Salicylic acid is a topical keratolytic agent. It is used to remove excess keratin in hyperkeratotic skin disorders such as common and plantar warts, psoriasis, seborrheic dermatitis, calluses, and corns. Salicylic acid also is used to treat acne. Salicylic acid works by causing desquamation of the horny layer of skin. Prolonged or repeated daily use over large areas of skin may result in salicylism, especially in children and patients with renal or hepatic impairment. This drug was approved by the FDA in 1939.
Route-Specific Administration
Topical Administration
-Do not use near the eyes, nose, mouth, or other mucous membranes. Do not apply to areas of inflamed or broken skin. Avoid contact with surrounding healthy skin.
-Wash hands after applying to remove any remaining medication.
-Hydrate skin by wet packs or baths for at least 5 minutes prior to application when used for the treatment of hyperkeratotic skin disorders.
-When occlusion is indicated, application may be made more frequently in those areas where occlusion is difficult or impossible.
Prolonged and repeated daily use over large areas, especially in children and patients with significant renal or hepatic impairment increases the potential for development of salicylism.
Topical application of salicylic acid is generally well tolerated, but may result in skin irritation including transient stinging, burning, or pruritus. Excessive erythema, peeling of the skin, and scaling may also occur, particularly if used on open skin lesions. Advise patients to discontinue use and consult a physician if excessive burning, stinging, or peeling occurs.
Topical over-the-counter (OTC) acne products, including salicylic acid, have been associated with rare but serious and potentially life-threatening hypersensitivity reactions. These reactions may occur within minutes to a day or longer after use of the product. Instruct patients to stop using topical acne products if they experience signs of anaphylactoid reactions such as throat tightness; difficulty breathing; feeling faint; or swelling of the eyes, face, lips, or tongue. The product should also be discontinued in patients who develop urticaria or pruritus. Based on the information reported to the FDA, it is uncertain whether the reactions are caused by the active ingredients benzoyl peroxide or salicylic acid, the inactive ingredients or a combination of both. When initiating therapy with an OTC topical acne product, advise patients to apply a small amount to one or two small affected areas for 3 days and monitor for signs of a hypersensitivity reaction. If no discomfort occurs, the instructions on the Drug Facts label may be followed.
Salicylic acid preparations are contraindicated in patients who have previously exhibited salicylate hypersensitivity.
Topical salicylic acid preparations in concentrations greater than 6% are contraindicated in patients with diabetes mellitus and other conditions of poor blood circulation such as peripheral vascular disease. Do not use these preparations on moles, birthmarks, warts with hair growing from them, genital warts, or warts on the face or mucous membranes.
Prolonged use of salicylic acid over large areas, especially in children and patients with renal impairment or hepatic disease may increase the risk for development of salicylism. In such patients, limit the treated area and closely monitor the patient for signs of salicylate toxicity such as nausea, vomiting, dizziness, loss of hearing, tinnitus, lethargy, hyperpnoea, diarrhea, and psychic disturbances. When the potential for toxicity is present, advise patients not to apply occlusive dressings, clothing or other occlusive topical products such as petrolatum-based ointments to prevent excessive systemic exposure to salicylic acid. Concomitant use of other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin and other salicylate containing medications, such as sports injury creams) should be avoided. Discontinue use of salicylic acid if salicylic acid toxicity occurs and treat appropriately.
The potential for Reye's syndrome should be considered with administration of salicylic acid products in children and adolescents with varicella or influenza.
Avoid accidental exposure of salicylic acid products to the eyes, lips, mucus membranes and inflamed or broken skin as increased absorption may occur. If unintended mucus membrane or ocular exposure occurs, thoroughly rinse affected areas with water.
There are no adequate and well-controlled studies in pregnant women. However, systemic exposure is considered negligible with normal prescription use. Roughly 10% of applied salicylates can remain in the skin after dermal application. Salicylic acid products should only be used during pregnancy if the potential benefit to the mother outweighs the potential risk to the fetus.
It is not known whether topically applied salicylic acid is excreted into breast milk. According to the manufacturer, salicylic acid should not be used during breast-feeding. However, systemic exposure is considered negligible with normal prescription use. Roughly 10% of applied salicylates can remain in the skin after dermal application. If the drug is used during breastfeeding, care should be taken to avoid application to the skin of the breast during lactation. Apply only water-miscible cream or gel products to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.
Per the manufacturer, this drug has been shown to be active against most strains of the following microorganisms either in vitro and/or in clinical infections: Cutibacterium acnes
NOTE: The safety and effectiveness in treating clinical infections due to organisms with in vitro data only have not been established in adequate and well-controlled clinical trials.
For the treatment of verruca vulgaris, verruca plantaris, and hyperkeratotic lesions (e.g., corns and calluses):
Topical dosage (17% gel and liquid):
Adults: Apply 1 drop at a time topically to sufficiently cover the wart, corn, or callus; avoid applying to healthy skin. Allow to dry. Repeat once or twice daily as needed (until wart, corn, or callus is removed) for up to 12 weeks.
Children and Adolescents 2 to 17 years: Apply 1 drop at a time topically to sufficiently cover the wart, corn, or callus; avoid applying to healthy skin. Allow to dry. Repeat once or twice daily as needed (until wart, corn, or callus is removed) for up to 12 weeks. NOTE: Topical salicylic acid is recommended for the treatment of cutaneous warts in children; however, data specific to young children is limited.
Topical dosage (40% medicated topical patches):
Adults: Apply 1 patch to wart, callus, or corn. Repeat every 48 hours as needed for up to 12 weeks.
Children and Adolescents 2 to 17 years: Apply 1 patch to wart, callus, or corn. Repeat every 48 hours as needed for up to 12 weeks. NOTE: Topical salicylic acid is recommended to treat cutaneous warts in children; however, data specific to young children is limited. A topical jelly containing 40% salicylic acid has been reported in children 4 years and older.
Topical dosage (15% medicated topical patches):
Adults: Apply 1 patch at bedtime. Remove in the morning after at least 8 hours. Repeat every 24 hours until wart is removed for up to 12 weeks. Patches may be trimmed to the appropriate size to cover the wart, but avoid contact with healthy skin.
Children and Adolescents 2 to 17 years: Apply 1 patch at bedtime. Remove in the morning after at least 8 hours. Repeat every 24 hours until wart is removed for up to 12 weeks. Patches may be trimmed to the appropriate size to cover the wart, but avoid contact with healthy skin.
Topical dosage (23%, 26%, 27.5%, 28%, and 28.5% topical liquid):
Adults: Apply to entire wart surface topically using supplied brush; avoid applying to healthy skin. Allow first application to dry and repeat. Apply once or twice daily. Maximum resolution may be expected after 4 to 6 weeks.
Children and Adolescents 2 to 17 years: Apply to entire wart surface topically using supplied brush; avoid applying to healthy skin. Allow first application to dry and repeat. Apply once or twice daily. Maximum resolution may be expected after 4 to 6 weeks. NOTE: Topical salicylic acid is recommended to treat cutaneous warts in children; however, data specific to young children is limited.
Topical dosage (6% topical gel, cream, and lotion):
Adults: Apply a thin layer topically to affected area at bedtime. Cover the treated area. In those areas where occlusion is difficult or impossible, application may be made more frequently. Wash off in the morning.
Children and Adolescents 2 to 17 years: Apply a thin layer topically to affected area at bedtime. Cover the treated area. In those areas where occlusion is difficult or impossible, application may be made more frequently. Wash off in the morning.
Topical dosage (6% topical foam):
Adults: Apply a thin layer topically to the affected area twice daily and rub in until completely absorbed.
Children and Adolescents 2 to 17 years: Apply a thin layer topically to the affected area twice daily and rub in until completely absorbed.
Topical dosage (10% cream):
Adults: Apply a thin layer topically to the affected area at bedtime, and wash off in the morning. Preferably, skin should be hydrated for at least 5 minutes prior to application.
Children and Adolescents 2 to 17 years: Apply a thin layer topically to the affected area at bedtime, and wash off in the morning. Preferably, skin should be hydrated for at least 5 minutes prior to application.
For the treatment of ichthyosis (i.e., vulgaris, sex-linked and lamellar), keratosis (i.e., palmaris, plantaris, and pilaris) and pityriasis rubra pilaris:
Topical dosage (6% topical gel, cream and lotion):
Adults, Adolescents, and Children 2 years and older: Apply to affected area at bedtime. Cover the treated area. In those areas where occlusion is difficult or impossible, application may be made more frequently. Wash off in the morning. Once clearing is apparent, occasional use will usually maintain the remission.
Topical dosage (6% topical foam):
Adults, Adolescents, and Children 2 years and older: Apply to the affected area twice daily and rub in until completely absorbed.
Topical dosage (5% topical lotion):
Adults: Apply to affected area at bedtime. Cover the treated area. In those areas where occlusion is difficult or impossible, may be applied more frequently.
Topical dosage (10% cream):
Adults, Adolescents, and Children 2 years and older: Apply topically to the affected area at bedtime, and wash off in the morning. Preferably, skin should be hydrated for at least 5 minutes prior to application.
For the treatment of psoriasis:
-for the treatment of psoriasis involving the body:
Topical dosage (3% cream, 2% and 5% gel, or 2% and 3% lotion):
Adults: Apply topically to the affected skin area(s) 1 to 4 times daily. Topical salicylic acid can be used for 8 to 16 weeks for the treatment of mild to moderate psoriasis. The combination of salicylic acid with topical corticosteroids can be used for the treatment of moderate to severe psoriasis (body surface area of 20% or less).
Children and Adolescents 12 to 17 years: Apply topically to the affected skin area(s) 1 to 4 times daily.
Topical dosage (5% lotion):
Adults: Apply topically to the affected skin area(s) at bedtime and cover the treated area; wash off in the morning. May apply more frequently to those areas where occlusion is difficult or not possible. Topical salicylic acid can be used for 8 to 16 weeks for the treatment of mild to moderate psoriasis. The combination of salicylic acid with topical corticosteroids can be used for the treatment of moderate to severe psoriasis (body surface area of 20% or less).
Topical dosage (6% cream, gel, or lotion):
Adults: Apply topically to the affected skin area(s) at bedtime and cover the treated area; wash off in the morning. May apply more frequently to those areas where occlusion is difficult or not possible. Topical salicylic acid can be used for 8 to 16 weeks for the treatment of mild to moderate psoriasis. The combination of salicylic acid with topical corticosteroids can be used for the treatment of moderate to severe psoriasis (body surface area of 20% or less).
Children and Adolescents 2 to 17 years: Apply topically to the affected skin area(s) at bedtime and cover the treated area; wash off in the morning. May apply more frequently to those areas where occlusion is difficult or not possible. Pretreating involved skin with 6% to 10% salicylic acid for 1 week may enhance the efficacy of subsequent calcipotriene monotherapy. However, care must be taken when salicylic acid is used with calcipotriene because the acid pH of salicylic acid will inactivate calcipotriene when the 2 are given simultaneously.
Topical dosage (10% cream):
Adults: Apply topically to the affected skin area(s) at bedtime; wash off in the morning. Topical salicylic acid can be used for 8 to 16 weeks for the treatment of mild to moderate psoriasis. The combination of salicylic acid with topical corticosteroids can be used for the treatment of moderate to severe psoriasis (body surface area of 20% or less).
-for the treatment of scalp psoriasis:
Topical dosage (5% or 6% gel):
Adults: Apply topically to the psoriatic scalp area(s) once daily until scalp improves, then once or twice weekly or as needed; wash off after 10 to 20 minutes, initially but may leave on for up to 1 hour as treatment progresses. Topical salicylic acid can be used for 8 to 16 weeks for the treatment of mild to moderate psoriasis. The combination of salicylic acid with topical corticosteroids can be used for the treatment of moderate to severe psoriasis (body surface area of 20% or less).
Children and Adolescents 2 to 17 years: Apply topically to the psoriatic scalp area(s) once daily until scalp improves, then once or twice weekly or as needed; wash off after 10 to 20 minutes, initially but may leave on for up to 1 hour as treatment progresses. Pretreating involved skin with 6% to 10% salicylic acid for 1 week may enhance the efficacy of subsequent calcipotriene monotherapy. However, care must be taken when salicylic acid is used with calcipotriene because the acid pH of salicylic acid will inactivate calcipotriene when the 2 are given simultaneously.
Topical dosage (5% or 6% shampoo):
Adults: Apply a liberal amount to wet hair and massage into lather once daily until scalp improves, then as needed; leave on for several minutes, then rinse. Alternately, may apply topically to the psoriatic scalp area(s) once daily until scalp improves, then as needed; wash off after 5 minutes, initially and gradually increase contact time up to 1 hour. Topical salicylic acid can be used for 8 to 16 weeks for the treatment of mild to moderate psoriasis. The combination of salicylic acid with topical corticosteroids can be used for the treatment of moderate to severe psoriasis (body surface area of 20% or less).
Children and Adolescents 2 to 17 years: Apply a liberal amount to wet hair and massage into lather once daily until scalp improves, then as needed; leave on for several minutes, then rinse. Alternately, may apply topically to the psoriatic scalp area(s) once daily until scalp improves, then as needed; wash off after 5 minutes, initially and gradually increase contact time up to 1 hour. Pretreating involved skin with 6% to 10% salicylic acid for 1 week may enhance the efficacy of subsequent calcipotriene monotherapy. However, care must be taken when salicylic acid is used with calcipotriene because the acid pH of salicylic acid will inactivate calcipotriene when the 2 are given simultaneously.
Topical dosage (10% cream):
Adults: Apply topically to the psoriatic scalp area(s) at bedtime; wash off in the morning. Topical salicylic acid can be used for 8 to 16 weeks for the treatment of mild to moderate psoriasis. The combination of salicylic acid with topical corticosteroids can be used for the treatment of moderate to severe psoriasis (body surface area of 20% or less).
Children and Adolescents 2 to 17 years: Apply topically to the psoriatic scalp area(s) at bedtime; wash off in the morning. Pretreating involved skin with 6% to 10% salicylic acid for 1 week may enhance the efficacy of subsequent calcipotriene monotherapy. However, care must be taken when salicylic acid is used with calcipotriene because the acid pH of salicylic acid will inactivate calcipotriene when the 2 are given simultaneously.
For the treatment of seborrheic dermatitis:
Topical dosage (2% and 5% shampoo):
Adults, Adolescents, and Children 2 years and older: Apply to scalp after wetting hair. Work into lather, leave on for several minutes, then rinse thoroughly. The shampoo may be used daily until the condition clears, then as needed to maintain remission.
Topical dosage (2% and 3% topical preparations):
Adults, Adolescents, and Children 2 years and older: Apply to the affected areas 1 to 4 times daily.
For the treatment of acne vulgaris:
Topical dosage (0.5% cream or 2% cream, pad, or solution):
Adults: Apply a thin layer topically to the affected skin area(s) 1 to 3 times daily. To minimize potential dryness, start with 1 application daily and gradually increase to 2 to 3 times daily. Reduce application to once daily or every other day if bothersome dryness or peeling occurs.
Adolescents: Apply a thin layer topically to the affected skin area(s) 1 to 3 times daily. To minimize potential dryness, start with 1 application daily and gradually increase to 2 to 3 times daily. Reduce application to once daily or every other day if bothersome dryness or peeling occurs.
Topical dosage (2% cleanser):
Adults: Apply to hands, and add water to work into a lather; then cleanse the affected skin area(s) twice daily. Reduce application to once daily or every other day if bothersome dryness or peeling occurs.
Adolescents: Apply to hands, and add water to work into a lather; then cleanse the affected skin area(s) twice daily. Reduce application to once daily or every other day if bothersome dryness or peeling occurs.
For the treatment of inflammation and irritation associated with dermatitis, eczematoid conditions and complications associated with pyodermas; and for the treatment of insect bites, burns, and fungal infections:
Topical dosage:
Adults: Apply to the affected area twice daily. Reevaluate treatment if there is no improvement in 7 days.
Maximum Dosage Limits:
-Adults
No maximum dosage information is available.
-Geriatric
No maximum dosage information is available.
-Adolescents
No maximum dosage information is available.
-Children
No maximum dosage information is available.
-Infants
Safety and efficacy have not been established.
-Neonates
Safety and efficacy have not been established.
Patients with Hepatic Impairment Dosing
No dosage adjustments are needed.
Patients with Renal Impairment Dosing
No dosage adjustments are needed.
*non-FDA-approved indication
Acetaminophen; Aspirin, ASA; Caffeine: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Acetaminophen; Aspirin: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Acetaminophen; Aspirin; Diphenhydramine: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Acitretin: (Moderate) Dryness of the skin and mucus membranes are common side effects of retinoid therapy. Simultaneous use of retinoids and topical drying agents, such as salicylic acid, can potentiate the drying effects of retinoids on the skin. Be alert for signs of skin irritation, the offending topical agents may need to be used less often or discontinued during retinoid therapy.
Adapalene: (Moderate) Concomitant use of other potentially irritating topical products with adapalene should be done cautiously because of additive local irritation. Particular caution should be exercised in using adapalene in combination with preparations containing salicylic acid. If these preparations have been used, it is advisable not to start therapy with adapalene until the effects of such preparations in the skin have subsided.
Adapalene; Benzoyl Peroxide: (Moderate) Concomitant use of other potentially irritating topical products with adapalene should be done cautiously because of additive local irritation. Particular caution should be exercised in using adapalene in combination with preparations containing salicylic acid. If these preparations have been used, it is advisable not to start therapy with adapalene until the effects of such preparations in the skin have subsided. (Moderate) Concurrent use of benzoyl peroxide and topical products containing salicylic acid on the same area of skin will cause additive irritant and drying effects. Reduction in the dose or temporary discontinuation of the benzoyl peroxide product may be needed until skin irritation resolves.
Aminosalicylate sodium, Aminosalicylic acid: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Aspirin, ASA: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Aspirin, ASA; Butalbital; Caffeine: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Aspirin, ASA; Caffeine: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Aspirin, ASA; Caffeine; Orphenadrine: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Aspirin, ASA; Carisoprodol; Codeine: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Aspirin, ASA; Citric Acid; Sodium Bicarbonate: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Aspirin, ASA; Dipyridamole: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Aspirin, ASA; Omeprazole: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Aspirin, ASA; Oxycodone: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Benzoyl Peroxide: (Moderate) Concurrent use of benzoyl peroxide and topical products containing salicylic acid on the same area of skin will cause additive irritant and drying effects. Reduction in the dose or temporary discontinuation of the benzoyl peroxide product may be needed until skin irritation resolves.
Benzoyl Peroxide; Clindamycin: (Moderate) Concurrent use of benzoyl peroxide and topical products containing salicylic acid on the same area of skin will cause additive irritant and drying effects. Reduction in the dose or temporary discontinuation of the benzoyl peroxide product may be needed until skin irritation resolves. (Moderate) When concomitantly prescribed for acne therapy, apply salicylic acid and clindamycin topical solutions separately, at different times of the day to minimize skin irritation, unless directed otherwise by the prescriber. If skin irritation occurs, a decrease in dose or frequency of one or both agents may be necessary.
Benzoyl Peroxide; Erythromycin: (Moderate) Concurrent use of benzoyl peroxide and topical products containing salicylic acid on the same area of skin will cause additive irritant and drying effects. Reduction in the dose or temporary discontinuation of the benzoyl peroxide product may be needed until skin irritation resolves.
Benzoyl Peroxide; Sulfur: (Moderate) Concurrent use of benzoyl peroxide and topical products containing salicylic acid on the same area of skin will cause additive irritant and drying effects. Reduction in the dose or temporary discontinuation of the benzoyl peroxide product may be needed until skin irritation resolves.
Bexarotene: (Moderate) Dryness of the skin and mucus membranes are common side effects of retinoid therapy. Simultaneous use of retinoids and topical drying agents, such as salicylic acid, can potentiate the drying effects of retinoids on the skin. Be alert for signs of skin irritation, the offending topical agents may need to be used less often or discontinued during retinoid therapy.
Bismuth Subsalicylate: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Bismuth Subsalicylate; Metronidazole; Tetracycline: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Butalbital; Aspirin; Caffeine; Codeine: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Choline Salicylate; Magnesium Salicylate: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Clindamycin: (Moderate) When concomitantly prescribed for acne therapy, apply salicylic acid and clindamycin topical solutions separately, at different times of the day to minimize skin irritation, unless directed otherwise by the prescriber. If skin irritation occurs, a decrease in dose or frequency of one or both agents may be necessary.
Clindamycin; Adapalene; Benzoyl Peroxide: (Moderate) Concomitant use of other potentially irritating topical products with adapalene should be done cautiously because of additive local irritation. Particular caution should be exercised in using adapalene in combination with preparations containing salicylic acid. If these preparations have been used, it is advisable not to start therapy with adapalene until the effects of such preparations in the skin have subsided. (Moderate) Concurrent use of benzoyl peroxide and topical products containing salicylic acid on the same area of skin will cause additive irritant and drying effects. Reduction in the dose or temporary discontinuation of the benzoyl peroxide product may be needed until skin irritation resolves. (Moderate) When concomitantly prescribed for acne therapy, apply salicylic acid and clindamycin topical solutions separately, at different times of the day to minimize skin irritation, unless directed otherwise by the prescriber. If skin irritation occurs, a decrease in dose or frequency of one or both agents may be necessary.
Clindamycin; Tretinoin: (Moderate) When concomitantly prescribed for acne therapy, apply salicylic acid and clindamycin topical solutions separately, at different times of the day to minimize skin irritation, unless directed otherwise by the prescriber. If skin irritation occurs, a decrease in dose or frequency of one or both agents may be necessary.
Cod Liver Oil: (Moderate) Dryness of the skin and mucus membranes are common side effects of retinoid therapy. Simultaneous use of retinoids and topical drying agents, such as salicylic acid, can potentiate the drying effects of retinoids on the skin. Be alert for signs of skin irritation, the offending topical agents may need to be used less often or discontinued during retinoid therapy.
Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Isotretinoin: (Moderate) Dryness of the skin and mucus membranes are common side effects of retinoid therapy. Simultaneous use of retinoids and topical drying agents, such as salicylic acid, can potentiate the drying effects of retinoids on the skin. Be alert for signs of skin irritation, the offending topical agents may need to be used less often or discontinued during retinoid therapy.
Magnesium Salicylate: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Methenamine; Sodium Salicylate: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Retinoids: (Moderate) Dryness of the skin and mucus membranes are common side effects of retinoid therapy. Simultaneous use of retinoids and topical drying agents, such as salicylic acid, can potentiate the drying effects of retinoids on the skin. Be alert for signs of skin irritation, the offending topical agents may need to be used less often or discontinued during retinoid therapy.
Salicylates: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Salsalate: (Moderate) Concomitant use of salicylic acid with other drugs which may contribute to elevated serum salicylate levels (e.g., oral aspirin or other oral salicylates and other salicylate containing medications, such as sports injury creams) should be avoided. Concurrent use may result in excessive exposure to salicylic acid. Consider replacing aspirin therapy with an alternative non-steroidal anti-inflammatory agent that is not salicylate based where appropriate.
Tretinoin, ATRA: (Moderate) Dryness of the skin and mucus membranes are common side effects of retinoid therapy. Simultaneous use of retinoids and topical drying agents, such as salicylic acid, can potentiate the drying effects of retinoids on the skin. Be alert for signs of skin irritation, the offending topical agents may need to be used less often or discontinued during retinoid therapy.
Tretinoin; Benzoyl Peroxide: (Moderate) Concurrent use of benzoyl peroxide and topical products containing salicylic acid on the same area of skin will cause additive irritant and drying effects. Reduction in the dose or temporary discontinuation of the benzoyl peroxide product may be needed until skin irritation resolves.
Trifarotene: (Moderate) Avoid concurrent use of trifarotene with other topical products that may dry or irritate the skin, such as salicylic acid.
Vitamin A: (Moderate) Dryness of the skin and mucus membranes are common side effects of retinoid therapy. Simultaneous use of retinoids and topical drying agents, such as salicylic acid, can potentiate the drying effects of retinoids on the skin. Be alert for signs of skin irritation, the offending topical agents may need to be used less often or discontinued during retinoid therapy.
Salicylic acid exhibits keratolytic action by dissolution of intercellular cement substance causing desquamation of the horny layer of skin.
Salicylic acid is administered topically.
-Route-Specific Pharmacokinetics
Topical Route
Following topical application, percutaneous absorption of salicylic acid does occur; however, systemic exposure is considered negligible with normal prescription use. Roughly 10% of applied salicylates can remain in the skin after dermal application; however, acute toxicity via dermal exposure is rarely seen for salicylic acid. Salicylism has occurred using high concentrations of salicylic acid on widespread areas of hyperkeratotic skin, but cases resulting from topically applied salicylic acid cosmetic or acne products have not been reported.