How To Include Salicylic Acid In Your Routine The Right Way

Salicylic acid works great for mild acne due to its strong skin exfoliation properties. It is very commonly used in face washes as an anti-acne ingredient. It is considered a Beta Hydroxy Acid (BHA), which means that it is oil-soluble and can clean out your pores by penetrating into your oil plugs. Salicylic acid works great for skin issues such as persistent blackheads and ingrown hairs. It is a staple ingredient for any good skincare routine, especially for persons with oily skin.

What is Salicylic Acid?

At low concentrations of 0.5% to 10%, salicylic acid is able to treat mild to moderate acne effectively ¹, while at high concentrations of 20%–30%, it is capable of peeling off the outer layer of skin (the superficial layer), revealing newer and younger skin below. However, these high concentration formulations should be used with caution and with professional cosmeticians, due to the preparations required and dangers of chemical burns involved. ²

Salicylic acid is allowed to be sold in OTC products in the US in concentrations between 0.5% to 2%, which would treat mild to moderate acne. In the EU and Japan, salicylic acid is restricted to 2% as well, while in South Korea, salicylic acid is banned in cosmetic products. If you are in a country like South Korea that prohibits the sale of products with salicylic acid, you may need to find alternative BHA treatments that may be less effective overall as an acne and skin exfoliation treatment. However, even if it is restricted in certain countries, there is sufficient scientific evidence for its use as a skin exfoliant and anti-acne treatment.

How does Salicylic Acid Affect The Skin?

Salicylic acid works by breaking down the bonds that holds the outermost layer of your skin to the inner layers. As gross as that may sound, the effect is very gentle when salicylic acid is applied to the skin in low concentrations. At higher concentrations, mild peeling can be observed, because your outermost skin layer is getting “unstuck”. This exfoliating effect is, of course, concentration dependent, meaning that lower concentrations will exfoliate less, and higher concentrations will exfoliate more. ¹

How Effective is Salicylic Acid for Treating Acne?

Usage of salicylic acid in wipe-on pads have been shown to be effective in treating and reducing acne in multiple clinical studies. It is also just as effective when used in a face-wash formulation, as shown in this comparative study that compares a salicylic-acid face wash versus a benzoyl peroxide face wash and found that the salicylic acid face wash was more effective in consistently reducing acne.³

This is great news for us, since form factor does not affect efficacy, we have much more flexibility when trying to fit salicylic acid into our skincare routine, which is great news for us.

Adding Salicylic Acid Into Your Skincare Routine

Selecting a Form Factor

As mentioned above, regardless of the form factor, the salicylic acid will still be able to do its skin exfoliation magic. With that said, the selected form factor will affect your skincare routine length, as well as how the product fits in with other treatments that you are using concurrently.

When using a face wash form factor, the salicylic acid will be deposited on the skin, and some of it may get washed off during the cleansing. This means that the overall exposure of the skin to the salicylic acid will be lesser as compared to a serum or pad form factor. Additionally, subsequent steps in your routine post-cleanse would reduce the effectiveness of the salicylic acid as it would get diluted or wiped off with the addition of new products. Additionally, cleanse at least twice a day if treating acne.

When using a serum or pad, we are applying the salicylic acid directly and allowing it to penetrate the skin layers with a waiting time (usually around 5 to 15 minutes). Even if you have a short waiting time of a minute, the exposure and penetration would be much greater in comparison to a face wash. Application frequency will depend on the concentration that you are using. A study used a twice daily frequency for a 0.5% salicylic acid pad, which is much less irritating than a 2% pad ¹. For such higher concentrations, consider starting off with once every two days, then if there is no irritation observed, increasing the frequency to daily. Some product manufacturers recommend working your way up to twice a day, but it really depends on how your skin responds to the salicylic acid treatment.

Use the serum or pad after cleansing, so that you will have a fresh and squeaky clean face for the salicylic acid treatment. Although there is no evidence of a pH requirement for salicylic acid, it does not make sense to neutralize the active ingredient in the treatment with potentially higher pH products.

You also do not need to have a salicylic acid face wash and an additional salicylic acid treatment, the effects do not stack like that. Choose one and be done with it. You might even have adverse reactions if you do that (since you are exfoliating your skin twice in a short time with the same exfoliating mechanism). You can consider adding in other different treatments that have different skin exfoliating mechanisms instead.

Should I Moisturise After Applying Salicylic Acid?

Yes. In general, one should moisturise based on the skin’s needs and dryness with regards to the climate one is living in. However, with salicylic acid concentrations greater than 2%, it is possible to have mild skin peeling, hence moisturising can reduce the irritation associated with this. Additionally, many moisturisers also contain anti-inflammatory ingredients, so your choice of moisturiser may help calm your skin if there is mild irritation or dryness from your skin exfoliation regime.⁴

Do You Need to Avoid Salicylic Acid When Pregnant?

No, you do not. Hydroxy acids (which salicylic acid falls under) are rated as pregnancy category C by the FDA ¹, meaning that there are animal studies that have shown an negative effect on the fetus but there are no well-controlled human studies available. The FDA do not require manufacturers to issue pregnancy-related health warnings on labels, so there is no cause for alarm when using OTC products.

A recent review focusing on the treatment of acne during pregnancy recommends that topical anti-acne treatments that include salicylic acid treatments should be considered as first-line treatments instead of oral anti-acne treatments.⁵ The review also noted that minimal topical salicylic acid is absorbed by the body especially when used over small areas of skin (such as the face). The review also advises that these products should not be applied over large areas of the body (like applying it all over your body… don’t do that🤦), as it would increase the absorption of the active ingredient into the body, which may have negative effects on the fetus. ⁵

If you would like to err on the side of caution, you can leave salicylic acid treatments out of your routine while pregnant, and resume them post-pregnancy. However, if getting the acne is on the top of your priority list, then consider using a lower concentration salicylic acid treatment and applying it on facial skin only.