salicylic acid topical

Salicylic acid topical is a medication used to soften and remove warts, calluses, and corns in the foot and in the treatment of skin conditions such as acne, psoriasis, and seborrheic dermatitis.

Salicylic acid is an organic compound that is extracted from white willow and wintergreen leaves, but is also manufactured synthetically. Salicylic acid is often an additive in skin care products and anti-dandruff shampoos.

The outermost protective layer of the skin is primarily made up of cells known as keratinocytes, which constantly grow, die, and slough off as new cells take their place. When keratinocytes do not slough off normally, they can form thick and hardened layers of skin such as corns and calluses, or scales and plaques in skin disorders such as psoriasis and seborrheic dermatitis.

Salicylic acid dissolves the intercellular cement substance that holds the skin cells together and softens keratin, a fibrous protein that is part of the skin structure. This helps soften the dry and hard skin tissue, making it easier to shed. In addition to breaking down keratinocytes, salicylic acid also has antifungal and antibacterial properties. In acne treatment, salicylic acid prevents clogging of pores and breaks down whiteheads and blackheads.

Salicylic acid is used for keratotic skin disorders such as psoriasis at 3% to 6% concentrations. Concentrations of 5% to 40% are used to remove corns and warts. Acne is treated with concentrations up to 2%. Salicylic acid topical is available as prescription drug, and some formulations are available over the counter (OTC). The uses of salicylic acid topical include:

• Acne vulgaris
• Warts on soles of feet and palms (plantar and palmar warts)
• Corns and calluses
• Dermatitis
• Psoriasis
• Seborrheic dermatitis
• Dandruff
• Keratosis pilaris
• Keratosis palmaris and plantaris
• Pityriasis rubra pilaris

• Do not use salicylic acid topical if you are hypersensitive to any of its components.
• Do not use salicylic acid topical on children under 2 years of age.
• Avoid prolonged use or application on large areas of the skin, it can cause salicylate toxicity (salicylism).
• If you self-medicate with OTC salicylic acid topical, do not use if you have diabetes or poor blood circulation.
• Do not use salicylic acid topical on:
  • Moles
  • Birthmarks
  • Warts with hair growing from them
  • Genital warts
  • Warts on the face or mucous membranes
  • Irritated, reddened or infected skin
• Avoid concurrent use with other drugs containing salicylate, it can increase the risk for salicylate toxicity.
• Use on limited area of skin in children below 12 years of age and patients with impaired kidney or liver function. Monitor for salicylism and discontinue if the patient develop symptoms of salicylate toxicity, including nausea, vomiting, diarrhea, dizziness, loss of hearing, ringing in the ears (tinnitus), lethargy, deeper breathing (hyperpnea), and psychic disturbances.
• Use of occlusive dressings, clothing, and other occlusive topical products can increase the risk for systemic absorption and salicylism. Advise patients appropriately.
• Do not use before ultraviolet-B (UVB) therapy, salicylic acid can increase its effects.
• Do not use in children and teenagers with varicella or influenza, unless directed by a physician, because of the potential risk for Reye’s syndrome.

Common side effects of salicylic acid topical include:

• Localized skin reactions including:
  • Irritation
  • Burning
  • Stinging
  • Scaling
  • Peeling and shedding
• Confusion
• Dizziness
• Headache
• Rapid and deep breathing (hyperventilation)
• Ringing in the ears (tinnitus)

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Topical Liquid

• 0.5%
• 1%
• 2%
• 3%
• 6%
• 12.6%
• 13.6%
• 16.7%
• 17%
• 17.6%
• 26%
• 27.5%

Gel

• 2%
• 6%
• 17%

Lotion

• 3%
• 6%

Cream

• 2%
• 6%

Aerosol/Foam

• 6%

Soap

• 2%
• 3%

Strips

• 40%

Pad

• 40%

Disk

• 40%

Plaster

• 40%

Patch

• 15%
• 40%

Adult and Pediatric:

Plantar Warts/Calluses/Corn

Children below 12 years

• Safety and efficacy not established

Adults and children above 12 years

• Hydrate skin prior to application by soaking in warm water for 5 minutes, then use a cloth, brush, or emery board to loosen wart tissue; dry skin thoroughly
• Liquid (27.5%): Protect surrounding unaffected skin with petrolatum, then apply liquid to each wart and allow to dry before applying a second application; repeat two application process once or twice daily for up to 6 weeks
• Liquid (17%) or gel: Apply to clean dry area at each wart and allow to dry; apply once daily or every 12 hours up to 12 weeks
• Gel (6%): Apply to affected area once daily; may apply at night and rinse off in the morning
• Foam: Apply to affected area every 12 hours; rub into skin until completely absorbed
• Patch (15%): Apply directly over affected area every night and remove in the morning for up to 12 weeks; patch should be trimmed to cover affected area
• Patch (40%): Apply directly over affected area and leave in place for 48 hours; may repeat for up to 12 weeks; may trim patch to cover affected area or secure with adhesive strips
• Plasters/strips: Apply as directed per individual product
• Product content varies, check individual labeling

Adult:

Seborrheic Dermatitis/Psoriasis

• Ointment (3%): Apply to plaques or scales on skin up to every 6 hours (not for use on scalp or face)
• Cream (2.5%): Apply to affected area every 6-8 hours; may be left in place overnight depending on the product
• Shampoo (1.8-3%): Massage product into wet hair or affected area and leave in place for several minutes; rinse thoroughly; may apply two or three times/week or as directed by a healthcare professional; may be left in place overnight depending on the product
• Foam: Apply to affected area every 12 hours; rub into skin until completely absorbed
• Keratolytic for treating skin/scalp seborrhea or psoriasis

Overdose

• Oral ingestion or prolonged use of salicylic acid topical over extensive areas of the skin can cause systemic absorption and salicylate toxicity (salicylism), particularly in children and patients with impaired kidney or liver function. Symptoms of salicylism include nausea, vomiting, diarrhea, dizziness, loss of hearing, ringing in the ears (tinnitus), lethargy, deeper breathing (hyperpnea), and psychic disturbances.
• Overdose is treated with discontinuation of salicylic acid, administration of oral or intravenous sodium bicarbonate, and fluids to promote drug excretion in the urine.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Salicylic acid topical has no listed severe or serious interactions with other drugs.
• Moderate interactions of salicylic acid include:
  • calcipotriene
• Salicylic acid topical has no listed mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• There are no adequate and well-controlled studies of salicylic acid topical use in pregnant women, however, animal studies show oral salicylic acid can cause fetal harm. Salicylic acid topical should be used during pregnancy only if the potential benefits to the mother justify the potential risks to the fetus.
• Salicylates are excreted in breast milk after oral administration, however, systemic absorption from topical use of salicylic acid is unlikely to be significant. The decision should be made to discontinue nursing or salicylic acid topical, depending on the importance of the drug to the mother, because of the potential for serious adverse reactions in the breastfed infant.
• If salicylic acid topical is used by a nursing mother, care should be taken to avoid exposure to the breast region.

• Use salicylic acid topical exactly as prescribed or as per label instructions.
• Salicylic acid topical is for external use on the skin only, not for oral, ophthalmic, or intravaginal use.
• Avoid contact with eyes and mucous membranes.
• Avoid using oral aspirin and other salicylate containing medications concurrently. if needed, use a non-steroidal anti-inflammatory drug (NSAID) that does not contain salicylate.
• Do not use occlusive dressings, clothing, or other occlusive topical products on the area treated with salicylic acid.
• If you use OTC salicylic acid topical, take care to apply to the affected area only. If large areas of skin are affected, consult with a physician before use. Stop use and contact your physician if the condition does not improve or worsens with regular use.
• Store safely out of reach of children.
• In case of overdose, seek medical help or contact Poison Control.