Table of ContentsView AllTable of ContentsSafetyPost-Treatment AppearanceSalicylic Acid TypesLong-Term EffectsAlternatives
Table of ContentsView All
View All
Table of Contents
Safety
Post-Treatment Appearance
Salicylic Acid Types
Long-Term Effects
Alternatives
Because of amalfunctioning immune systemresponse, psoriasis causes skin inflammation and skin cells to grow faster than usual. Those skin cells pile on the skin’s surface as patches calledskin plaques. Salicylic acid can help soften and lift skin scales and reduce the swelling that leads to psoriatic lesions.
Salicylic acid topicals are not your only options for treating psoriasis. Additional treatments likecoal tartopicals and drugs that treat the underlying immune processes that lead to psoriasis can also help.
This article covers the safety of salicylic acid for treating psoriasis, side effects, available options, alternative treatments, and more.
Fiordaliso / Getty Images
Salicylic Acid for Psoriasis Symptoms: Safe or Unsafe?
Salicylic acid is one of the most used treatments for psoriasis.It has been used as a monotherapy (solo treatment) and in combination with other psoriasis treatments.
Skin
Salicylic acid is a keratolytic agent that works to shed dead skin cells. It also has anti-inflammatory effects and can reduce skin inflammation.By offering these benefits, your skin’s appearance will be improved. This is especially helpful for people with plaque psoriasis.
Psoriasis Symptoms, Types, and Images
One 2015Dermatology and Therapyreport revealed that salicylic acid alone is enough to treat psoriasis plaques for most people.For more severe psoriasis cases, pairing it with stronger prescription medicines can offer further skin clearing.
The primary reason for treating psoriasis with salicylic acid is the keratolytic effect. Salicylic acid products will only target skin plaques and not the immune processes that lead to skin inflammation and skin cell overgrowth.
If your skin is not clearing or symptoms are severe, your healthcare provider can prescribe systemic medicines to taper down your overactive immune system. Systemic therapies affect either the entire body or specific body systems (i.e., the immune system).
Scalp
When psoriasis affects the scalp, it is calledscalp psoriasis. The scalp is one of the most commonly affected body areas in people with psoriasis.It can sometimes be difficult to treat due to challenges in delivering therapy. Even so, treatment is vital for improving quality of life.
Medicated OTC shampoos containing salicylic acid can help treatmild psoriasis.These products may also increase the effectiveness of other topical scalp treatments. Unfortunately, few studies demonstrate salicylic acid’s effectiveness in treating scalp psoriasis, and available studies have included only small numbers of participants.
Salicylic acid 6% was evaluated in a small open pilot study of 10 people. Here, there was a significant decrease in scalp skin symptoms.Six of the 10 participants were noted to have completely cleared or almost cleared skin at four weeks.
Another small study of 20 people found those who were treated for three to six weeks with daily 6% salicylic acid saw significant scalp clearing from psoriasis scales.
Adding coal tar allowed further skin clearing for study participants with slower or less improvement. As a result, most study participants experienced improved skin, while one even experienced clear skin.
What Is Coal Tar?
Depending on the severity of psoriatic skin lesions, you should at least see some skin symptom improvement. When applied to the scalp, salicylic acid will break down skin plaques and minimize scalp irritation and itch.
While salicylic acid can cause side effects, it typically will not worsen scalp psoriasis. In rare cases, it is possible to experience skin reactions from higher concentrations that inflame plaques and add further skin inflammation.
Acne
Salicylic acid is also used to treat acne. It seems to work best for mild acne.Acne occurs when hair follicles (pores) become clogged with dead skin cells and oils. This results in blackheads, whiteheads, and pimples on the face and other body areas.
Treating Psoriasis With A DermatologistA dermatologist is a doctor who specializes in treating nail, skin, scalp, and hair conditions, including psoriasis. This healthcare provider can make a diagnosis, prescribe treatments, and provide suggestions on lifestyle changes. If you think you have psoriasis, reach out to your primary care provider. They can examine your skin and then refer you to a dermatologist.Once the dermatologist confirms your diagnosis, they will prescribe treatment. After that, you will need regular follow-ups to monitor your symptoms and to assess how treatments are working.Before making an appointment with a dermatologist, you may want to check with your insurance company to see if the provider is in their network and your insurance will cover the cost of dermatology visits.
Treating Psoriasis With A Dermatologist
A dermatologist is a doctor who specializes in treating nail, skin, scalp, and hair conditions, including psoriasis. This healthcare provider can make a diagnosis, prescribe treatments, and provide suggestions on lifestyle changes. If you think you have psoriasis, reach out to your primary care provider. They can examine your skin and then refer you to a dermatologist.Once the dermatologist confirms your diagnosis, they will prescribe treatment. After that, you will need regular follow-ups to monitor your symptoms and to assess how treatments are working.Before making an appointment with a dermatologist, you may want to check with your insurance company to see if the provider is in their network and your insurance will cover the cost of dermatology visits.
A dermatologist is a doctor who specializes in treating nail, skin, scalp, and hair conditions, including psoriasis. This healthcare provider can make a diagnosis, prescribe treatments, and provide suggestions on lifestyle changes. If you think you have psoriasis, reach out to your primary care provider. They can examine your skin and then refer you to a dermatologist.
Once the dermatologist confirms your diagnosis, they will prescribe treatment. After that, you will need regular follow-ups to monitor your symptoms and to assess how treatments are working.
Before making an appointment with a dermatologist, you may want to check with your insurance company to see if the provider is in their network and your insurance will cover the cost of dermatology visits.
How Does Psoriasis Look After Using Salicylic Acid?
If the 1% result is achieved after three months, you would see your healthcare provider every six months to ensure treatments are still working. If you do not meet the 1% target after three months, your provider will offer additional treatments and reassess your condition in the next three months.
A second treatment recommendation, says the NPF, is “acceptable response.” This means psoriasis covers 3% or less BSA, or you have experienced up to 75% improvement in BSA.
Plaque Psoriasis: Pictures and Symptoms of the Types You May See on Your Body
Potential Side Effects
Salicylic acid is safe and gentle for use on most skin types. But like other topicals, it does cause side effects.
Such side effects of salicylic acid include:
True allergies to topical salicylic acid are rare, although severe reactions have been reported, includinganaphylaxis(a severe allergic reaction).Topical salicylic acid poisoning is rare.
Topical salicylic acid may not be a suitable treatment option for children due to side effects.It is not recommended for people with liver or kidney problems and anyone who is pregnant, breastfeeding, or on blood-thinning medicines.
Types of Salicylic Acid for Psoriasis
Salicylic acid is an ingredient in lotions, creams, ointments, shampoos, cosmetics, soaps, toners, and more.
When treating psoriasis with OTC salicylic acid, consider salicylic acid products containing moisturizing ingredients. Salicylic acid can dry out skin, which means it is helpful for oily skin but not so much for psoriasis-affected skin.Salicylic acid products calledceramidescan seal moisture in the skin.
If symptoms of psoriasis are not responding to OTC salicylic acid topicals, seek help from a dermatologist. Higher strengths can be prescribed to treat psoriasis containing formulations of salicylic acid combined with coal tar, calcineurin inhibitors, and steroids.
You can use topical treatments for as long as you have psoriasis skin plaques. Salicylic acid can help soothe your skin during flares—periods of high disease activity in which skin inflammation and skin cell turnover are high.
You do not need to use salicylic acid topical treatments if your skin is clear, but you want to keep using moisturizers to keep your skin hydrated. Your healthcare provider might also prescribe systemic therapies that keep skin symptoms from occurring in the first place.
When to See a Dermatologist
Ideal Dosage
OTC salicylic acid topical concentrations for treating psoriasis range from 2% to 10%.Higher concentrations can be prescribed and might be more effective in removing scales, but the risk for side effects and adverse reactions is higher.
In some cases, skin reactions from higher concentrations can lead to worsening psoriasis. Your dermatologist can help you find the right concentration for best treating your symptoms.
How Long to Leave On
You can apply salicylic acid to psoriasis-affected skin based on the product label’s instructions, often once or twice a day.A topical treatment can stay on your skin like other lotions and creams applied to dry skin.
You can use a salicylic acid shampoo every time you shampoo if you have scales. Continue to use the shampoo at least once a week after the scales have cleared.
Make sure you follow the label instructions for salicylic acid products. Do not use more of it or use it more often than recommended. Too much could lead to skin absorption into the bloodstream and lead to salicylic acid poisoning.
Avoid contact with the eyes, nose, and genitals. Do not use on infected or irritated skin areas. Unless your hands are being treated, you should wash them immediately after applying topical medicines.
Long-Term Effects of Treating Psoriasis With Salicylic Acid
Despite these concerns, salicylic acid can effectively treat psoriatic skin. To avoid severe side effects, salicylic acid should be used sparingly and only when needed. If you have sensitive or dry skin, you may avoid its use entirely and consider other treatments.
Salicylic Acid Alternatives to Try Instead
Salicylic acid is not your only treatment option for managing psoriasis. Your dermatologist can develop a treatment plan tailored to your psoriasis type and specific symptoms.
Additional treatment options for psoriasis include:
How Psoriasis Is Treated
Quick-Acting Treatments
No single treatment is considered for psoriasis, but some treatments might be quick-acting for reducing skin inflammation and irritation and removing scales.
For example, an Epsom salt or oatmeal bath can soothe skin plaques, help lift scales, and reduce itch immediately. Aloe vera might also offer relief from skin irritation and dryness.
Products containing salicylic acid might also offer a quick way to remove scales when they appear and, when paired with a moisturizer like aloe vera, can offer relief from itch and dryness.
Summary
Salicylic acid acts as a peeling agent to help shed those extra dead skin cells. It can be prescribed alone or in combination with other therapies.
While salicylic acid can be an effective treatment, it is not your only option. Other OTC topicals like coal tar and steroid creams can also help, as can natural options like oatmeal and Epsom salt baths. Your other options include systemic drugs that control the underlying processes leading to psoriasis skin cell overgrowth and light therapy.
A dermatologist can help you decide whether salicylic acid might help clear your skin. They can also recommend other treatments, including medications, lifestyle therapies, and natural remedies.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Psoriasis Foundation.Psoriasis and psoriatic arthritis OTC topicals.Jacobi A, Mayer A, Augustin M.Keratolytics and emollients and their role in the therapy of psoriasis: a systematic review.Dermatol Ther (Heidelb). 2015;5(1):1-18. doi:10.1007/s13555-015-0068-3Arif T.Salicylic acid as a peeling agent: a comprehensive review.Clin Cosmet Investig Dermatol. 2015;8:455-461. doi:10.2147/CCID.S84765National Psoriasis Foundation.Locations & types of psoriasis.Mosca M, Hong J, Hadeler E, Brownstone N, Bhutani T, Liao W.Scalp psoriasis: a literature review of effective therapies and updated recommendations for practical management.Dermatol Ther (Heidelb). 2021;11(3):769-797. doi:10.1007/s13555-021-00521-zNational Psoriasis Foundation.Psoriasis shampoos your scalp will love.Sekhon S, Jeon C, Nakamura M, et al.Review of the mechanism of action of coal tar in psoriasis.J Dermatolog Treat. 2018;29(3):230-232. doi:10.1080/09546634.2017.1369494National Psoriasis Foundation.Targeting to treat.Vender RB, Andriessen A, Barankin B, et al.Cohort using a ceramides containing cleanser and cream with salicylic acid for dry, flaking,and scaling skin conditions.J Drugs Dermatol. 2019;18(1):80-85.MedlinePlus.Salicylic acid topical.Psoriasis: update on topical therapy from the American Academy of Dermatology.Am Fam Physician. 2022;105(5):558-560Liu H, Yu H, Xia J, et al.Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne.Cochrane Database Syst Rev. 2020;5(5):CD011368. Published 2020 May 1. doi:10.1002/14651858.CD011368.pub2Draelos ZD.The efficacy and tolerability of turmeric and salicylic acid in psoriasis treatment.Psoriasis (Auckl). 2022;12:63-71. doi:10.2147/PTT.S360448National Psoriasis Foundation.The pocket guide for psoriasis and psoriatic arthritis.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Psoriasis Foundation.Psoriasis and psoriatic arthritis OTC topicals.Jacobi A, Mayer A, Augustin M.Keratolytics and emollients and their role in the therapy of psoriasis: a systematic review.Dermatol Ther (Heidelb). 2015;5(1):1-18. doi:10.1007/s13555-015-0068-3Arif T.Salicylic acid as a peeling agent: a comprehensive review.Clin Cosmet Investig Dermatol. 2015;8:455-461. doi:10.2147/CCID.S84765National Psoriasis Foundation.Locations & types of psoriasis.Mosca M, Hong J, Hadeler E, Brownstone N, Bhutani T, Liao W.Scalp psoriasis: a literature review of effective therapies and updated recommendations for practical management.Dermatol Ther (Heidelb). 2021;11(3):769-797. doi:10.1007/s13555-021-00521-zNational Psoriasis Foundation.Psoriasis shampoos your scalp will love.Sekhon S, Jeon C, Nakamura M, et al.Review of the mechanism of action of coal tar in psoriasis.J Dermatolog Treat. 2018;29(3):230-232. doi:10.1080/09546634.2017.1369494National Psoriasis Foundation.Targeting to treat.Vender RB, Andriessen A, Barankin B, et al.Cohort using a ceramides containing cleanser and cream with salicylic acid for dry, flaking,and scaling skin conditions.J Drugs Dermatol. 2019;18(1):80-85.MedlinePlus.Salicylic acid topical.Psoriasis: update on topical therapy from the American Academy of Dermatology.Am Fam Physician. 2022;105(5):558-560Liu H, Yu H, Xia J, et al.Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne.Cochrane Database Syst Rev. 2020;5(5):CD011368. Published 2020 May 1. doi:10.1002/14651858.CD011368.pub2Draelos ZD.The efficacy and tolerability of turmeric and salicylic acid in psoriasis treatment.Psoriasis (Auckl). 2022;12:63-71. doi:10.2147/PTT.S360448National Psoriasis Foundation.The pocket guide for psoriasis and psoriatic arthritis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Psoriasis Foundation.Psoriasis and psoriatic arthritis OTC topicals.Jacobi A, Mayer A, Augustin M.Keratolytics and emollients and their role in the therapy of psoriasis: a systematic review.Dermatol Ther (Heidelb). 2015;5(1):1-18. doi:10.1007/s13555-015-0068-3Arif T.Salicylic acid as a peeling agent: a comprehensive review.Clin Cosmet Investig Dermatol. 2015;8:455-461. doi:10.2147/CCID.S84765National Psoriasis Foundation.Locations & types of psoriasis.Mosca M, Hong J, Hadeler E, Brownstone N, Bhutani T, Liao W.Scalp psoriasis: a literature review of effective therapies and updated recommendations for practical management.Dermatol Ther (Heidelb). 2021;11(3):769-797. doi:10.1007/s13555-021-00521-zNational Psoriasis Foundation.Psoriasis shampoos your scalp will love.Sekhon S, Jeon C, Nakamura M, et al.Review of the mechanism of action of coal tar in psoriasis.J Dermatolog Treat. 2018;29(3):230-232. doi:10.1080/09546634.2017.1369494National Psoriasis Foundation.Targeting to treat.Vender RB, Andriessen A, Barankin B, et al.Cohort using a ceramides containing cleanser and cream with salicylic acid for dry, flaking,and scaling skin conditions.J Drugs Dermatol. 2019;18(1):80-85.MedlinePlus.Salicylic acid topical.Psoriasis: update on topical therapy from the American Academy of Dermatology.Am Fam Physician. 2022;105(5):558-560Liu H, Yu H, Xia J, et al.Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne.Cochrane Database Syst Rev. 2020;5(5):CD011368. Published 2020 May 1. doi:10.1002/14651858.CD011368.pub2Draelos ZD.The efficacy and tolerability of turmeric and salicylic acid in psoriasis treatment.Psoriasis (Auckl). 2022;12:63-71. doi:10.2147/PTT.S360448National Psoriasis Foundation.The pocket guide for psoriasis and psoriatic arthritis.
National Psoriasis Foundation.Psoriasis and psoriatic arthritis OTC topicals.
Jacobi A, Mayer A, Augustin M.Keratolytics and emollients and their role in the therapy of psoriasis: a systematic review.Dermatol Ther (Heidelb). 2015;5(1):1-18. doi:10.1007/s13555-015-0068-3
Arif T.Salicylic acid as a peeling agent: a comprehensive review.Clin Cosmet Investig Dermatol. 2015;8:455-461. doi:10.2147/CCID.S84765
National Psoriasis Foundation.Locations & types of psoriasis.
Mosca M, Hong J, Hadeler E, Brownstone N, Bhutani T, Liao W.Scalp psoriasis: a literature review of effective therapies and updated recommendations for practical management.Dermatol Ther (Heidelb). 2021;11(3):769-797. doi:10.1007/s13555-021-00521-z
National Psoriasis Foundation.Psoriasis shampoos your scalp will love.
Sekhon S, Jeon C, Nakamura M, et al.Review of the mechanism of action of coal tar in psoriasis.J Dermatolog Treat. 2018;29(3):230-232. doi:10.1080/09546634.2017.1369494
National Psoriasis Foundation.Targeting to treat.
Vender RB, Andriessen A, Barankin B, et al.Cohort using a ceramides containing cleanser and cream with salicylic acid for dry, flaking,and scaling skin conditions.J Drugs Dermatol. 2019;18(1):80-85.
MedlinePlus.Salicylic acid topical.
Psoriasis: update on topical therapy from the American Academy of Dermatology.Am Fam Physician. 2022;105(5):558-560
Liu H, Yu H, Xia J, et al.Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne.Cochrane Database Syst Rev. 2020;5(5):CD011368. Published 2020 May 1. doi:10.1002/14651858.CD011368.pub2
Draelos ZD.The efficacy and tolerability of turmeric and salicylic acid in psoriasis treatment.Psoriasis (Auckl). 2022;12:63-71. doi:10.2147/PTT.S360448
National Psoriasis Foundation.The pocket guide for psoriasis and psoriatic arthritis.
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