Factors Which Influence Topical Therapy
Treatment regimens must be individualized according to the patient’s age, sex, occupation, understanding, and the available resources.
Treatment also depends on the site of the lesions and their extent and severity. Assessment of severity should include the patient’s own perception of disability, the need for treatment, and an objective assessment of extent and severity.
The choice of vehicle can significantly alter the use and penetration of medications, and hence the therapeutic effect. There is a vast array of vehicles including creams, gels, solutions, foams, sprays, shampoos, and lotions. Different vehicles are indicated for different body sites. Scalp is commonly involved in psoriasis and requires gel, solutions, or foams that are not as messy as ointments and creams. Elsewhere, patients may prefer a less greasy preparation such as a cream during the daytime, and an ointment which is more effective but less cosmetically appealing at night.
Occlusive therapy, in which the skin is covered, often with a plastic membrane, enhances the penetration of topical agents such as corticosteroids. The occlusive dressings trap heat and moisture, hydrating and macerating the skin and forcing the medication through the plaques.
All patients on topical therapy should be examined regularly to look for the development of side effects at the earliest.
What Other Information Should I Know
Keep all appointments with your doctor.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are using topical salicylic acid.
If you are using prescription strength topical salicylic acid, do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
Ask your pharmacist any questions you have about topical salicylic acid.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Is It Right For You
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.
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Why Is This Medication Prescribed
Topical salicylic acid is used to help clear and prevent pimples and skin blemishes in people who have acne. Topical salicylic acid is also used to treat skin conditions that involve scaling or overgrowth of skin cells such as psoriasis , ichthyoses , dandruff, corns, calluses, and warts on the hands or feet. Topical salicylic acid should not be used to treat genital warts, warts on the face, warts with hair growing from them, warts in the nose or mouth, moles, or birthmarks. Salicylic acid is in a class of medications called keratolytic agents. Topical salicylic acid treats acne by reducing swelling and redness and unplugging blocked skin pores to allow pimples to shrink. It treats other skin conditions by softening and loosening dry, scaly, or thickened skin so that it falls off or can be removed easily.
Before Taking This Medicine
You should not use salicylic acid topical if you are allergic to it.
Using this medicine in a child or teenager with flu symptoms or chickenpox can cause a serious or fatal condition called Reyes syndrome.
Ask a doctor or pharmacist if this medicine is safe to use if you have:
liver or kidney disease
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Where Does Salicylic Acid Come From
Salicylic acid is a natural substance that can be derived from the bark of a willow tree. It was first discovered and named way back in 1763. However, there are earlier accounts dating back to ancient Greece, about Hippocrates using willow bark compounds to help relieve aches and pains. Salicylic acid is really quite common these days. In fact, we all likely have a form of it in our medicine cabinets right now. If you look at the back of an aspirin bottle you will notice that it is made from a derivative of salicylic acid called acetylsalicylic acid. Salicylic acid got its start in topical skincare products sometime in the early 20th century. It wasnt until later in the 20th century that the FDA began to recognize salicylic acid as an over-the-counter drug treatment for psoriasis.
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.
- Price: $$$
- Salicylic acid: 2% concentration
SkinMedicas facial cleanser includes both alpha- and beta-hydroxy acids to boost exfoliating action. Reviewers say it keeps their skin feeling smooth and clear.
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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.
Precautions When Using Topical Salicylic Acid Preparations
When using salicylic acid preparations do not use any of the following preparations on the affected area, unless directed to do so by your doctor.
- Alcohol containing preparations
- Abrasive soaps and cleansers
- Cosmetics or soaps that dry the skin or are designed to peel/exfoliate
Inform your doctor if you are pregnant or breast-feeding. Salicylic acid can be absorbed through the mother’s skin. The risks and benefits will need to be discussed with your doctor before using any preparations containing salicylic acid.
Salicylic acid preparations should not normally be used in children younger than 2 years. Use in young children should be monitored carefully as children are more likely to get skin irritation and the absorption through skin is greater.
New Zealand approved datasheets are the official source of information for these prescription medicines, including approved uses and risk information. Check the individual New Zealand datasheet on the Medsafe website.
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Liquid Solution: Salicylic Acid 26% To 285% : Adults:
Can Psoriasis Be Managed By Only Using Topical Treatments
You may find that what works for you today stops working for you a year from now. Topicals such as creams and ointments can be very effective for reducing or even eliminating symptoms. However, theyre not a cure.
Avoiding triggers can help make topical treatments more effective. In some instances, they may also be more beneficial when combined with prescribed medications and changes to your nutrition.
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How Does Salicylic Acid Work
Salicylic acid works by softening keratin, a protein that forms part of the skin structure. This helps to loosen dry scaly skin making it easier to remove. When salicylic acid is used in combination with other medicines it takes off the upper layer of skin allowing the additional medicines to penetrate more effectively.
In acne, topical salicylic acid helps slow down shedding of the cells inside the follicles, preventing clogging. Salicylic acid also helps break down blackheads and whiteheads.
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With a thicker consistency, this ointment is choice for dabbing onto smaller spots, ideal for anyone who suffers from random, smaller areas of plaques and scale. It touts 2% salicylic acid in a steroid- and fragrance-free formula thats also hypoallergenic.
The scalp is a common spot where psoriasis can crop up. Admittedly, it may be less visible here than when its on your arms or legs, but the discomfort can be intense. We know, we know, this isnt a cream, but really who wants to apply a cream on their scalp? Well let this one sneak onto the list, especially because it came highly recommended for scalp psoriasis by both of the derms we spoke to.
It contains coal tar, the other FDA-approved ingredient for psoriasis, which, has been shown to calm inflammation in the skin and slow the growth of skin cells, helping with the itch and scaling associated with psoriasis, notes Birnbaum. FYI, to fully reap the benefits, Miller recommends using it two to three times per week and letting it sit on the scalp for at least a few minutes before rinsing.
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Psoriasis Cream With Coal Tar
Coal Tar is pretty much exactly what it sounds like. Coal is actually used in a lot of skincare products and has become quite popular in several skin care lines. However, when coal tar is used in a psoriasis cream it must be used at a specific concentration to make it effective for the treatment of psoriasis.
When used in higher concentrations coal tar can often have a very strong smell that many people dislike. However, for some people if this is the only ingredient that works for their psoriasis they will gladly deal with the smell just to reduce the symptoms of their psoriasis. If you wish to avoid a smelly product you may want to start with a salicylic acid based psoriasis cream.
Why Trust Verywell Health
As a seasoned health writer, Danielle Zoellner knows the importance of finding just the right product to fit your medical needs. Throughout her career, Danielle has interviewed a variety of experts in the medical and health fields while reviewing dozens of products. Her experience and knowledge in the field work together to help readers like yourself find the best products for your daily life.
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Itchiness can be one of the most debilitating symptoms of psoriasis, making it hard for you to focus on your everyday life. Cortizone-10 Anti Itch Lotion specifically targets that symptom to provide long-lasting relief to irritated skin. Included in the product is maximum strength hydrocortisone, a leading ingredient in treating itchiness. The hydrocortisone is combined with seven different types of moisturizers and two vitamins to hydrate the skin while helping it heal.
Customers say the lotion is the holy grail of aiding their psoriasis because its non-drying, compared to other anti-itch creams on the market, and it relieves their red and irritated skin patches.
Salicylic Acid For Psoriasis
Salicylic acid is a topical, over-the-counter treatment approved by the Food and Drug Administration to treat psoriasis. Salicylic acid is often used as an ingredient in creams, lotions, soaps, and shampoos, sometimes in combination with coal tar. Some doctors recommend the use of salicylic acid with a prescribed topical corticosteroid such as Luxiq. Salicylic acid is frequently used to treat psoriasis on the scalp. Salicylic acid is also referred to as sal acid.
Salicylic acid should be used with caution in people with diabetes, poor blood circulation, liver or kidney problems, skin infections, or an allergy to non-steroidal anti-inflammatory medications such as Motrin. Children and teenagers should not use salicylic acid while they are infected with the flu or chicken pox. Salicylic acid may not be appropriate for women who are pregnant or breastfeeding.
Salicylic acid is a keratolytic, or medication that promotes peeling. In cases of psoriasis, Salicylic acid is believed to work by softening scales and making them easier to remove.
How do I take it?Always check with your doctor before taking a new medication, including over-the-counter medications.
Use products containing salicylic acid according to directions given by your doctor or found on the medication package. Do not exceed the recommended dosage.
Avoid getting salicylic acid on broken skin, eyes, nose, mouth, or genitals. Wash your hands after applying salicylic acid.
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Other Topical Treatments For Psoriasis
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.
How Should I Use Salicylic Acid Topical
Salicylic acid topical is available in many different forms, such as liquid, gel, lotion, cream, ointment, foam, soap, shampoo, cloth pads, and skin patches.
Use exactly as directed on the label, or as prescribed by your doctor.
Do not take by mouth. Topical medicine is for use only on the skin.
Salicylic acid topical can cause a rare but serious allergic reaction or severe skin irritation. Apply a very small amount of the medicine as a “test dose” to 1 or 2 small skin areas every day for 3 days in a row. If you do not have a reaction to the medicine, begin using your full prescribed amount on the 4th day.
You may need to shake the medicine before use. Follow all directions on the product label.
Do not use salicylic acid topical to treat any condition that has not been checked by your doctor.
Your symptoms may not improve for several days. Call your doctor if your symptoms do not improve, or if they get worse.
Store salicylic acid topical in the original container at room temperature, away from moisture and heat.
Keep the foam canister away from open flame or high heat. The canister may explode if it gets too hot. Do not puncture or burn an empty aerosol canister.
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While urea may not be one of the FDA-approved psoriasis ingredients, Birnbaum says its still a good choice: Moisturizers that include urea are very beneficial for psoriasis as they exfoliate while enhancing the barrier of the skin. This is one of her favorites, and we especially like it for slathering onto the chest, stomach, and back, areas where you definitely dont want any kind of lingering greasy residue.
Another pick with urea, grab this the next time youre at the drugstore and slather it on from head to toe. Along with the smoothing, exfoliating benefits of the urea, its also super hydrating, not to mention, fragrance-, dye-, and paraben-free, all important qualities to seek out in a product when you have psoriasis.
Salicylic Acid Topical Side Effects
Salicylic acid topical can cause a rare but serious allergic reaction or severe skin irritation. These reactions may occur just a few minutes after you apply the medicine, or within a day or longer afterward.
Stop using this medicine and get emergency medical help if you have signs of an allergic reaction: hives, itching difficult breathing, feeling light-headed swelling of your face, lips, tongue, or throat.
Also stop using salicylic acid topical and call your doctor at once if you have:
severe headache, ringing in your ears, problems with hearing, thinking problems
severe burning, dryness, or irritation of the skin.
Common side effects may include:
minor skin irritation, rash, or peeling or
changes in the color of treated skin .
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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Some Side Effects Can Be Serious If You Experience Any Of These Symptoms Call Your Doctor Immediately:
- ringing or buzzing in the ears
- hearing loss
- feeling faint
- swelling of the eyes, face, lips, or tongue
Topical salicylic acid may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
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