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Although psoriasis has no cure, a variety of treatments are available, including topical creams, medication, and light therapy. One common topical treatment is salicylic acid. Read on to learn how salicylic acid works to treat psoriasis.

Salicylic acid helps soften, lift, and clear away flakes of skin on psoriasis plaques. It may also reduce swelling.

It is often used in combination with other topical treatments, as removing scales may help to improve the effectiveness of some treatments.

What salicylic acid concentration is okay for psoriasis?

The recommended concentration of salicylic acid for psoriasis ranges from 2 to 10 percent. Products with higher concentrations may only be available with a prescription.

In addition, keep in mind that while higher concentrations may be more effective at removing scales, they are also more likely to cause side effects. They may even worsen your psoriasis. Your doctor can help you find the right concentration.

There are many OTC products that contain salicylic acid for psoriasis. The following products were chosen based on their ingredients, customer reviews, and brand reputation. Ask your dermatologist for additional recommendations.

CeraVe Psoriasis Cleanser

  • Price: $$
  • Salicylic acid: 2% concentration

Reviewers say this fragrance-free body wash effectively relieves itchiness, scaling, and flaking caused by psoriasis. It balances the drying effects of salicylic acid with natural moisturizers such as glycerin, urea, and shea butter.

Paula’s Choice BHA 9 Treatment

  • Price: $$$
  • Salicylic acid: 9% concentration

This leave-on spot treatment is designed to target skin imperfections, including rough and scaly skin. It contains one of the highest concentrations of salicylic acid on the market, and the time-release formula means that it works around-the-clock to clear away dry and flaky skin.

MG217 Medicated Moisturizing Psoriasis Cream

  • Price: $
  • Salicylic acid: 3% concentration

This moisturizer is part of a line of skin care products designed to be used in combination to target psoriasis. Users say that it helps to remove scales and keep skin feeling moist. It also contains a number of skin-soothing ingredients, including avocado oil, shea butter, and provitamin B5.

CeraVe SA Lotion for Rough and Bumpy Skin

  • Price: $$
  • Salicylic acid: 3% concentration

This lotion contains both salicylic and lactic acid to gently exfoliate and soften rough patches of skin. Free of parabens, dyes, and fragrances, it also contains ceramides, a type of fatty acid naturally found in the cells that make up the outer layer of the skin.

SkinMedica AHA/BHA Exfoliating Cleanser

  • Price: $$$
  • Salicylic acid: 2% concentration

SkinMedica’s facial cleanser includes both alpha- and beta-hydroxy acids to boost exfoliating action. Reviewers say it keeps their skin feeling smooth and clear.

Follow the instructions on the product or prescription label carefully.

When you first start using a salicylic gel, cream, lotion, or ointment, apply only a small amount to a single patch of psoriasis. Try this for several days to see how your body reacts.

At first, you might find that symptoms such as dryness and itchiness worsen as your skin adjusts to the treatment. If you don’t experience any significant side effects, you can begin using the product as directed.

Apply salicylic acid to patches of psoriasis as needed up to several times per day unless otherwise directed by your doctor or pharmacist. Note that it may take a few weeks before you see an improvement.

You should avoid applying salicylic acid to more than 20 percent of your body surface area, as it is absorbed through the skin and too much can cause side effects. In addition, steer clear of your eyes, nose, mouth, and genitals.

If you specific concerns about using salicylic acid and your skin, routines, or health, it’s best to speak to a dctor or pharmacist.

According to a 2017 literature review, no randomized controlled studies have evaluated the use of salicylic acid alone in the treatment of psoriasis.

Most studies have instead investigated its use alongside other treatments, particularly topical corticosteroids, anthralin, and immunomodulators.

The authors of the literature review mentioned above reported that salicylic acid appears to increase the effectiveness of topical corticosteroids by making psoriasis patches easier to penetrate. In addition, adding salicylic acid to anthralin appears to be more effective than anthralin alone.

The most common side effects of salicylic acid are irritation, dryness, and stinging at the site of application. Although these symptoms aren’t usually cause for concern, you should talk to your doctor about them if they persist.

Other side effects of salicylic acid are rare, but potentially serious. You should seek emergency medical assistance right away if you experience any of the following:

  • confusion
  • diarrhea
  • hair loss
  • headaches
  • hearing problems
  • light-headedness
  • nausea and vomiting
  • rapid breathing
  • tinnitus
  • weakness and fatigue

The authors of a 2015 literature review caution that salicylic acid is not a suitable treatment for psoriasis in young children due its risk of side effects. In addition, people with kidney or liver problems and widespread psoriasis may be at an increased risk of experiencing side effects.

There are several other topical treatments for psoriasis, some of which may be used in combination with salicylic acid. They include:

  • Anthralin. This tar product has anti-inflammatory properties and reduces scales. It must be washed off after it is applied. Using salicylic acid in combination with anthralin is more effective than using anthralin alone.
  • Calcineurin inhibitors. Also known as immunomodulators, calcineurin inhibitors reduce inflammation and plaque growth. They can be used alongside salicylic acid.
  • Coal tar. Topical coal tar may work to relieve psoriasis by suppressing the synthesis of DNA. It can be used alongside salicylic acid.
  • Corticosteroids. Mild-to-moderate strength topical corticosteroids help to reduce and prevent symptoms of psoriasis. They are commonly used alongside salicylic acid, which improves their effectiveness.
  • Moisturizers and emollients. Thick moisturizing creams and ointments help to lock in moisture, ensuring that the outer layer of the skin stays hydrated. They can be used alongside salicylic acid.
  • Retinoids. Retinoids are synthetic versions of vitamin A found in a variety of skin care products. They may help with psoriasis by slowing skin cell growth and reducing inflammation.
  • Vitamin D analogs. These synthetic versions of vitamin D reduce skin cell proliferation. Calcipotriol, a vitamin D analog, should not be used in combination with salicylic acid.

Do you need a prescription to use salicylic acid for psoriasis?

No, you do not need a prescription to use salicylic acid for psoriasis. A number of OTC products formulated to treat psoriasis contain salicylic acid. Ask your doctor or pharmacist for a recommendation.

Does salicylic acid work for scalp psoriasis?

According to the National Psoriasis Foundation, over-the-counter shampoos that contain salicylic acid may be helpful in cases of mild psoriasis or to boost the effectiveness of topical scalp treatments.

Is coal tar or salicylic acid better for psoriasis?

Coal tar and salicylic acid address different issues. Coal tar appears to reduce inflammation, itching, and scaling as well as slowing down skin cell regeneration, while salicylic acid helps to dissolve dead skin cells. Research suggests that salicylic acid can improve the effectiveness of coal tar.

Many psoriasis treatments that contain salicylic acid are available without a prescription. However, you should see a dermatologist if you haven’t found an OTC treatment that works for your psoriasis.

In addition, make an appointment with a doctor if you experience a change in psoriasis symptoms or treatment side effects.