PoreWise One finding · Review article · 2020
Study title
Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne
- Kind of evidence
- Review article 2020 · 46 people · People with mild to moderate acne, mostly aged 12 to 30 · PMID 32356369
- Measured outcome
- Skin effect
- Year
- 2020
- Who was studied
- People with mild to moderate acne, mostly aged 12 to 30
- Sample size
- 46
- Measured outcome
- Against topical tretinoin, salicylic acid showed similar values in overall acne improvement (RR 1.00, 95% CI 0.92 to 1.09; one trial, 46 participants). The review graded the certainty of that finding as low.
- Certainty
- Low
- Who was measured
- Topical salicylic acid for mild to moderate acne. Most participants in the review were 12 to 30 years old, and most studies ran longer than eight weeks.
- Study limits
- The review covers 49 trials with 3880 participants, salicylic acid appears in a small part of them: 41 to 86 participants per comparison. Every salicylic acid comparison was graded low or very low certainty.
Where it comes from
- Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne
Published by Cochrane Database of Systematic Reviews (Liu et al.) · Last checked 2026-10-26
Ingredients it was measured on
Skin concerns studied
Other findings on the same ingredient or concern
- Skin effectGuidelines of care for the management of acne vulgaris (2024)
The 2024 American Academy of Dermatology acne guideline lists topical salicylic acid as a conditional recommendation. Strong recommendations in the same guideline go to benzoyl peroxide, topical retinoids, topical antibiotics and oral doxycycline.
Clinical guideline · 2024 · Acne vulgaris in people aged nine and older, as covered by the guideline's scope.
- IrritationTopical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne
Trials of topical salicylic acid for acne reported application-site reactions such as scaling and redness.
Review article · 2020 · People with mild to moderate acne in the included trials · Topical salicylic acid in acne trials, mainly leave-on use over eight weeks or longer. · The review graded the salicylic acid adverse-event comparisons as very low certainty.
- Skin effectClinical Efficacy of a Salicylic Acid-Containing Gel on Acne Management and Skin Barrier Function: A 21-Day Prospective Study
In a 21-day prospective study of 42 people with mild-to-moderate acne and oily or combination skin, a salicylic-acid-containing gel used twice daily was associated with a 23.65% fall in sebum, a 40.5% rise in skin hydration, a 49.26% fall in transepidermal water loss and a 23.81% improvement in acne grade (all P < 0.05 except IGA P < 0.001).
Human trial · 2025 · 42 people · people (37 women, 5 men) with mild-to-moderate acne and oily or combination skin, mean age 25.9 · Sebum, skin hydration, transepidermal water loss and acne grade over 21 days in people with oily or combination skin. · One centre, 21 days, 37 of 42 participants were women, and the research group was affiliated with the product maker.
- Skin effectEfficacy and safety of a facial serum and a mask containing salicylic acid and lipohydroxy acid in acne management: A randomized controlled trial
In 83 adults with comedones, a serum containing salicylic acid and lipohydroxy acid significantly improved open comedones on the nose, closed comedones on the face, skin pore density, sebum secretion and skin hydration from baseline after 8 weeks; adding a mask improved closed comedones more than the serum alone (-6.56 vs -5.19, p = 0.022).
Human trial · 2023 · 83 people · adults with comedones (41 serum+mask, 42 serum alone) · Adults in Shanghai with comedones, PIE and PIH, using the serum for 8 weeks. · Both groups used active products; improvements were reported against baseline and between the two active groups. Industry-funded. This is the trial found that counted open and closed comedones separately.
- Skin effectSalicylic Acid (CeraVe ingredient page)
Salicylic acid is a keratolytic: it loosens the bonds between dead skin cells so they shed.
Brand claim · Acne and keratolysis, at the concentrations permitted for cosmetic use. · Most evidence comes from leave-on acne treatments. A cleanser is on the skin for a minute. · Finding · SALICYLIC ACID