Salicylic acid is an exfoliant and chemical irritant. Efficacy
The AHRQ review14 located three RCTs (Table 13.3).66-68 The largest study found 2% salicylic acid to be more effective against all lesion types than the alcoholic lotion vehicle at 12 weeks in 114 paired individuals with mild-to-moderate acne.66 The second study enrolled 30 individuals and had major losses to follow up;68 1-5 % salicylic acid was more beneficial than placebo. One further crossover RCT in 30 individuals with mild acne compared a 2% cleanser with 10% benzoyl peroxide facial wash; neither product was therefore in prolonged contact with the skin.67 The results of the study cannot be considered as valid evidence, however, because the trial was only 4 weeks in total and there was no wash-out period between the 2-week treatment periods.
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