Which active ingredients can be combined with salicylic acid?

It is quite common to associate salicylic acid and the zinc for formulating skincare products aimed at oily or blemish-prone skin. Indeed, zinc, whether in the form of zinc gluconate or zinc PCA, is an astringent, mattifying agent capable of limiting the proliferation of bacteria Cutibacterium acnes, which, as their name implies, are involved in acne. Additionally, zinc exhibits an anti-inflammatory action via its regulatory effect on the release of certain pro-inflammatory cytokines, such as interleukin-1. It is therefore particularly useful for soothing inflammatory acne lesions.

Pairing zinc with salicylic acid enhances their respective purifying effects while engaging multiple complementary mechanisms. Salicylic acid works both on the surface and in depth to exfoliate the epidermis, unclog pores, and soothe inflammation. Zinc reinforces this action through its mattifying and calming properties.

The combination of salicylic acid with retinoids, such as retinol, retinal, or synthetic retinoids like adapalene, is regularly considered in acne-prone skin care. These two active ingredients act via complementary mechanisms: salicylic acid exfoliates the skin’s superficial layers and unclogs pores thanks to its lipid solubility, while retinoids regulate keratinocyte differentiation and stimulate deep cell renewal. Their combination could enable simultaneous targeting of blackheads, open or closed comedones, and hyperkeratinization.

The combination of salicylic acid and a retinoid may also influence the signs of photoaging. This is at least what a 2016 study by Draelos et al. suggests. The study compared the efficacy of 0.25% retinol and 0.25% tretinoin when applied immediately after a 30% salicylic acid peel. Twenty women underwent two sessions, spaced two weeks apart, during which each half of the face received one of the two retinoids, followed by the application of the peel. Double-blind assessments by investigators and the participants themselves showed that after four weeks, both protocols significantly improved pore size, skin texture, and overall skin appearance. Tretinoin demonstrated slightly greater efficacy than retinol according to investigator evaluations, but the study concluded that either retinoid could be safely used after a salicylic acid peel to mitigate the signs of photoaging.

However, it is recommended to exercise caution when using this combination, particularly for sensitive skin.

Retinoids and salicylic acid can be irritating, especially with initial use. To limit side effects, it is preferable to avoid introducing them into your skincare routine simultaneously and to apply them at different times (for example, you can use salicylic acid in the morning and retinol in the evening). Finally, during oral isotretinoin therapy, it is generally advised to avoid concurrent use of salicylic acid, so as not to further weaken the skin barrier.

Note: If you are undergoing a topical retinoid-based acne treatment, it is best to consult your dermatologist directly to determine whether using salicylic acid is possible. For example, salicylic acid and adapalene together are often contraindicated.

Salicylic acid can also be combined with benzoyl peroxide to care for acne-prone skin. Each compound works via a distinct mechanism: benzoyl peroxide is particularly valued for its powerful antibacterial properties, which allow it to significantly reduce the proliferation of Cutibacterium acnes, while salicylic acid exfoliates clogged pores and limits the buildup of sebum and dead cells responsible for comedones. This combination therefore acts on both the bacterial cause of acne and its keratinous component.

The risk of irritation is not negligible when combining benzoyl peroxide and salicylic acid. If you wish to use both active ingredients, introduce each gradually into your routine.

Two studies, presented in the table below, investigated this combination and achieved favorable clinical outcomes with minimal adverse effects. They were not limited to the salicylic acid–benzoyl peroxide pairing; they also evaluated other active ingredient combinations, thereby broadening the potential applications.

The azelaic acid and salicylic acid have complementary modes of action that are particularly interesting for skin prone to blemishes or redness. Azelaic acid is recognized for its antibacterial, anti-inflammatory, and mattifying properties, while salicylic acid primarily acts as a keratolytic agent, promoting the removal of dead cells and the unclogging of pores. By combining these two active ingredients, it may be possible to simultaneously target inflammation, the bacteria responsible for acne, and comedones. This combination could also be beneficial for skin exhibiting a couperose mild or diffuse redness, azelaic acid is often recommended to even out the complexion.

A study conducted on 34 patients with mild to moderate acne evaluated the effects of four peeling sessions performed at two-week intervals. A combined solution of 20% salicylic acid (SA) and 20% azelaic acid (AA) was applied to one half of the face, while the other half received a 25% trichloroacetic acid (TCA) peel. Clinical assessments demonstrated a more rapid improvement in inflammatory lesions on the SA/AA-treated side, and improvement in non-inflammatory lesions on the TCA-treated side. After the four sessions, both treatments yielded significant improvement with no marked difference between them, although participants reported a preference for the SA/AA-treated side, which was considered more comfortable.

The combination of salicylic acid and glycolic acid, an AHA, is often highlighted in exfoliating products because these two molecules act in a complementary manner on cell renewal. The blend of glycolic acid and salicylic acid allows one to harness the combined properties of both active ingredients. Salicylic acid, being lipophilic, easily penetrates pores to unclog them and limit the formation of blackheads and comedones, while glycolic acid removes dead cells from the skin’s surface and accelerates cell renewal. Therefore, combining glycolic acid with salicylic acid may effectively smooth the skin, diminish pigmentation spots, and prevent pore blockage.

A study was conducted to evaluate the efficacy of a serum combining glycolic acid and salicylic acid. 66 patients aged 17 to 46 years with mild to moderate inflammatory acne applied this serum in the evening for two weeks. The results show that over 90% of participants observed a significant improvement in their acne, with a reduction in comedones and cystic lesions, while 70% to 80% reported less oily and more even skin.

Although highly efficacious, this combination is not recommended for sensitive skin.

Note: To prevent irritation, it is preferable to alternate the use of glycolic acid serums and salicylic acid serums (for example, every other day) rather than mixing them directly together or layering them. Moreover, it is important not to attempt to replace professional formulators, who master not only the compatibility of active ingredients but also that of the other components in a cosmetic formulation (film-forming agents, surfactants, preservatives, solvents, texturizing agents...).

The association between lactic acid and salicylic acid is quite similar to that between salicylic acid and glycolic acid. Indeed, the lactic acid also belongs to the AHA family and has exfoliating properties. The main difference from glycolic acid lies in its higher molecular weight, which gives it a more superficial yet gentler action. Moreover, lactic acid enhances the natural moisturizing factor (NMF), a collection of amino acids in the stratum corneum that hydrate the skin. The combination of salicylic acid and lactic acid is interesting because it merges the keratolytic and unclogging action of the BHA with the hydrating and mild exfoliating properties of the AHA. It can, for example, be beneficial for combination skin with dry areas because lactic acid partially offsets the potentially drying effect of salicylic acid.

Note: To date, no clinical study has tested this combination. Nevertheless, researchers have formulated a microemulsion composed of 12% salicylic acid and 4% lactic acid and verified its stability through a series of experiments. The next step will be to evaluate its efficacy.

Associating hyaluronic acid with salicylic acid could help to counteract the drying effect that BHA can sometimes cause. Hyaluronic acid, thanks to its high hygroscopic capacity, intensely hydrates the top layers of the epidermis and helps maintain skin suppleness. This synergy is particularly valuable for combination or oily skin seeking the purifying action of salicylic acid without disrupting their hydrolipidic barrier. Although salicylic acid and hyaluronic acid are seldom combined in a single product, they often coexist in the same skincare routine.

Although the benefits of this combination have not been formally evaluated, there is no contraindication to combining salicylic acid with hyaluronic acid.

Combining salicylic acid and tranexamic acid may be relevant for skin prone to pigmentation spots or uneven tone. Salicylic acid, through its exfoliating and keratolytic actions, facilitates the removal of dead cells and enhances the penetration of depigmenting actives. Tranexamic acid, in turn, regulates melanin production and curbs the inflammation that promotes hyperpigmentation. It can be hypothesized that salicylic acid and tranexamic acid may act synergistically to prevent or lessen post-inflammatory hyperpigmentation or brown spots in general.

In the absence of clinical studies on the subject, the potential synergy between salicylic acid and tranexamic acid remains hypothetical.

The combination of salicylic acid and vitamin C is primarily intended to even out skin tone and enhance skin radiance. Salicylic acid exfoliates the skin, enabling vitamin C, in the form of ascorbic acid or one of its derivatives, to penetrate more effectively and exert its antioxidant and brightening properties. Using vitamin C and salicylic acid together may help achieve smoother skin and a more uniform complexion. However, if you use pure vitamin C, we recommend proceeding with caution. Indeed, this ingredient can be irritating for sensitive skin due to its highly acidic pH. Since salicylic acid can also be somewhat drying, extra care is advised if you have sensitive skin.

A study evaluated the efficacy of a 30% salicylic acid peel combined with vitamin C mesotherapy for managing melasma in 50 patients divided into two groups. All participants received a peel every two weeks for two months, while one group also received vitamin C injections directly into the lesions. Six-month follow-up revealed a significant reduction in the MASI (Melasma Area and Severity Index) score, indicating clinical improvement of the brown patches. The treatment was well tolerated, with only mild burning reported as a side effect.

The association between salicylic acid and niacinamide is particularly valuable for oily, acne-prone, or redness-prone skin. Salicylic acid, through its keratolytic and anti-inflammatory actions, helps to unclog pores and reduce blemishes, while niacinamide strengthens the skin barrier and soothes inflammation. Combining niacinamide with salicylic acid enables simultaneous exfoliation and barrier function enhancement, two effects that are often at odds.

In addition to the studies presented above demonstrating the benefits of the combination of salicylic acid, niacinamide, and benzoyl peroxide, an investigation focused on a cleanser containing 0.45% salicylic acid, 1% gluconolactone, 2% niacinamide, and three types of ceramides (EOP, NP, and AP). Forty-three individuals with oily, acne-prone skin and thirty-nine with sensitive skin were recruited to use the cleanser daily. After four weeks, a significant reduction in the number of inflammatory and non-inflammatory lesions, as well as a notable decrease in sebum production, was observed in the first group. Moreover, no side effects were reported in either the acne-prone group or the group of individuals with sensitive skin.

Some people combine salicylic acid with aloe vera gel. Derived from the plant of the same name, the latter is renowned for its hydrating properties—stemming from its richness in hygroscopic amino acids—and its soothing effects. Aloe vera gel is often used to alleviate tightness and sensations of skin discomfort. It could therefore counterbalance the potentially irritating effects of salicylic acid. Aloe vera and salicylic acid are rarely found together in the same formulation, but, as with hyaluronic acid, there are no contraindications to using both in a skincare routine.

Finally, certain formulas combine salicylic acid and tea tree essential oil to address stubborn skin imperfections. While salicylic acid promotes cell turnover and unclogs skin pores, thereby preventing comedone formation, tea tree essential oil targets the bacteria C. acnes, which are responsible for inflammatory flare-ups. Their combination thus allows the pairing of an exfoliant with an antibacterial agent, thereby enhancing their respective anti-acne effects. The combination of salicylic acid and tea tree oil is also found in some anti-dandruff shampoos. Indeed, tea tree essential oil exhibits antifungal properties against the yeasts Malassezia, whose proliferation partly causes the appearance of dandruff.

Important: Do not add tea tree essential oil to a formulation that already contains salicylic acid. A skincare product can include both active ingredients if it is properly formulated. However, adding this oil yourself to an existing product may cause irritation and redness if dosed incorrectly.

• SWANEPOEL S. J. Formulation of cosmetic products for the treatment of acne containing tea tree oil and salicylic acid. Medicine (2005).

• DRAELOS Z. Combination superficial peels with salicylic acid and post-peel retinoids. Journal of Drugs in Dermatology (2016).

• ABUL-HAJ M. & al. Topical salicylic acid and lactic acid microemulsion. Organic & Medicinal Chemistry (2017).

• BALEVI A. & al. Salicylic acid peeling combined with vitamin C mesotherapy versus salicylic acid peeling alone in the treatment of mixed type melasma: A comparative study. Journal of Cosmetic and Laser Therapy (2017).

• HAY R. A. & al. Clinical and dermoscopic evaluation of combined (salicylic acid 20% and azelaic acid 20%) versus trichloroacetic acid 25% chemical peel in acne: An RCT. Journal of Dermatological Treatment (2019).

• PEINEMANN F. & al. Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha‐hydroxy acid) for acne. Cochrane Database of Systematic reviews (2020)

• HADDAD L. & al. Two is better than one: The combined effects of glycolic acid and salicylic acid on acne-related disorders. Journal of Cosmetic Dermatology (2020).

• CAIXIA L. & al. Efficacy and safety of a cream containing octyl salicylic acid, salicylic acid, linoleic acid, nicotinamide, and piroctone olamine combined with 5% benzoyl peroxide in the treatment of acne vulgaris: a randomized controlled study. Chinese Medical Journal (2022).

• YOUSAF A. M. & al. Formulation and in vitro characterization of tea tree oil anti-dandruff shampoo. Current Cosmetic Science (2022).

• DRENO B. & al. A salicylic acid-based dermocosmetic is effective as an adjunct to benzoyl peroxide for mild to moderate acne and as monotherapy in maintenance post benzoyl peroxide. Journal of Drugs in Dermatology (2023).

• AI Y. & al. Anti-acne and tolerance assessment of a cleanser containing salicylic acid, gluconolactone and niacinamide. Asian Journal of Beauty and Cosmetology (2024).