![]() 7 SA has keratolytic and comedolytic properties, although the exact mechanisms involved are not clear. SA is a lipid-soluble agent, in contrast with the α-hydroxy acids (such as glycolic acid), and is therefore miscible with epidermal lipids and sebaceous gland lipids in hair follicles. It is possible that SA was labeled as a β-hydroxy acid at a time when β-hydroxy acid peels were introduced in the market in order to exploit the benefit of the popularity of α-hydroxy acids. 8, 9 Moreover, the carbon atoms of aromatic compounds are counted in arabic numerals (eg, 1, 2, 3) rather than the Greek letter designations (eg, alpha, beta, gamma) applying to aliphatic structures (non-aromatic compounds). Secondly, the hydroxyl group of SA has acidic properties whereas the hydroxyl group of a true β-hydroxy acid is neutral. SA has carboxyl (−COOH) and hydroxyl (−OH) groups directly attached to an aromatic benzene ring, unlike a true β-hydroxy acid, which contains an aliphatic carbon atom chain. ![]() Kligman 8 described SA as a β-hydroxy acid, but Yu and Van Scott 9 have classified it as a phenolic aromatic acid. ![]() However, SA can also be synthesized artificially. Sources of SA and salicylates include willow bark, sweet birch, and wintergreen leaves. This review also resolves some queries regarding the position of SA among hydroxy acids its mechanism of action being desmolytic rather than true keratolytic, and its safety among dark skinned people.Ĭhemically, SA is 2-hydroxybenzoic acid or orthohydrobenzoic acid. 2 The aim of this review is to give a detailed account of SA as a peeling agent in cosmetic dermatology. 1 Salicylic acid (SA) is a member of a group of compounds known as hydroxy acids, which are widely used for a number of cosmetic indications because of their many important properties. Deep peels cause necrosis to the level of the reticular dermis, so are indicated for deep wrinkles, severe photoaging, and deep scars. Medium-depth peels penetrate to the papillary dermis, and are useful in the treatment of solar keratoses, dyschromias, and pigment disorders. Superficial peels cause injury to the epidermis, so are used to treat superficial conditions, including melasma, acne, and dyschromias. Accordingly, chemical peels can be divided into three broad categories, ie, superficial, medium-depth, and deep. A useful approach is to classify them according to the level of injury caused to the skin, which determines the indications they can be used to treat. 1 Chemical peels can be classified in different ways. The principle of peeling involves controlled chemical injury to the skin in order to prompt it to rejuvenate, leading to smoothening of the skin and improvement of its surface texture. An account of salicylism is also included.Ĭhemical peeling is a safe, efficacious, and cost-effective procedure for treating various skin disorders and for enhancing cosmetic appearance. Its properties, efficacy and safety, the peeling procedure, and possible side effects are discussed in detail. This paper reviews the available data and literature on salicylic acid as a peeling agent and its possible indications. The efficacy and safety of salicylic acid peeling in Fitzpatrick skin types I–III as well as in skin types V and VI have been well documented in the literature. ![]() Salicylic acid as a peeling agent has a number of indications, including acne vulgaris, melasma, photodamage, freckles, and lentigines. Once considered as a keratolytic agent, the role of salicylic acid as a desmolytic agent, because of its ability to disrupt cellular junctions rather than breaking or lysing intercellular keratin filaments, is now recognized and is discussed here. In particular, the comedolytic property of salicylic acid makes it a useful peeling agent for patients with acne. The ability of salicylic acid to exfoliate the stratum corneum makes it a good agent for peeling. Salicylic acid has been used to treat various skin disorders for more than 2,000 years.
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