Which active ingredients can be combined with salicylic acid?

It is fairly common to combine salicylic acid and the zinc to formulate treatments designed for 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 suggests, play a role in acne. Moreover, zinc has an anti-inflammatory effect due to its regulatory impact 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 mobilising several complementary mechanisms. Salicylic acid acts both at the surface and in depth to exfoliate the epidermis, decongest pores and soothe inflammation. Zinc supports this action with 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 treatments for acne-prone skin. These two active ingredients act on complementary mechanisms: salicylic acid exfoliates the outermost 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 allow them to act jointly on blackheads, open or closed comedones and hyperkeratinisation.

The combination of salicylic acid and a retinoid could also affect the signs of photoageing. This is what a 2016 study conducted by DRAELOS and colleagues suggests. It compared the efficacy of 0.25% retinol and 0.25% tretinoin when applied immediately after a 30% salicylic acid peel. Twenty women each underwent two sessions two weeks apart, during which each half of the face received one of the two retinoids, followed by the application of the peel. Assessments performed in a double-blind manner by investigators and the participants themselves showed that after four weeks, both protocols significantly improved pore size, skin texture and overall appearance. Tretinoin demonstrated slightly greater efficacy than retinol according to the investigators’ assessment, but the study concluded that either retinoid could be safely used after a salicylic acid peel to reduce the signs of photoageing.

It is, however, recommended to be cautious about this combination, particularly for sensitive skin. Retinoids and salicylic acid can be irritating, especially at the start of use. To minimise side effects, it is preferable not to introduce them simultaneously into one’s skincare routine and to apply them at different times (for example, salicylic acid in the morning and the retinoid in the evening). Finally, when undergoing oral isotretinoin treatment, it is generally advised to avoid the concomitant use of salicylic acid so as not to further weaken the skin barrier.

Salicylic acid can also be combined with benzoyl peroxide to care for acne-prone skin. Each acts through a distinct mechanism of action: benzoyl peroxide is particularly valued for its potent antibacterial properties, which significantly reduce the proliferation of Cutibacterium acnes, whereas salicylic acid exfoliates clogged pores and limits the accumulation of sebum and dead skin cells responsible for comedones. This combination therefore targets both the bacterial cause of acne and its keratinous component.

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

Two studies, presented in the table below, explored this association and achieved favourable clinical outcomes with few adverse effects. They did not limit themselves to the combination of salicylic acid and benzoyl peroxide, but also evaluated other active ingredient combinations, thereby broadening the scope of potential applications.

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

A trial involving 34 patients with mild to moderate acne assessed 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 half of the face, while the other half received a 25% trichloroacetic acid (TCA) peel. Clinical assessments revealed a more rapid improvement in inflammatory lesions on the SA/AA-treated side, and in non-inflammatory lesions on the TCA-treated side. By the end of the four sessions, both treatments achieved significant improvement, with no marked difference between them, although participants expressed 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 cellular renewal. Salicylic acid, lipid-soluble, penetrates easily into pores to clear them and limit the formation of blackheads and comedones, whereas glycolic acid removes dead cells from the skin’s surface and accelerates cellular renewal. Combining salicylic acid and glycolic acid could therefore effectively smooth the skin, reduce 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 marked improvement in their acne, with a reduction in comedones and cystic lesions, while 70 to 80% reported less oily, more even skin.

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

The association between salicylic acid and lactic acid is quite similar to that between salicylic acid and glycolic acid. Indeed, the lactic acid belongs to the AHA family and also has exfoliating properties. The main difference with glycolic acid lies in its higher molecular weight, giving it a more superficial yet gentler action. Moreover, lactic acid strengthens the natural moisturising factor (NMF), a group of amino acids present in the stratum corneum that helps hydrate the skin. The association of salicylic acid and lactic acid is interesting because it combines 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 the combination skin with dry areas because lactic acid partially counteracts the potentially drying effect of salicylic acid.

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

Combining salicylic acid with hyaluronic acid could help to compensate for the drying effect that BHA can sometimes induce. Hyaluronic acid, thanks to its strong hygroscopic properties, intensely moisturises the upper layers of the epidermis and helps maintain skin suppleness. This synergy is particularly beneficial for combination or oily skin seeking to benefit from salicylic acid’s purifying action without disrupting the hydrolipidic barrier. Although salicylic acid and hyaluronic acid are rarely formulated together in the same product, they frequently coexist within a single 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 may be pertinent for skin prone to pigmentation spots or an uneven complexion. Salicylic acid, thanks to its exfoliating and keratolytic action, promotes the removal of dead cells and enhances the penetration of depigmenting agents. Tranexamic acid, for its part, regulates melanin production and limits the inflammation that drives hyperpigmentation. One might hypothesise that salicylic acid and tranexamic acid could act synergistically to prevent or mitigate 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 aimed at evening out the complexion and improving 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 deliver its antioxidant and illuminating effects. Using salicylic acid and vitamin C together may help achieve smoother skin and a more uniform tone. However, if you use pure vitamin C, we recommend exercising caution. Indeed, this active can be irritating for sensitive skin due to its very acidic pH. As salicylic acid itself can be somewhat drying, it is advisable to be careful 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 female patients divided into two groups. All participants received a peel every two weeks over a two-month period, while one group also underwent vitamin C injections at the lesion sites. A six-month follow-up demonstrated a significant reduction in the MASI (Melasma Area and Severity Index) score, reflecting clinical improvement of the brown patches. 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 compelling for oily, acne-prone skin or skin prone to redness. Salicylic acid, through its keratolytic and anti-inflammatory effects, helps to clear blocked pores and diminish blemishes, while niacinamide fortifies the skin barrier and soothes inflammation. Combining niacinamide with salicylic acid enables both exfoliation and strengthening of the barrier function, two effects that are often at odds.

Aside from the studies presented above that have demonstrated the benefits of combining salicylic acid, niacinamide and benzoyl peroxide, a study investigated 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, along with a marked decrease in sebum production, was observed in the first group. Furthermore, no side effects were reported in either the acne group or among those with sensitive skin.

Certain people combine salicylic acid with aloe vera gel. Derived from the plant of the same name, the latter is acknowledged for its moisturising properties, owing to its richness in hygroscopic amino acids, and for its soothing qualities. Aloe vera gel is often used to reduce tightness and sensations of skin discomfort. It may therefore counterbalance the potentially irritating effects of salicylic acid. Aloe vera and salicylic acid rarely occur together in the same formulation but, as with hyaluronic acid, there are no contraindications to using both in a skincare routine.

Finally, certain formulations combine salicylic acid and tea tree essential oil to overcome stubborn imperfections. While salicylic acid promotes cell turnover and unclogs skin pores, thus limiting comedone formation, tea tree essential oil targets the bacteria C. acnes, responsible for inflammatory breakouts. Their combination thus allows an exfoliant to be paired with an antibacterial agent, thereby enhancing their respective anti-acne effects. The association between salicylic acid and tea tree essential oil is also found in certain anti-dandruff shampoos. Tea tree essential oil indeed has antifungal properties against the yeasts Malassezia, whose proliferation is partly responsible for 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 properly formulated. However, adding this oil yourself to an existing product risks causing irritation and redness if incorrectly dosed.

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