Salicylic acid acne vulgaris

Grimes et al. [8] reported substantial efficacy and minimal side effects in 25 patients treated with 20 and 30% salicylic acid peels in darker racial-ethnic groups. Conditions treated included acne vulgaris, melasma and post-inflammatory hyperpigmentation. 

Given these findings, indications for salicylic acid peels include acne vulgaris (inflammatory and non-inflammatory lesions), acne rosacea, melasma, post-inflammatory hyperpigmentation, freckles, lentigines, mild to moderate photodamage, and texturally rough skin. 

When treating acne vulgaris, topical and systemic therapies (if indicated) are initiated 2 to 4 weeks prior to peeling. Topical antibiotics and benzoyl peroxide based products can be used daily and discontinued 1 or 2 days prior to peeling. However, unless a deeper peel is desired, retinoids should be discontinued 7-10 days prior to salicylic acid peeling. Broad-spectrum sunscreens (UVA and UVB) should be worn daily (see Photo damage. Sunscreen section). 

Fig. 6.5a, b. Acne vulgaris before and after four salicylic acid peels... 

Lee HS, Kim IH (2003) Salicylic acid peels for the treatment of acne vulgaris in Asian patients. Dermatol Surg 29 1196-1199... 

The author has observed enhanced improvement of oily skin, enlarged pores, and acne vulgaris with the use of salicylic acid peels compared with glycolic acid peels. Possible mechanisms for this observation include salicylic acid s effect on lipid solubility and microcome-odone formation. 

Fig. 16.2. a Post-inflammatory hyperpigmentation from acne vulgaris, b After a series of salicylic acid peels and hydroquinone 4%... 

ACID CHEMICAL PEELING. The peel will be performed to improve the overall appearance of the skin at the site of treatment. Salicylic acid peels are used to improve acne vulgaris, hyperpigmentation (dark spots), rough texture, oily skin, and photodamage (sun damage). 

Fig. 11.3 Patient with acne vulgaris after 3 salicylic acid peels and 3 microdermabrasion treatments...

In a study from Korea, by Lee and Kim, 35 patients with facial acne were treated with 30% salicylic acid peels biweekly for 12 weeks. Lesion counts and Dr. Cunliffe s scores revealed a decrease in both inflammatory and noninflammatory acne lesions. The peels were also well tolerated [17]. In another prospective, noncomparative study of 268 Asian patients who underwent 30% salicylic acid peels weekly for 8 weeks for various indications including melasma, acne vulgaris, freckles, postinflammatory scars/pigmentation, the peels were tolerated well. Mild discomfort, bum-... 

GargVK, Sinha S, Sarkar R. Glycolic acid peels versus salicylic-mandelic acid peels in active acne vulgaris and post-acne scarring and hyperpigmentation a comparative study. Dermatol Surg 2009 35 59-65. 

Conditions treated included acne vulgaris, melasma, and PIH. In addition, in a retrospective analysis of 90 patients treated by the author with salicylic acid peeling, 70% had significant improvement in acne and pigmentation, 25% had mild improvement, and 5% had minimal improvement. 

---