Salicylic acid, which naturally occurs in plants such as willow bark, is classified as a beta hydroxy acid and has both antibacterial and anti-inflammatory properties. Salicylic acid exerts its pharmacologic action via unclogging blocked pores that contribute to acne and decreases the skin’s production of sebum, which results in fewer acne breakouts. Additionally, salicylic acid helps to gently exfoliate the skin. The American Academy of Dermatology recommends treating certain types of acne such as pustules, papules, blackheads, and whiteheads with a topical product that contains salicylic acid.

OTC products that contain salicylic acid typically have concentrations between 0.5% to 2%. Many dermatologists recommend OTC products for acne that are also formulated with ceramides, which are lipids that comprise an estimated 50% of the natural skin barrier. Products containing ceramides are beneficial for overall skin health since research has revealed that acne-prone skin typically has diminished levels of these vital skin-barrier lipids.

Ceramides also help to maintain the natural skin barrier. Some individuals also use topical salicylic acid products in conjunction with topical benzoyl peroxide to treat acne. Additionally, dermatologists recommend that patients who are prone to acne establish a skin care routine that involves cleansing the skin with a gentle cleanser formulated for acne and using moisturizers and protecting the skin with noncomedogenic moisturizers that contain essential ceramides, hyaluronic acid, and niacinamide for hydration as well as a SPF protection of at least 30.

Examples of products frequently recommended by dermatologists and pharmacists include CeraVe’s Renewing SA Cleanser, which is formulated as a noncomedogenic, fragrance-free cleanser that contains salicylic acid, ceramides, hyaluronic acid, and niacinamide, and CeraVe’s AM Facial Moisturizing Lotion and Sunscreen, which is a noncomedogenic moisturizer with SPF protection formulated for all skin types that will not clog the skin pores or contribute to flareups of acne.

During counseling, pharmacists should remind patients that the use of OTC salicylic acid products is sometimes associated with potential adverse reactions (ADRs), which can vary from patient to patient and may depend on the concentration used. Examples of potential ADRs may include dryness of skin, mild irritation, mild burning and stinging, and skin peeling. It is vital that pharmacists and other clinicians counseling patients about OTC acne products remind them to use these products as recommended and to discontinue use if they experience severe ADRs, such as skin irritation.  

As described in the article, patients should be reminded that when using topical acne products such as salicylic acid, actual improvement in skin’s appearance may not be noticed for at least 6 to 8 weeks and that patient adherence to the recommended skin-care regimen is critical to overall outcomes. It is also important that patients seek further medical care if their acne worsens or if there are no noticeable improvements in this time frame. In some cases, alternative therapies, including prescription medications or a combination of therapies, may be warranted. 

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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