Although psoriasis is a rare disease with no known cure, there are many treatment options to help manage and alleviate the symptoms associated with this disease. Apart from the physical manifestations of psoriasis- red, itchy plaques, people may find it challenging to manage the emotional burden that is present.
In this article, we are going to discuss a topical treatment salicylic acid for psoriasis. We will go into detail about how it works to treat psoriasis, its benefits and side effects, and answer some questions that you may have if you have just started salicylic acid treatment or are considering it as a potential option for your psoriasis.
Psoriasis Overview
Read MoreCommon symptoms associated with psoriasis:
- Small scaling spots
- Swollen or stiff joints
- Burning, itching, or soreness of the skin
- Small scaling spots
- Cracked and dry skin that may itch or bleed
- Ridged or thickened nails
- Red patches of skin covered with silvery scales
The different types of psoriasis that may present in the affected person:
- Plaque psoriasis- This is the most common type of psoriasis that may occur, causing itchy and tender, raised, dry skin patches.
- Nail psoriasis -affects the toenails and the fingernails and may even cause the nails to loosen from the nail bed.
- Guttate psoriasis children and young adults are normally affected by this disease that is typically caused by an infection such as strep throat.
- Inverse psoriasis The skin folds such as areas in the buttocks, groin, and breasts are mainly affected in this type of psoriasis. Sweating and friction in these areas may cause psoriasis to worsen.
- Psoriatic arthritis This type of psoriasis affects the person’s joints, as they become painful and swollen.
- Pustular psoriasis- This is a rare type of psoriasis that is characterized by the formation of patches of pus-filled blisters throughout the body.
- Erythrodermic psoriasis- This is another rare type of psoriasis that covers the entire body with a peeling, red rash that may have an intense burning sensation or be itchy.
Treatment options
Current treatment options for psoriasis can be grouped into three different categories:
- Topical therapy are ointments and creams, such as coal tar, salicylic acid, topical corticosteroids, vitamin D analogues, retinoids, and calcineurin inhibitors.
- Systemic therapy consists of oral medication and injections that target the whole body, not just the surface of the skin. Oral medications for psoriasis include, Otezla(Apremilast), methotrexate, or cyclosporine. Injections or intravenous infusions (IV) can be given to target specific parts of the immune system.
- Phototherapy– light therapy; this treatment is favorable for those that find topical treatments ineffective. Phototherapy is also recommended for psoriasis patients that are looking for an alternative option to medications that affect their entire bodies.
"When I see a psoriasis patient, I first determine the extent of their condition. If it's fairly localized, I'm able to treat the patient with topical therapy by itself," Dr. Linda Stein Gold, Director of Clinical Research in the Department of Dermatology at Henry Ford Health in Detroit, said in a previous interview with SurvivorNet. "But if they have a more widespread condition, topicals alone are not practical."
What is Salicylic Acid?
Salicylic acid falls under topical treatment for psoriasis, and it belongs to a classification of medicine called keratolytics. It is an active ingredient in multiple over-the-counter (OTC) products, such as creams, shampoos, ointments, and cleansers. Some salicylic acid preparations are only available with a doctor’s prescription. Topical preparations of salicylic acid can be used either alone or in combination with other medications to successfully treat the following scaly skin conditions:
- Psoriasis
- Acne
- Lichen simplex
- Viral warts
- Chronic atopic dermatitis
- Seborrheic dermatitis
How Does it Work?
Salicylic acid is known as a peeling agent that works by softening a protein (keratin) that forms part of the skin structure. This helps to loosen the dry, scaly skin that presents with psoriasis, making it easier for you to remove the scales. Salicylic acid, in combination with other medications, has been shown to effectively remove the affected upper layer of skin, allowing additional medications to penetrate the skin more effectively.
How to use Salicylic acid preparations?
- It is important to avoid contact with your eyes, mouth, genitals, and inside of the nose.
- Wash your hands immediately after applying the medicine to your affected areas unless your hands are being treated.
- Discontinue use if your skin is irritated or if any part of your skin becomes reddened or infected.
- Use the salicylic acid preparations precisely as prescribed or directed on the label.
- Do not overuse the medication as it will lead to increased absorption through the skin and potentially salicylic acid poisoning.
Efficacy and Safety
There are no placebo-controlled studies that verify both the safety and efficacy of salicylic acid when used alone. Generally, salicylic acid is combined with other topical therapies and has shown to significantly increase the penetration rate of some topical therapies such as (TCS) due to its skin peeling ability.
When receiving treatment involving phototherapy for your psoriasis, you should only apply salicylic acid preparations after this treatment, as salicylic acid blocks/inhibits UV light.
The Side Effects
Strong concentrations of salicylic acid in preparations can cause irritation on a person's skin. The most common side effects experienced at the site of the application when using salicylic acid:
- Irritation
- Stinging
- Dryness
Other side effects that only present rarely, but can potentially be serious. It is important to contact your doctor or seek emergency medical assistance if you experience any of the following symptoms:
- Weakness and fatigue
- Confusion
- Headaches
- Hair loss
- Light-headedness
- Tinnitus
- Nausea and vomiting
- Hearing problems
- Rapid breathing
Precautions when using salicylic acid preparations
Unless directed by your doctor or dermatologist, it is not advisable to use any of the following salicylic acid preparations on the affected area of skin:
- Any preparations that contain alcohol in them
- Soaps or cosmetic scrubs that are made to exfoliate/peel the skin or dry out the skin
- Any abrasive cleaners or soaps
- Any other medicated topical agents such as topical retinoids, benzoyl peroxide, or calcipotriol.
If you are breastfeeding or pregnant, it is important that you inform your doctor, as salicylic acid can be absorbed through the mother’s skin and affect the baby.
Questions to ask your Doctor
- Is salicylic acid the only option to treat my psoriasis?
- Will salicylic acid work for my scalp psoriasis?
- Do I need to get a prescription to purchase salicylic acid?
- Is it common to get side effects when using salicylic acid to treat my psoriasis?
- What types of psoriasis does salicylic acid work best for?
The Bottom Line
It is always best to discuss with your doctor, the most suitable treatment options for you. Treatment options for psoriasis will be recommended based on your overall health, age, comorbidities, and the severity and type of psoriasis. Do not give up hope if salicylic acid does not work effectively for you; it is one of many topical treatments, and your doctor can prescribe phototherapy or systemic treatment options to help you control and manage your psoriasis. SurvivorNet has a list of resources to help you understand this disease so that you can advocate for yourself and your treatment needs.
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