Which active ingredients can be combined with salicylic acid?

It is quite common to combine salicylic acid and zinc to formulate skincare products for oily or blemish-prone skin. Indeed, zinc, whether in the form of zinc gluconate or zinc PCA, is an astringent and mattifying agent capable of limiting bacterial proliferation Cutibacterium acnes, which, as their name suggests, play a role in acne. Moreover, zinc has anti-inflammatory properties due to 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.

Combining zinc with salicylic acid enhances their respective purifying actions while engaging multiple complementary mechanisms. Salicylic acid works both on the surface and deep within the skin to exfoliate the epidermis, unclog pores, and soothe inflammation. Zinc supports 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 routinely considered in treatments for acne-prone skin. These two actives indeed operate through complementary mechanisms: salicylic acid exfoliates the superficial layers of the skin and unclogs pores thanks to its lipid solubility, while retinoids regulate keratinocyte differentiation and stimulate deep cellular renewal. Their combination could enable them to act simultaneously on blackheads, open or closed comedones, and hyperkeratinization.

The combination of salicylic acid and a retinoid may also act on the signs of photoaging. This is indeed what a study conducted by DRAELOS et al. in 2016 suggests. It compared the efficacy of 0.25% retinol and 0.25% tretinoin when applied immediately after a 30% salicylic acid peel. Twenty women completed two treatment sessions, two weeks apart, during which each half of the face received one of the two retinoids, followed by the peel application. Double-blind evaluations by both investigators and participants demonstrated that after four weeks, both protocols significantly improved pore size, skin texture, and overall appearance. According to the investigators’ ratings, tretinoin was slightly more effective than retinol, but the study concluded that either retinoid could be used safely after a salicylic acid peel to attenuate the signs of photoaging.

It is, however, recommended to be cautious with this combination, especially for sensitive skin. Retinoids and salicylic acid can be irritating, particularly during initial use. To minimize side effects, it is best not to introduce them simultaneously into your skincare routine and to apply them at different times (for example, salicylic acid in the morning and the retinoid in the evening). Finally, in cases of oral isotretinoin treatment, it is generally advised to avoid the concomitant use of salicylic acid so as not to further compromise the skin barrier.

Salicylic acid can also be combined with benzoyl peroxide to care for acne-prone skin. Each acts via a distinct mechanism: benzoyl peroxide is especially notable for its potent antibacterial properties, which 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 addresses both the bacterial cause of acne and its keratinous component.

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

Two studies, presented in the table below, investigated this association and reported favorable clinical outcomes with minimal side effects. They did not limit themselves to the combination of salicylic acid and benzoyl peroxide but also evaluated other active‐ingredient pairings, thereby broadening potential applications.

The azelaic acid and salicylic acid exhibit complementary mechanisms of action that are particularly useful for skin prone to blemishes or redness. Azelaic acid is recognized for its antibacterial, anti-inflammatory, and mattifying properties, while salicylic acid primarily functions as a keratolytic agent, promoting the shedding of dead skin cells and the unclogging of pores. By combining these two actives, it may be possible to simultaneously target inflammation, acne-causing bacteria, and comedones. This combination may also benefit skin showing a couperose mild couperose or diffuse redness, with azelaic acid often recommended to even out skin tone.

A trial involving 34 patients with mild to moderate acne evaluated the effect 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 side of the face, while the other side received a 25% trichloroacetic acid (TCA) peel. Clinical assessments showed a faster improvement of inflammatory lesions on the SA/AA-treated side, and noninflammatory lesions on the TCA-treated side. At the end of the four sessions, both treatments yielded significant improvement, with no marked difference between them, although participants preferred the SA/AA side, finding it 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 cellular renewal. Salicylic acid, which is lipophilic, easily penetrates pores to unclog them and limit blackhead and comedone formation, while glycolic acid removes dead cells from the skin’s surface and accelerates cell turnover. Combining salicylic acid and glycolic acid can therefore effectively smooth the skin, reduce pigmentary spots, and prevent pore clogging.

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 more than 90% of participants experienced a noticeable 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 effective, this combination is not recommended for sensitive skin.

The combination of salicylic acid and lactic acid is quite similar to that of salicylic acid and glycolic acid. Indeed, 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 but milder action. Moreover, lactic acid reinforces the natural moisturizing factor (NMF)—a collection of amino acids in the stratum corneum that help hydrate the skin. The pairing of salicylic acid and lactic acid is compelling because it merges the BHA’s keratolytic and pore-unclogging effects with the gentle exfoliating and hydrating properties of an AHA. For example, it can 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. However, researchers have formulated a microemulsion composed of 12% salicylic acid and 4% lactic acid and evaluated its stability through a series of experiments. The next step will be to evaluate its efficacy.

Associating salicylic acid with hyaluronic acid could help to offset the drying effect that BHA can sometimes induce. Hyaluronic acid, thanks to its high hygroscopic capacity, intensely hydrates the upper layers of the epidermis and helps maintain skin suppleness. This synergy is particularly appealing for combination or oily skin types that want to benefit from the purifying action of salicylic acid without compromising their hydrolipidic barrier. Although salicylic acid and hyaluronic acid are rarely formulated together in a single product, they often coexist within the same skincare routine.

Although the benefits of this combination have not been formally tested, there are no contraindications to combining salicylic acid with hyaluronic acid.

Combining salicylic acid and tranexamic acid could be relevant for skin prone to pigmented spots or an uneven complexion. Salicylic acid, thanks to its exfoliating and keratolytic action, promotes the removal of dead skin cells and enhances the penetration of depigmenting agents. Tranexamic acid, in turn, regulates melanin production and limits the inflammation that drives hyperpigmentation. One can hypothesize that salicylic acid and tranexamic acid may act synergistically to prevent or diminish 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 the skin’s radiance. Salicylic acid exfoliates the skin, allowing the vitamin C, in the form of ascorbic acid or one of its derivatives, to better penetrate and exert its antioxidant and brightening action. Using salicylic acid and vitamin C simultaneously may help achieve smoother skin and a more uniform complexion. However, if you use pure vitamin C, we recommend proceeding with caution. Indeed, this active ingredient can be irritating to sensitive skin due to its highly acidic pH. Since salicylic acid itself can be slightly drying, caution is also advised if you have sensitive skin.

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

The combination of salicylic acid and niacinamide is particularly interesting for oily, acne-prone, or redness-prone skin. Salicylic acid, through its keratolytic and anti-inflammatory action, helps to unclog pores and reduce imperfections, while niacinamide strengthens the skin barrier and soothes inflammation. Combining niacinamide with salicylic acid allows exfoliation and reinforcement of barrier function, two often opposing effects.

Beyond the studies presented above that demonstrated the benefits of combining salicylic acid, niacinamide, and benzoyl peroxide, one investigation examined a cleanser containing 0.45% salicylic acid, 1% gluconolactone, 2% niacinamide, and three types of ceramides (EOP, NP, and AP). 43 individuals with oily, acne-prone skin and 39 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, were observed in the first group. Moreover, no side effects were reported in either the acne group or the sensitive-skin cohort.

Some people combine salicylic acid with aloe vera gel. Derived from the plant of the same name, the latter is renowned for its moisturizing properties—thanks to its abundance of hygroscopic amino acids—and its soothing effects. Aloe vera gel is often used to reduce 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 in the same formula, but, as with hyaluronic acid, there is no contraindication to using both in the same skincare routine.

Finally, some formulations combine salicylic acid and tea tree essential oil to tackle stubborn blemishes. While salicylic acid promotes cellular turnover and unclogs skin pores, thereby limiting comedone formation, tea tree essential oil targets the bacteria C. acnes, which are responsible for inflammatory flare-ups. Their combination therefore pairs an exfoliant with an antibacterial agent, thereby reinforcing their respective anti-acne effects. This pairing of salicylic acid and tea tree essential oil is also found in certain anti-dandruff shampoos. Tea tree essential oil indeed possesses antifungal properties against the yeast Malassezia, whose proliferation is partly responsible for the onset of dandruff.

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

• 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).