Salicylic acid (ortho-hydroxybenzoic acid) is a beta hydroxy acid agent. It is a lipophilic compound which removes intercellular lipids that are covalently linked to the cornified envelope surrounding cornified epithelioid cells. Salicylic acid peeling can alter the underlying dermal tissue without directly wounding the tissue or causing inflammation. Salicylic acid has also been shown to have anti-inflammatory and antimicrobial properties.
Indications for salicylic acid peels include acne vulgaris (inflammatory and non-inflammatory lesions), acne rosacea, melasma, post-inflammatory hyperpigmentation, freckles, lentigines, mild to moderate photodamage, and texturally rough skin. Salicylic acid has an established safety profile in patients with skin types I–VI. It is an excellent peeling agent in patients with acne vulgaris. After several minutes the peel can induce an anesthetic effect whereby increasing patient tolerance.