How Does Salicylic Acid Work for Acne?

Let’s talk about salicylic acid. As you know, Cassandra has had an extensive history with acne and acne treatments like salicylic acid. Cassandra’s skincare products used to have so many products that contained salicylic acid, but it wasn’t until years ago that she truly took the time to understand what salicylic acid id and how it works. So, we’re going to share what Cassandra wishes she knew. 

What is salicylic acid?

Salicylic acid is a beta hydroxy acid, better known as “a BHA.” The term, BHA, indicates that it is fat-soluble compound. In other words, it dissolves in fat or oil. This function is very helpful when it comes to skincare because the oils in our skin are fats. Given that,  BHAs can exfoliate and remove those top layers of skin. 

Salicylic acid is found in nature, but it can also be made in a laboratory. In nature, it comes from the white willow tree or the wintergreen plant. It can be extracted or made within a lab too since we know its chemical structure. When it’s made this way, it works just as well. Furthermore, salicylic acid is anti-inflammatory and likewise found in aspirin, the painkiller. 

What does salicylic acid do, and who does it help? 

Salicylic acid is often put into acne products given its anti-inflammatory features. So, not only is it very helpful for acne-prone skin, it also helps hose who have oily skin but no acne. Salicylic acid has a very potent ability to break down oil since it’s “oil-soluble.” Additionally, salicylic acid can be used in the removal of warts and even some skin tags. Because salicylic acid helps to break down the top layer of the skin, which is composed of lipids (fats), it also helps to exfoliate off things like warts and skin tags. As mentioned before, salicylic acid mainly does two things: it breaks up oil, and it helps exfoliate the skin, or more specifically, the top layer of the stratum corneum.

How does salicylic acid work with acne?

Remember that acne is made up of four main building blocks: oil, inflammation, bacteria, and the plug. Salicylic acid primarily goes to work on two facets -  the plug and the oil. Let’s talk about what “the plug” is. The plug is an overgrown sebaceous filament. Regular sebaceous filaments are normal, and may even go unnoticed, but when too much sebum forms and combines with dead skin cells, the filament thickens and deposits as a hard, pasty, or gooey substance. Sebaceous filaments are made of sebum. Sebum is not the clear fluid that comes out when you squeeze. That is oedema, a substance that forms in reaction to redness and swelling. Sebum is yellowish, and it is a mixture of triglyceride lipids, free fatty acids, wax esters, squalene, cholesterol esters, and cholesterol. 


(Accumulation of dead cells and sebum in picture 2 indicates plug).

These lipids work together to moisturize the skin and defend the body” (Lovászi M, Szegedi A, Zouboulis C, Törőcsik D, 2017).” For example, the squalene and wax esters work to create a protective barrier that seal in moisture and electrolytes. The triglycerides and free fatty acids are also antimicrobial agents and protect against and infection (Lovászi M, Szegedi A, Zouboulis C, Törőcsik D, 2017).

However, when that sebum can’t escape to the surface because of clogged dead skin cells and hardened sebum, bacteria starts to consume it and create waste products. This process inflames the skin, and a pimple forms. Squeezing can cause further inflammation, and that’s why products like salicylic acid are good loosening up those plugs instead. 

Before, we mentioned how salicylic is anti-inflammatory too. However, salicylic acid fights inflammation most fiercely when taken orally.  Applied topically though - it mainly has the potential to combat the plug and the oil. Salicylic acid’s ability to chip away at oil and plugs has made it a stable in acne skincare. As proven by science, it is highly recommended and efficacious for those with acne-prone skin.

When salicylic acid is applied to the skin, it penetrates into the epidermis, loosens up the lipids that hold our skin together, and allows it to come off easier. Salicylic also breaks down desmoglein proteins. Desmoglein proteins are proteins that hold our skin together like staples. It’s why our skin doesn’t slip around and come off. Salicylic acid breaks down desmosomes carefully so the very top of the stratum corneum can come off. In effect, it’s great for getting rid of the dead skin cells plugged within acne-prone skin. 

Is there anyone who shouldn’t use salicylic acid? 

The answer is pretty much no. Salicylic acid is generally regarded as safe. Depending on how much of it you use though, it could cause some sensitivity. So, if you have super sensitive skin, you might want to be aware of that. If you are on an oral or topical skin thinner like tretinoin, you may not want to expose yourself to salicylic acid. For most people, however, it can be used low concentrations without sensitization. 

With over-the-counter products, salicylic acid is found at 2 to 5 percent. But upon going to a doctor or esthetician, you can get a salicylic acid peel, a Jessner peel with salicylic acid, or just a salicylic acid with a higher percentage. The higher percentage of salicylic acid, the more concentrated it is. Higher concentrations penetrate deeper, but they also could cause a little more irritation.

Cassandra’s experience with salicylic acid has been positive, but in the past, her acne was too severe for salicylic acid to truly work. Because salicylic acid is so limited as an over-the-counter product, it may not show a marked difference in severe acne. Upon repetitively using products that had salicylic acid, Cassandra would notice only a slight change in her skin. However, it would only improve it to a certain point, and then it would plateau. She would still be left with deep cysts that salicylic acid just couldn’t penetrate. In this case, it’s best to see a derm. 

But, all in all, salicylic acid is medically proven to be helpful. It has been shown for many years to create some positive changes in acne-prone skin, but again, there is not a one-size-fits-all solution for acne. Your acne might not be responsive to salicylic acid, or it may react better to other treatments. 

In any case, hopefully now, you have more knowledge on salicylic acid and whether or not you would integrate it into your skincare routine. Below, we have also provided some salicylic product acne recommendations. 

We hope this helps you understand your skincare so it can do what you want it to do.

Juice Beauty Sal-A Blemish Serum With Organic Ingredients - $32


The Ordinary Salicylic Acid 2 % - $5.90


Eminence Clear Skin Willow Bark Booster, 1 Fl Oz - $56

At-Home Peel With SAL-A Green Apple - $49

Ole Henriksen Balancing Force Oil Control Toner and Balance It All Kit - $32


Salicylic Acid Green Apple Cleanser With Organic Ingredients - $28

CCoverphoto cred: Stockphotos