Salicylic acid is a beta hydroxy acid (BHA), which is used in face wash in a 2% form for oily and acne prone skin. BHAs are soluble in oil which make them different to alpha hydroxy acids (AHA) such as glycolic acid, which is only water soluble. Salicylic acid is used in a 14% strength in Jessner’s solution, but at a higher strength has been found to be beneficial for age spots, actinic keratosis, and fine wrinkling, especially in the non-face areas, such as hands, arms and chest.
Salicylic acid peels are easy to perform, have a low incidence of complications, easy to control, and effective at treating difficult non-face areas.
- The area to be peeled should be pre-treated with a retinoic acid for at least two weeks prior to the peel.
- Hyper-keratotic and hyper-pigmented lesions can be pretreated with a glycolic gel and skin lightener prior to the peel.
- Pre-malignant (Actinic Keratosis) or hyper keartotic areas can be treated with 20% TCA prior to the application of Salicylic acid.
The skin needs to be cleansed and degreased prior to the application of the Salicylic acid paste, which is 40 to 50% salicylic concentration. The areas of peel are isolated and the paste is applied. This can be left on for minutes or more effectively for up to 48 hours. The areas need to be occluded with plastic wraps and gauze.
- During the time of salicylic peeling it is advised to hydrate with at least 8 glasses of water to avoid the effects of salicylisim.
- Salicylisim can present as nausea, disorientation, or ear wringing.
After a Salicylic acid peel, the skin can be swollen and peeling will begin on the second to third day.
- The salicylic acid paste will be gently removed with moist soaks.
- The skin is gently cleansed and then an anti-biotic ointment or moisturizer should be applied during the peeling face.
- The skin is monitored for infection, because this can lead to scarring.
After the peeling phase and initial healing, the skin should be protected for the sun, and retinoic acid and lightening agents can be restarted.
Smaller areas should be selected for this peel technique, and each arm can be done separately.
Salicylic acid peels can be the answer to effectively treat difficult areas with age spots and thin skin.