salicylic acid

salicylic acid

 [sal″ĭ-sil´ik]

a keratolytic and caustic, used to treat a variety of skin conditions, such as dandruff, seborrheic dermatitis, acne, and psoriasis, and to remove calluses, corns, and warts. Its salts are the salicylates.

sal·i·cyl·ic ac·id

(sal'i-sil'ik as'id),

A component of aspirin (acetylsalicylic acid), derived from salicin and made synthetically; used externally as a keratolytic agent, antiseptic, and fungicide.

salicylic acid

/sal·i·cyl·ic ac·id/ (sal″ĭ-sil´ik) a topical keratolytic and caustic; see also salicylate.

salicylic acid

(săl′ĭ-sĭl′ĭk)

n.

A white crystalline benzoic acid derivative, C₇H₆O₃, used in making aspirin, as a preservative, and in the external treatment of skin conditions such as eczema.

salicylic acid

[sal′isil′ik]

a keratolytic agent.

indications It is prescribed in the treatment of hyperkeratotic skin conditions and as an adjunct in fungal infections.

contraindications Diabetes, impaired circulation, or known hypersensitivity to this drug prohibits its use.

adverse effects Among the more serious adverse effects are skin inflammation and salicylism.

sal·i·cyl·ic ac·id

(sal'i-sil'ik as'id)

A component of aspirin, derived from salicin and made synthetically; used externally as a keratolytic agent.

salicylic acid

A drug that softens and loosens the horny outer layer of the skin (the epidermis) and is used in the treatment of various skin disorders such as ACNE, PSORIASIS, ICHTHYOSIS, WARTS and CALLOSITIES. The drug is on the WHO official list. Brand names are Acnisal, Occlusal, Pyravlex, and Verugon. Numerous skin preparations contain salicyclic acid in conjunction with other ingredients.

Salicylic acid

An agent prescribed in the treatment of hyperkeratotic skin conditions and fungal infections.

Mentioned in: Warts

salicylic acid

; SA topical agent that is caustic/keratolytic in high strengths (i.e. 40–70%, applied topically as ointment/paste; used to treat verrucae and heloma dura – see Table 1), and antifungal (see Table 2), antiseptic and astringent (Table 3) in lower strengths (i.e. 3–5% applied topically as an ointment/lotion/cream/powder); it is incompatible with iodine, iron salts and oxidizing agents

Table 1: Treatment of dyshidrosis

Pathology	Treatment options
Hyperhidrosis	Topical astringents, e.g. 3% salicylic acid solution; aluminium salts (e.g. Anhydrol forte solution; ZeaSORB dusting powder), foot baths: 1: 10 000 potassium permanganate solution; contrast foot baths Non-occlusive foot wear (e.g. leather shoes/sandals; cotton socks) Drug therapy: iontorphoresis of 0.05% glycopyrronium bromide solution; local injection of botulinum A toxin–haemagglutinin complex
Anhidrosis	Topical emollients: aqueous cream; emulsifying ointment; hydrous ointment; lanolin; liquid and white soft paraffin ointment; white soft paraffin; proprietary products, e.g. Diprobase, E45
Bromidrosis	As hyperhidrosis ± deodorant sprays

Table 2: Caustic agents used in podiatric practice to achieve local tissue destruction

Agent	Action	Special precautions	Contraindications
Monochloroacetic acid (crystals or saturated solution) e.g. single VP	Keratolytic; hydrolysing agent Non-self-limiting	Deep penetration Painful Do not use mask if applying solution Use a mask if applying crystals Review in 5–7 days Neutralize with foot bath ± NaHCO3 or NaCl	Soft-tissue atrophy Peripheral vascular disease Sensory neuropathy
Salicylic acid paste (40–70%) e.g. single VP; plantar hard corn	Keratolytic; hydrolysing agent	Macerates tissues Review in 7–14 days May be used in conjunction with monochloroacetic acid crystals Neutralize with foot bath ± NaHCO3 or NaCl	Soft-tissue atrophy Peripheral vascular disease Sensory neuropathy
Pyrogallic acid e.g. single VP	Keratolytic; oxidizing agent	Deep penetration Review in 3–5 days Prolonged caustic action Do not apply more than 3 times sequentially Stains skin black/brown	Use with great care: may cause deep tissue breakdown Soft-tissue atrophy Peripheral vascular disease Sensory neuropathy
Trichloroacetic acid (saturated solution; 10% solution) e.g. mosaic VP	Mild keratolytic Protein precipitant	Shallow penetration Neutralize with foot bath ± NaHCO3 or NaCl Review in 3 weeks	Peripheral vascular disease Sensory neuropathy
Silver nitrate (70% solution; 75–95% stick) e.g. mosaic VP; as a protective skin application below a mask	Protein precipitant Self-limiting Stains skin black/brown Maximum effect occurs within 24 hours	Some patients show hypersensitivity to silver nitrate (or experience acute pain) Neutralize with NaCl foot bath May be applied in alternate layers with trichloroacetic acid	Peripheral vascular disease Known sensitivity
Potassium hydroxide (KOH; 85% pellets)	Strong keratolytic	Potentially deep penetration Action of KOH stopped by application of 5% acetic acid after macerated coagulum has been removed Single treatment	Soft-tissue atrophy Peripheral vascular disease Sensory neuropathy
Phenol (80% solution or 100% crystal)	Protein precipitate	Action retarded by flooding with industrial methylated spirit Skin overspill flooded with glycerine Review as per postoperative protocol	Peripheral vascular disease (phenol suppresses inflammatory response)
VP, verruca pedis.

Table 3: Treatment of fungal infections of skin and nails

Infection site	Agent
	Antimycotic agent (for the treatment of dermatophytosis)
Skin	Topical allylamine (e.g. 1% terbinafine cream for 7 days) Topical imidazoles (e.g. 2% miconazole or 1% clotrimazole for 28 days) Topical 0.25% amorolfine Topical 1% econazole Topical griseofulvin spray (400 µg puff daily for 14 days) Topical 1% sulconazole Topical tea tree (manuka) oil Topical undecenoate (20% zinc undecenoate + 5% undecenoic acid) Topical Whitfield's ointment (6% benzoic acid + 3% salicylic acid) Other topicals include: weak iodine solution 2.5%; potassium permanganate paint 1%; salicylate acid cream or alcoholic solution 3–5%; benzoic acid (Whitfield's) ointment; sodium polymetaphosphate dusting powder Systemic terbinafine (250 mg daily for 2 weeks) Systemic itraconazole (100 mg daily for 15 days) Systemic griseofulvin (500 mg daily )
Nail	Topical amorolfine 0.25% lacquer as an adjunct to systemic treatment Topical borotannic acid complex acid; Phytex paint (1.46% salicylic acid + 4.89% tannic acid + 3.12% boric acid) Topical 28% tioconazole lacquer Topical undecenoate lacquer; Monphytol paint (5% methyl undecenoate + 0.7% propyl undecenoate + 3% salicylic acid + 25% methyl salicylate + 5% propyl salicylate + 3% chlorambucil) Other topicals: strong iodine 10% solution Systemic terbinafine (250 mg daily for 12–16 weeks) Systemic itraconazole (400 mg for 1 week in a month, repeated overall 3 or 4 times) Anticandidal agent (for the treatment of candidiasis)
Skin	Topical antimycotic creams (1% clotrimazole; 1% econazole; 2% miconazole) Topical nystatin (100 000 units ± 1% tolnaftate) Antipityriasis versicolor agent (for the treatment of pityriasis versicolor)
Skin	Topical 2% ketoconazole Topical 2.5% selenium sulphide Topical antimycotic agents (1% clotrimazole; 1% econazole; 2% miconazole; 1% sulconazole; 1% terbinafine) Systemic fluconazole/itraconazole/ketoconazole/miconazole/voriconazole

salicylic acid

o-hydroxybenzoic acid; used as a keratolytic. See also salicylate.