Referred to as beta hydroxy acid (BHA), salicylic acid can be a judicious starting point in the treatment of breakouts for all skin types. This is a multifunctional ingredient that addresses many of the systemic causes of blemishes (Source: Seminars in Dermatology, December 1990, pages 305-308), and it is exceedingly effective when combined with benzoyl peroxide (Source: Skin Pharmacology and Physiology, May 2006, pages 283-289). For decades dermatologists have been prescribing salicylic acid because it is such an effective keratolytic (exfoliant). Yet, in addition to salicylic acid’s incredibly helpful exfoliating properties, it can do even more. Salicylic acid is a derivative of aspirin (both are salicylates—aspirin’s technical name is acetyl salicylic acid) and so it also functions as an anti-inflammatory (Sources: Seminars in Cutaneous Medicine and Surgery, September 2008, pages 170-176; and Archives of Dermatology, November 2000, pages 1390-1395). Combining exfoliation with reduced irritation has many advantages for skin, especially for someone struggling with breakouts. Diminishing or eliminating the redness and swelling blemishes cause can help skin heal, prevent scarring, and decrease the chance of further breakouts.
Preventing pores from becoming clogged is a requisite key to preventing blemishes. One way to achieve this is to improve the shape of the pore lining. The lining of a pore is made of skin cells (epithelial tissue) that can become thick and misshapen, preventing the natural flow of oil out of the pore. To act on the pore lining it is necessary to exfoliate inside the pore, dislodging excess skin cells. Exfoliants such as alpha hydroxy acids (AHAs) or mechanical scrubs have limitations for blemish-prone skin due to their inability to penetrate inside the pore. AHAs are water-soluble and can’t get through the oil. Mechanical scrubs have particle sizes that are too large for them to have any effect below the surface of skin, though they can make the surface smoother. Salicylic acid is the perfect answer. It is an effective exfoliant, it is lipid soluble (so it effortlessly penetrates into the pore), and it is an anti-inflammatory so it can actually reduce irritation, swelling, and redness.
Another notable aspect of salicylic acid for breakouts is that it has antimicrobial properties (Sources: Preservatives for Cosmetics, by David Steinberg, Allured Publishing, 1996; Health Canada Monograph Category IV, Antiseptic Cleansers). That means it can be effective in killing the bacteria that cause acne. Together, all these properties mean salicylic acid is one of the more multifunctional ingredients in combating the causes of acne.
As wonderful as this sounds, salicylic acid is a tricky product to buy. The concentration must be at least 0.5%, but 1% to 2% is far more effective. Additionally, the formula’s pH is a critical factor. For salicylic acid to work as an exfoliant on skin, it must be in a formulation with a pH of 3 to 4; if it isn’t, it loses its ability to exfoliate skin (Source: Cosmetic Dermatology, October 2001, pages 65-72). Plus the product must not contain any irritating ingredients. Well-formulated salicylic acid products do exist, and once you’ve found the right one, it can be a successful part of your battle plan to fight blemishes.
(Other sources: Journal of the European Academy of Dermatology and Venereology, May 2008, pages 629-631; Dermatology, January 2003, pages 68-73; and European Journal of Dermatology, July-August 2002, pages 64-50.)