathing

• Ringing in the ears or trouble hearing 

• Nausea, vomiting, or diarrhea 

As always, consult a healthcare professional before using any new medications or supplements. This is especially important if you’re pregnant, breastfeeding, have very sensitive skin, or have any underlying medical conditions (MedlinePlus, 2016).

There are different ways to use salicylic acid depending on the product. Some are available as a lotion or daily wash, while others are meant to be used on the skin for only a short time. 

Be sure to read the instructions that come with the product. The label will give you step-by-step instructions on how to prepare your skin and apply it. If you have questions, consult a healthcare or dermatology professional. They can also recommend a skincare routine that’s best for your skin condition and skin type.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

June 21, 2022

Written by

Patricia Weiser, PharmD

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.