The first acne treatment many of us encounter is bleaching sheets and towels (here's to benzoyl peroxide!) ), that gooey white stuff. Once the linens are sufficiently ruined, people usually get wise and move on to other acne treatments. Salicylic acid (open in new tab) is one of the most effective acne treatments. But what is salicylic acid? What does it do? With the help of dermatologists Joyce Imahiyerobo-Ip of Vibrant Dermatology and Skin Bar MD in Boston and Cheri Frey of Advanced Dermatology in Maryland, we have put together a guide to salicylic acid.

From a molecular perspective, Frey explains, salicylic acid is a natural compound found in plants that is part of a family of compounds considered phenolic acids and beta hydroxy acids. In other words, salicylic acid is a mild chemical exfoliant.

"In the skin, these acids break apart cellular bonds and cause dead skin cells to flake off," Frey continues.

Some studies suggest that salicylic acid has anti-inflammatory properties.

Commercially available salicylic acid is found in concentrations of 0.5% to 2% in spot treatments, cleansers, body soaps, masks, lotions, and creams. In these topical products, salicylic acid "helps to exfoliate, increase skin cell turnover, and give a brighter, smoother complexion," says Imahierobo-Ip.

Because salicylic acid is oil-soluble, it is particularly effective for face acne, such as white and black acne. Inflamed acne, which presents as painful acne cysts or pustules, is best treated with benzoyl peroxide.

"Salicylic acid is also used in concentrations of 20% or 30% for chemical peels performed by dermatologists," Imahierobo-Ip continues, noting that specialized treatments effectively address both acne and pigmentation.

Salicylic acid has mild side effects. Salicylic acid has a low pH and can irritate the skin," Frey explains, noting that this is why concentrations above 2% are not commercially available. She adds, "In patients with darker skin, the irritation can lead to hyperpigmentation."

Working with a dermatologist to develop a targeted layering regimen is a good idea, as layering salicylic acid with other topical medications such as glycolic acid or retinoic acid can dry or irritate the skin. Salicylic acid may also be absorbed into the skin and is not recommended during pregnancy.

While there are countless salicylic acid skin care products on the market, dermatologists have recommendations. My personal favorite is the La Roche-Posay cleanser," says Frey: "It contains patented lipohydroxy acid derived from salicylic acid; LHA stays in the surface layer of the skin, making it more potent without irritation." It also stimulates the production of hyaluronic acid and collagen, which has an anti-aging effect similar to that of retinol."

As for Imahieroboip: "Neutrogena has an affordable acne body soap with salicylic acid. I also like Murad's blemish control spray (opens in new tab). The Hydropeptide serum contains salicylic acid and azelaic acid to gently treat and prevent mild breakouts." [21