How should Algesal (salicylic acid) ointment be used?

How to Use Algesal (Salicylic Acid) Ointment

Algesal ointment containing salicylic acid should be applied as a thin film to affected areas once or twice daily, with initial application of once daily and gradual increase to twice daily if needed and tolerated. 1

Proper Application Method

• Apply a thin layer to the affected area(s) only
• For best results:
  • Wash and dry the area before application
  • Gently massage the ointment into the skin until absorbed
  • Wash hands after application (unless treating hands)
  • If excessive dryness or peeling occurs, reduce to once daily or every other day 1

Dosing Guidelines

• Initial dosing: Apply once daily
• Maintenance dosing: Can increase to twice daily if needed and tolerated
• Duration: Continue for up to 3-4 months for conditions like warts 1
• For thick lesions: Consider occlusion after application to enhance penetration 1

Precautions and Contraindications

• Do not use if:

  • Known hypersensitivity to salicylic acid or any ingredients in the formulation 1
  • On broken or irritated skin
  • On the face or genitals without specific medical direction
  • Over large body surface areas (>20% of body) due to risk of systemic absorption 1

• Use with caution in:

  • Children under 12 years (increased risk of salicylate toxicity) 1
  • Patients with diabetes or poor circulation
  • Pregnant women (Pregnancy Category C) 1
  • Nursing mothers (avoid application to chest area) 1

Potential Side Effects

• Local irritation, burning sensation, or stinging
• Erythema (redness) and mild peeling
• Contact dermatitis in sensitive individuals 2
• Excessive dryness or scaling 1
• Rare risk of salicylate toxicity with extensive use (symptoms: tinnitus, nausea, vomiting, dizziness) 3

Drug Interactions

• Avoid combining with:
  • Other potentially irritating topical products 1
  • Photosensitizing agents
  • UVB phototherapy (salicylic acid decreases efficacy due to filtering effect) 1
  • Other oral salicylate drugs (aspirin) due to risk of systemic toxicity 1

Special Considerations

• For warts: Can be used daily for up to 3-4 months with occlusion for better results 1
• For psoriasis: Acts as a keratolytic agent that reduces scaling by decreasing keratinocyte-to-keratinocyte binding 1
• For acne: Can be used as part of a treatment regimen to help with exfoliation 1

Monitoring

• Watch for signs of excessive irritation or allergic reaction
• If treating large areas, be alert for signs of salicylate toxicity (headache, dizziness, tinnitus, nausea)
• Discontinue use if severe irritation or systemic symptoms develop

Remember that salicylic acid has keratolytic, bacteriostatic, and mild anti-inflammatory properties, making it useful for various skin conditions, but proper application technique and awareness of potential side effects are essential for safe and effective use.