Version May 2024
Acne vulgaris (alternative agent):
Note: Reserve for patients who are not able to use a topical retinoid (Ref). For moderate to severe acne, may be used as part of an appropriate combination regimen (Ref).
Topical:
Salicylic acid 0.5% to 2%: OTC labeling: Apply thin layer to affected area 1 to 3 times daily. Because excessive drying may occur, products that are labeled for multiple daily doses should be initiated with 1 dose daily and increased gradually. Reduce to once daily or every other day if dryness or peeling occurs.
Cream, gel, liquid, pads: Salicylic acid ≤2%: Apply thin layer to affected area 1 to 3 times daily; reduce to once daily or every other day if dryness or peeling occurs.
Cleansers: Salicylic acid ≤2%: Use to cleanse skin 1 to 2 times daily.
Gel mask: Salicylic acid 0.5%: Use 1 to 2 times per week.
Liquid: Salicylic acid 10% (Salicate): Apply to affected area once every 1 to 3 days depending on skin sensitivity and/or tolerance. Leave on for up to 1 minute and then flush skin with cool water. Using more than once per week will increase skin sensitivity.
Callus and corns: Topical: Note: Before applying product, soak area in warm water for 5 minutes; dry area thoroughly, then apply medication.
Gel, liquid: Salicylic acid 13.9 to 17.6%: OTC labeling: Apply one drop to cover corn or callus. Let dry. Repeat once or twice daily until corn is removed for up to 14 days.
Pads: Salicylic acid 40%: OTC labeling: Apply directly over affected area; leave in place for 48 hours. Some products may be cut to fit area or secured with adhesive strips. May repeat procedure every 48 hours as needed for up to 14 days.
Dandruff, psoriasis, or seborrheic dermatitis: Topical: Note: Product-specific indications may vary; refer to manufacturer's labeling.
Cream, gel: Salicylic acid 2% or 3%: OTC labeling: Apply to affected area 1 to 4 times daily.
Shampoo: Salicylic acid 3%: OTC labeling: Apply to wet hair and gently massage into scalp; work up lather; rinse thoroughly. Use at least twice weekly.
Dermatitis: Topical: Ointment: Salicylic acid 3% (Bensal HP only): Apply twice daily. Reevaluate if improvement is not seen within 7 days.
Hyperkeratotic skin disorders: Topical:
Cream:
Salicylic acid 5.9% (RayaSal): Apply twice daily to affected area and occlude overnight. Hydrate skin for at least 5 minutes prior to application. In areas where occlusion is difficult or impossible, application may be more frequent; once affected area becomes clear, occasional use will maintain remission.
Salicylic acid 6% (Salimez, Salycim) or 10% (Salimez Forte): Apply daily to affected area before bedtime. Hydrate skin for at least 5 minutes prior to application. Do not cover with occlusive dressings, clothing, or petrolatum-based products that may increase absorption. Wash off in morning. Once affected area becomes clear, occasional use will maintain remission.
Foam: Salicylic acid 6% (Salvax): Apply to affected area twice daily
Gel: Salicylic acid 6% (Keralyt): Apply daily to affected area and occlude overnight. Hydrate skin for at least 5 minutes prior to application. Wash off in morning. Once affected area becomes clear, occasional use will maintain remission. If applying the gel to the scalp, initially wash off after 10 to 20 minutes, but may be left on for up to 1 hour if needed as treatment progresses; avoid contact with normal hair or skin.
Liquid: Salicylic acid 10% (Salicate): Apply to affected area once every 1 to 3 days depending on skin sensitivity and/or tolerance. Leave on for up to 1 minute and then flush skin with cool water. Using more than once per week will increase skin sensitivity.
Shampoo:
Salicylic acid 6% (Keralyt): To use as a concentrated scalp treatment, apply daily to affected areas of scalp while hair is dry. Leave on for 5 minutes; may gradually increase contact time to 1 hour. After treatment, wash hair thoroughly with water or nonmedicated shampoo. To use as a medicated shampoo, apply daily to scalp while hair is wet; work into a lather; leave on for several minutes, then rinse. Once affected area becomes clear, occasional use will maintain remission.
Salicylic acid 6% (Salex): Apply to scalp while hair is wet; work into a lather; leave on for several minutes, then rinse. Repeat as needed. Once affected area becomes clear, occasional use will maintain remission.
Warts: Topical:
Liquid, solution: Salicylic acid 26% to 28.5%: Adults: Soak wart in warm water for 5 minutes. Dry area thoroughly. Apply to entire wart surface, allow to dry, and then apply a second time. Avoid contact with surrounding skin. Continue therapy once or twice daily. Resolution may be expected after 4 to 6 weeks; some warts may take longer to remove.
Liquid: Salicylic acid 17%: OTC labeling: Soak wart in warm water for 5 minutes. Dry area thoroughly. Apply 1 drop to cover wart. Let dry. Repeat once or twice daily until wart is removed for up to 12 weeks.
Pads: Salicylic acid 40%: OTC labeling: Soak wart in warm water for 5 minutes. Dry area thoroughly. Apply medicated pad directly over wart and secure firmly to skin. Repeat every 48 hours as needed until wart is removed for up to 12 weeks.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Topical salicylic acid: Pediatric drug information")
Acne vulgaris, mild: Topical: Children ≥12 and Adolescents: OTC labeling: Note: Before using a topical OTC acne drug product for the first time, apply sparingly to 1 or 2 small affected areas for 3 days to test for sensitivity. If no discomfort occurs, follow directions for use as stated on specific product label (Ref).
Salicylic acid 0.5% to 2%: General dosing instructions: Apply thin layer to affected area 1 to 3 times daily. Because excessive drying may occur, products that are labeled for multiple daily doses should be initiated with 1 dose daily and increased gradually. Reduce to once daily or every other day if dryness or peeling occur.
Cream, gel, liquid, lotion, pads: Salicylic acid ≤2%: Apply thin layer to affected area 1 to 3 times daily; reduce to once daily or every other day if dryness or peeling occur
Cleansers: Salicylic acid ≤2%: Use to cleanse skin 1 to 2 times daily
Gel mask: Salicylic acid 0.5%: Use 1 to 2 times per week
Callus and corns: Topical: Children and Adolescents: Note: Approved ages and uses for over the counter products may vary; consult labeling for specific information.
Gel, liquid: Salicylic acid 13.9% to 17.6%: Apply one drop to cover corn or callus. Let dry. Repeat once or twice daily until corn is removed for up to 14 days.
Bandages/Discs/Pads/Removers: Salicylic acid 40%: Apply directly over affected area; leave in place for 48 hours. Some products may be cut to fit area or secured with adhesive strips. May repeat procedure every 48 hours as needed for up to 14 days.
Hyperkeratotic skin disorders: Topical: Note: Approved ages and uses for generic products may vary; consult labeling for specific information.
Cream, lotion: Salicylic acid 5% or 6%: Children ≥2 years and Adolescents: Apply daily to affected area before bedtime. Wash off in morning. Once affected area becomes clear, occasional use will maintain remission.
Foam: Salicylic acid 6% (eg, Salvax): Children ≥2 years and Adolescents: Apply to affected area twice daily
Gel: Salicylic acid 6% (eg, Keralyt): Children ≥2 years and Adolescents: Apply daily to affected area and occlude overnight. Wash off in morning. Once affected area becomes clear, occasional use will maintain remission. If applying the gel to the scalp, initially wash off after 10 to 20 minutes, but may be left on for up to 1 hour if needed as treatment progresses; avoid contact with normal hair or skin.
Shampoo: Children ≥2 years and Adolescents:
Salicylic acid 6% (Keralyt): To use as a concentrated scalp treatment, apply daily to affected areas of scalp while hair is dry. Leave on for 5 minutes; may gradually increase contact time to 1 hour. After treatment, wash hair thoroughly with water or nonmedicated shampoo. To use as a medicated shampoo, apply daily to scalp while hair is wet; work into a lather; leave on for several minutes, then rinse. Once affected area becomes clear, occasional use will maintain remission.
Salicylic acid 6% (Salex): Apply to scalp while hair is wet; work into a lather; leave on for several minutes, then rinse. Repeat as needed. Once affected area becomes clear, occasional use will maintain remission.
Warts: Topical: Children and Adolescents: Note: Approved ages and uses for over the counter products may vary; consult labeling for specific information.
Liquid: Salicylic acid 17%: Apply 1 drop to cover wart. Let dry. Repeat once or twice daily until wart is removed for up to 12 weeks.
Bandages/Discs/Pads/Removers: Salicylic acid 40%: Apply medicated pad directly over wart and secure firmly to skin. Repeat every 48 hours as needed until wart is removed for up to 12 weeks.
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Central nervous system: Confusion, dizziness, headache, localized burning (at site of exposure on normal tissue)
Dermatologic: Desquamation, exfoliation of skin
Local: Localized irritation (at site of exposure on normal tissue)
Otic: Tinnitus
Respiratory: Hyperventilation
Hypersensitivity to salicylic acid or any component of the formulation.
Additional contraindications:
Bensal HP: Hypersensitivity to topical polyethylene glycols.
Keralyt, Salex, Salimez, Salimez Forte, Salycim: Children <2 years of age.
Salicate: Concurrent use or use within the past 6 months of isotretinoin; patients with tendency to scar; patients with AIDS, herpes simplex, or who are HIV positive; patients undergoing chemotherapy or radiation; pregnancy; breastfeeding.
UltraSal-ER, Virasal: Impaired circulation or diabetes; moles, birthmarks; warts with hair growth or on face.
OTC labeling: Corns/Warts: When used for self-medication, do not use if you have diabetes or have poor blood circulation; do not use on irritated skin, on any area that is infected or reddened, on moles, birthmarks, warts with hair growing from them, genital warts, or warts on the face or mucous membranes.
Concerns related to adverse effects:
• Hypersensitivity reaction: Rare but serious and potentially life-threatening allergic reactions or severe irritation have been reported with use of topical OTC benzoyl peroxide or salicylic acid containing products; it has not been determined if the reactions are due to the active ingredients (benzoyl peroxide or salicylic acid), the inactive ingredients, or a combination of both. Hypersensitivity reactions may occur within minutes to a day or longer after product use and differ from local skin irritation (redness, burning, dryness, itching, peeling or slight swelling) that may occur at the site of product application. Treatment should be discontinued if hives or itching develop; patients should seek emergency medical attention if reactions such as throat tightness, difficulty breathing, feeling faint, or swelling of the eyes, face, lips, or tongue develop. Before using a topical OTC acne product for the first time, consumers should apply a small amount to 1 or 2 small affected areas for 3 days to make sure hypersensitivity symptoms do not develop (FDA Drug Safety Communication, 2014).
Concurrent drug therapy issues:
• Salicylates: Do not combine use of topical salicylic acid with use of other salicylates or drugs that can increase salicylate serum concentrations; systemic absorption following topical use may occur and lead to toxicity (Menter 2009).
Disease-related concerns:
• Hepatic impairment: Avoid prolonged use over large areas in patients with significant hepatic impairment; may result in salicylism.
• Renal impairment: Avoid prolonged use over large areas in patients with significant renal impairment; may result in salicylism.
Dosage form specific issues:
• Salicate: For external use only; not for ophthalmic or oral use. May cause photosensitivity; limit sun exposure during use and for 1 week after discontinuation; use sunscreen and wear protective clothing. Do not tan for 1 week prior to administration or 2 weeks after administration. If excessive stinging or discomfort occurs, flush skin with cool water. If redness persists for ≥30 minutes, decrease the contact time with the next application or discontinue use.
Special populations:
• Pediatric: Avoid prolonged use over large areas; may result in salicylism. Limit application area in children <12 years of age. Use may be associated with Reye syndrome; use caution in children or adolescents with varicella or influenza. Some products are contraindicated in children <2 years.
Other warnings/precautions:
• Appropriate use: For external use only.
• Self-medication (OTC use): Acne: Apply to affected areas only. Do not apply to broken skin or large areas of body. Dryness or irritation may be increased if other topical acne products are used at the same time. If irritation occurs, use only one topical acne product at a time. New users may test for sensitivity by applying the product sparingly to 1 to 2 affected areas for the first 3 days; if no discomfort occurs, may continue with directions on product labeling. May increase skin sensitivity to sunburn; use sunscreen and limit sun exposure during use and for 1 week afterward.
• Self-medication (OTC use): Hyperkeratotic skin disorders: Prior to self-medication, patients should contact a health care provider if the condition covers a large area of the body and if the condition worsens or does not improve after regular use.
• Self-medication (OTC use): Warts: Prior to OTC use, consult with a health care provider if you have diabetes or poor circulation. For external use only; not for application to areas that are irritated, infected, reddened, birthmarks, genital or facial warts, eyes, or mucous membranes.
• UVB phototherapy: May decrease the efficacy of UVB phototherapy; do not use before therapy (Menter 2009).
Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Cream, External:
Atrix Medicated Formula: 2% (59 mL) [contains disodium edta]
CeraVe Psoriasis: 2% (227 g [DSC]) [contains cetearyl alcohol, cetyl alcohol, disodium edta]
RayaSal: 5.9% (95 g) [contains cetyl alcohol, disodium edta, propylene glycol]
Salimez: 6% (227 g)
Salimez Forte: 10% (227 g)
Salycim: 6% (57 g) [contains cetyl alcohol, soybean oil]
Generic: 6% (454 g [DSC])
Foam, External:
Salvax: 6% (70 g, 200 g) [contains ethylparaben, methylparaben, polysorbate 80, propylene glycol, propylparaben, trolamine (triethanolamine)]
Generic: 6% (70 g, 200 g)
Gel, External:
AcNesic: 0.5% (48 g [DSC]) [contains benzalkonium chloride, butylparaben, egg shells, ethylparaben, isobutylparaben, methylparaben, propylene glycol, propylparaben, trolamine (triethanolamine)]
Keralyt: 3% (28.4 g) [contains alcohol, usp]
Keralyt: 6% (40 g, 60 g, 100 g) [contains hydroxypropyl cellulose, propylene glycol, sd alcohol 40]
Sal-Plant: 17% (14 g [DSC])
Generic: 6% (40 g)
Kit, External:
Atrix System 1: 2% [contains disodium edta, menthol]
GoodSense Corn & Callus: 17% [contains alcohol, usp]
Keralyt Scalp: 6% [contains edetate (edta) sodium (tetrasodium), propylene glycol, sd alcohol 40]
Salex: 6% [DSC] [contains cetyl alcohol, disodium edta, edetate (edta) sodium (tetrasodium), methylparaben, propylparaben, trolamine (triethanolamine)]
Generic: 6%
Liquid, External:
DermacinRx Atrix Antibac Wash: 2% (118 mL) [contains disodium edta, menthol]
DermacinRx Atrix Clarify Toner: 2% (118 mL) [contains benzalkonium chloride, benzyl alcohol, menthol]
GoodSense Liquid Wart Remover: 17% (9 mL) [contains alcohol, usp, castor oil (ricine oil)]
Neutrogena Oil-Free Acne Wash: 2% (124 mL) [contains benzalkonium chloride, disodium edta, fd&c red #40 (allura red ac dye), propylene glycol]
Neutrogena Oil-Free Acne Wash: 2% (124 mL) [contains benzalkonium chloride, disodium edta, fd&c red #40, propylene glycol]
Psoriasin: 3% (177 mL [DSC]) [dye free, fragrance free]
Salicate: 10% (30 mL) [contains propylene glycol]
Salicylic Acid Wart Remover: 27.5% (10 mL) [contains isopropyl alcohol]
Virasal: 27.5% (10 mL) [contains isopropyl alcohol, isopropyl-metacresol (isopropyl-m-cresol]
Generic: 27.5% (10 mL [DSC])
Lotion, External:
Generic: 6% (473 mL [DSC])
Ointment, External:
Bensal HP: 3% (30 g)
Generic: 3% (30 g)
Pad, External:
Clear Away 1-Step Wart Remover: 40% (14 ea [DSC])
Corn Remover One Step: 40% (6 ea [DSC])
Mediplast: 40% (1 ea [DSC], 25 ea [DSC])
Stri-Dex Maximum Strength: 2% (55 ea [DSC], 90 ea [DSC]) [alcohol free]
Stri-Dex Sensitive Skin: 0.5% (55 ea [DSC], 90 ea [DSC]) [alcohol free]
Stridex Essential: 1% (55 ea [DSC]) [alcohol free; contains menthol, tetrasodium etidronate]
Shampoo, External:
Betasal: 3% (480 mL)
DHS Sal: 3% (120 mL) [contains disodium edta]
Ionil: 2% (120 mL [DSC])
Keralyt: 6% (160 mL) [contains cocamidopropyl betaine, edetate (edta) sodium (tetrasodium), propylene glycol]
P & S: 2% (236 mL) [contains edetate (edta) sodium (tetrasodium), methylparaben, propylparaben, trolamine (triethanolamine)]
Salex: 6% (177 mL [DSC]) [contains methylparaben, propylparaben, trolamine (triethanolamine)]
Generic: 6% (177 mL)
Solution, External:
Gordofilm: 16.7% (15 mL)
Salactic Film: 17% (15 mL [DSC])
UltraSal-ER: 28.5% (10 mL) [contains isopropyl alcohol, phenol, polysorbate 80]
Xalix: 28% (10 g) [contains isopropyl alcohol]
Generic: 26% (10 mL); 28.5% (10 mL)
May be product dependent
Cream (Atrix Medicated Formula External)
2% (per mL): $33.47
Cream (Salycim External)
6% (per gram): $17.46
Foam (Salicylic Acid External)
6% (per gram): $3.66
Foam (Salvax External)
6% (per gram): $3.54
Gel (Keralyt External)
3% (per gram): $0.51
6% (per gram): $0.94
Gel (Salicylic Acid External)
6% (per gram): $8.90
Kit (Atrix System 1 External)
2% (per mL): $14.71
Kit (Keralyt Scalp External)
6% (per each): $87.60
Kit (Salicylic Acid-Cleanser External)
6% cream (per each): $300.79
Liquid (DermacinRx Atrix Antibac Wash External)
2% (per mL): $5.33
Liquid (DermacinRx Atrix Clarify Toner External)
2% (per mL): $5.33
Liquid (Salicate External)
10% (per mL): $65.88
Liquid (Virasal External)
27.5% (per mL): $43.65
Ointment (Salicylic Acid External)
3% (per gram): $28.87
Shampoo (Betasal External)
3% (per mL): $0.02
Shampoo (DHS Sal External)
3% (per mL): $0.06
Shampoo (Keralyt External)
6% (per mL): $0.35
Shampoo (P & S External)
2% (per mL): $0.08
Shampoo (Salicylic Acid External)
6% (per mL): $2.50
Solution (Gordofilm External)
16.7-16.7% (per mL): $1.07
Solution (Salicylic Acid ER External)
28.5% (per mL): $27.28
Solution (Salicylic Acid External)
26% (per mL): $39.28
Solution (UltraSal-ER External)
28.5% (per mL): $60.44
Solution (Xalix External)
28% (per gram): $4.20
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
For external use only; not for ophthalmic, oral, or vaginal use. Avoid contact with eyes and mucous membranes. Discontinue use if excessive peeling or stinging occurs. Unless hands are being treated, wash them thoroughly after application.
Acne products: Do not apply to broken skin or large areas of the body. Except for products intended for use while bathing, apply to clean, dry skin. Creams and gels should be applied in a thin layer to the affected area only. Products used for cleansing should be massaged gently into wet skin, worked into lather and rinsed thoroughly. For products used as a mask, apply a thin layer to the face, avoiding mouth and eyes. Allow to dry for 5 minutes or until mask turns white. Once mask has dried, rinse thoroughly and pat dry. Medicated pads should be used to cover affected area with thin layer of salicylic acid; do not leave pad on skin. Bath gels should be massaged over skin prone to acne while in the shower or bath; rinse well.
Bensal HP: Rinse area with water or saline. Pat dry. Using a cotton tipped applicator, apply thin continuous layer (~1/8th inch thick) directly to wound or to a dry gauze to place directly over wound. Do not use wet-to-dry dressings or wet-packs (will dilute ointment and decrease efficacy). Slight burning may occur for 3 to 5 minutes after application. Apply dressing to shield the area from clothes or exposure to water or dirt; expose treatment area to air when possible.
Corn and callus products: Allow affected area to soak in warm water for 5 minutes and allow dry thoroughly before applying product.
Keralyt gel: If applying to scalp, may wash off with warm water or Keralyt shampoo.
Keralyt shampoo: Apply to affected areas of dry scalp; leave on for 5 minutes and then rinse off with water or nonmedicated shampoo; gradually increase treatment time up to 1 hour. Alternatively, may apply as a medicated shampoo; wet hair and apply to scalp; work into lather, leave on for several minutes, then rinse.
RayaSal cream, Salycim cream: Hydration by wet packs or bath prior to applying may enhance the effect. Rub into the affected area until completely faded; it is recommended to occlude the area at night and wash off in the morning. A bland cream or lotion may be applied if affected area has excessive drying or irritation. Do not apply to broken, inflamed, or exudated skin.
Salicate liquid: May clean area prior to administration using an isopropyl alcohol prep pad to degrease the skin and remove any oils, dirt, or impurities; do not use if skin is sensitive. Apply in a circular motion evenly over the affected area using a gauze or cotton pad; leave on skin for up to 1 minute and then flush skin with cool water. May layer to increase penetration and create a deeper exfoliating effect. Not everyone will experience visible peeling; this does not mean the liquid is not working. Do not apply to sensitive areas or open wounds. Avoid exfoliating agents, hair removal products (including shaving or waxing), masks, self-tanners, or scrubs for at least 48 hours prior to administration; stop AHA, BHA, and vitamin A topical products 2 days before administration. Avoid sun exposure and tanning for 1 week prior to and 1 to 2 weeks after treatment. If redness persists for ≥30 minutes, decrease the contact time with the next application or discontinue use.
Salvax foam: Shake vigorously before use; turn nozzle down to dispense foam. Rub in until completely absorbed.
Wart products: After soaking in water for 5 minutes, may remove loosened wart tissue with a brush, wash cloth, or emery board prior to drying skin and applying medication. For products in a collodion-like vehicle, avoid inhaling vapors.
Topical: For external use only. Not for ophthalmic, oral, anal, or intravaginal use. When applying in concentrations >10%, protect surrounding normal tissue with petrolatum. Discontinue use if excessive peeling or stinging occurs. Unless hands are being treated, wash them thoroughly after application.
Acne products: Do not apply to broken skin or large areas of the body. Except for products intended for use while bathing, apply to clean, dry skin. Creams, gels, and lotions should be applied in a thin layer to the affected area only. Products used for cleansing should be massaged gently into wet skin, worked into lather and rinsed thoroughly. For products used as a mask, apply a thin layer to the face, avoiding mouth and eyes. Allow to dry for 5 minutes or until mask turns white. Once mask has dried, rinse thoroughly and pat dry. Medicated pads should be used to cover affected area with thin layer of salicylic acid; do not leave pad on skin. Bath gels should be massaged over skin prone to acne while in the shower or bath; rinse well.
Corn and callus products: Allow affected area to soak in warm water for 5 minutes and allow to dry thoroughly before applying product.
Keratolytic products:
Keralyt gel: If applying to scalp, may wash off with warm water or Keralyt shampoo.
Keralyt shampoo: Apply to affected areas of dry scalp; leave on for 5 minutes and then rinse off with water or nonmedicated shampoo; gradually increase treatment time up to 1 hour. Alternatively, may apply as a medicated shampoo; wet hair and apply to scalp; work into lather, leave on for several minutes, then rinse.
Salvax foam: Shake vigorously before use; turn nozzle down to dispense foam. Rub in until completely absorbed.
Bensal HP: Rinse area with water or saline. Pat dry. Using a cotton tipped applicator, apply thin continuous layer (~1/8-inch thick) directly to wound or to a dry gauze to place directly over wound. Do not use wet-to-dry dressings or wet-packs (will dilute ointment and decrease efficacy). Slight burning may occur for 3 to 5 minutes after application. Apply dressing to shield the area from clothes or exposure to water or dirt; expose treatment area to air when possible.
Wart products: After soaking in water for 5 minutes, may remove loosened wart tissue with a brush, wash cloth, or emery board prior to drying skin and applying medication. For products in a collodion-like vehicle, avoid inhaling vapors.
Acne vulgaris: Topical management of acne.
Dermatitis: Bensal HP: Treatment of inflammation and irritation associated with dermatitis, including eczematoid conditions and complications associated with pyodermas; treatment of insect bites, burns, and fungal infections.
Hyperkeratotic skin disorders: Removal of excess keratin in various hyperkeratotic skin disorders and psoriasis (including affected areas of scalp, skin, and feet); treatment and removal of common and plantar warts.
OTC labeling: Dandruff, psoriasis, or seborrheic dermatitis; removal of warts, calluses, or corns.
Occlusal-HP may be confused with Ocuflox
KIDs List: Salicylates, when used in pediatric patients <18 years of age with suspicion of viral illness (influenza, chickenpox), are identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be used with caution due to risk of Reye syndrome (weak recommendation; very low quality of evidence) (PPA [Meyers 2020]).
Transdermal patch may contain conducting metal (eg, aluminum); remove patch prior to MRI.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Calcipotriene: Salicylic Acid may diminish the therapeutic effect of Calcipotriene. Management: Monitor for reduced calcipotriene efficacy if combined with salicylic acid. Consider separating the administration of these agents by 10 to 12 hours to minimize the risk of this potential interaction. Risk C: Monitor therapy
Salicylates cross the placenta (Østensen 1998). Systemic absorption of topical salicylic acid occurs and varies depending on duration and vehicle (~9% to 25%) and is increased with occlusion (Akhavan 2003). Current guidelines do not recommend salicylic acid for the treatment of psoriasis in pregnant women due to limited safety data and the potential for systemic absorption (Bae 2012). For the topical treatment of acne or warts, salicylic acid can be used in pregnant women if the area of exposure and duration of therapy is limited, although other agents may be preferred (Murase, 2014). Consider maternal/fetal adverse events associated with aspirin if significant systemic exposure occurs (Akhavan 2003).
Salicylates are excreted in breast milk after oral administration (Bar-Oz 2003). Systemic absorption of topical salicylic acid occurs and varies depending on duration and vehicle (~9% to 25%) and is increased with occlusion. Consider adverse events associated with aspirin in nursing infants if significant systemic exposure occurs (Akhavan 2003). For the topical treatment of warts, salicylic acid can be used in breast-feeding women (systemic absorption is usually minimal) (Butler 2014). Breast-feeding women should avoid use around the chest area to prevent exposure to the nursing child. Due to the potential for serious adverse reactions in the nursing infant, the manufacturer recommends a decision be made whether to discontinue nursing or the drug, taking into account the importance of treatment to the mother.
Signs of salicylate toxicity
Produces desquamation of hyperkeratotic epithelium via dissolution of the intercellular cement which causes the cornified tissue to swell, soften, macerate, and desquamate. Salicylic acid is used for keratolytic skin disorders at concentrations of 3% to 6%; concentrations of 5% to 40% are used to remove corns and warts; concentrations up to 2% are used for acne (Akhavan 2003).
Onset of action: Treatment of warts: 1 to 2 weeks; full resolution may take >4 to 6 weeks.
Absorption: Salicylic acid gel 6%: >60% (under occlusion). Percutaneous; systemic toxicity unlikely with normal use
Protein binding: 50% to 80% to albumin
Time to peak, serum: Salicylic acid cream 5.9%, salicylic acid gel 6%: Within 5 hours of application with occlusion
Excretion: Urine (Salicyluric acid [52%], salicylate glucuronides [42%], and salicylic acid [6%])
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
