Salt water for acne: no trial has tested it

No trial has tested salt water on acne, so no source shows that it helps. A 2021 review of salt solution in skin medicine says so in one line: "In dermatology, no large studies investigated the benefits of saline." Saline is the medical word for salt dissolved in water. This page is part of Skinli's guide to home remedies for acne.

Skinli gives general education and is not a doctor. For the studies below, Skinli read the published summaries (abstracts). No source read for this guide gives a recipe for a salt wash or a sea salt spray, so this page gives none.

What the salt studies tested

The searches run for this guide found three records on salt and skin. None of them is about acne.

Study	What was tested	Why it leaves the acne question open
International Journal of Dermatology, 2005	People with dry, eczema-prone skin held one forearm for 15 minutes in a bath with 5 percent Dead Sea salt, and the other forearm in tap water. The salt arm became less rough and less red	The skin was on the forearm and had no acne. The salt was a branded product "rich in magnesium chloride", and the authors link the result to "the high magnesium content". Table salt is a different salt, sodium chloride. The summary gives no number of volunteers
Skin Research and Technology, 2003	Skin irritated on purpose with a detergent in a laboratory, and one boy aged 6 with eczema. The group's earlier work found that sea water left on for 20 minutes eased the irritation	The authors say "seawater or its components would induce a feel of stinging in patients with AD". AD is atopic dermatitis, a type of eczema. They also say: "Although the mineral water would not cure those skin diseases, it could be an adjunctive therapy." Adjunctive means added to the main treatment
Journal of Cosmetic Dermatology, 2021	A review of how skin doctors use saline	The uses it lists are injections, such as saline to dilute a steroid injection and saline injected into sunken acne scars. Its summary reports no use on the skin surface for acne

The NHS acne page and the NICE acne guideline for England do not mention salt, saline or sea water. The same is true of the American Academy of Dermatology (AAD) pages read for this guide.

Salt water on a popped or open pimple

A popped pimple is broken skin, so the advice for small wounds applies. The AAD says of a minor cut: "Use cool or lukewarm water and a mild soap or cleanser to gently remove dirt or debris." The NHS says: "Clean the wound by rinsing it with bottled or tap water, or by using sterile wipes." Neither names salt water.

Clinics often clean wounds with a medical salt solution called normal saline. A 2022 Cochrane review looked at whether it works better than plain water. It found 13 trials with 2,504 participants, who had wounds such as surgical cuts and broken bones with open skin. On infection, "eight trials found the effect of cleansing with tap water compared with normal saline is uncertain". The review's authors rated all the evidence they found as low in certainty or lower.

Two points follow. Medical saline has not been shown to do better than tap water, even on wounds treated in clinics. And salt water mixed at home was not in those trials at all.

Skinli's guide on what to do after popping a pimple covers the next steps. The page on hydrogen peroxide for acne covers a household liquid that is sold for cleaning minor cuts.

Washing, scrubbing and sun

For washing a face with acne, the AAD's advice is specific: "Gently wash your face up to twice daily and after sweating." On the product, it says: "Choose a gentle, non-abrasive cleanser. Apply it with your fingertips, as scrubbing with washcloths, sponges, and other tools can irritate your skin." NICE advises a "non-alkaline" cleanser for acne-prone skin.

Extra washes with salt water count as washes. The AAD says: "Washing your face several times a day can further irritate your skin, leading to more breakouts."

Dry salt rubbed on the face is a scrub. The AAD's guide to exfoliating, which means removing dead skin, says: "Those with dry, sensitive or acne-prone skin may prefer just a washcloth and a mild chemical exfoliator, as mechanical exfoliation may be too irritating for this skin type." Mechanical exfoliation is removal by rubbing, and a chemical exfoliator dissolves dead skin with an acid. The same guide says: "Never exfoliate if you have open cuts or wounds or if your skin is sunburned." The NHS agrees: "do not scrub your skin as this can irritate it and make acne worse". The guide on how often to exfoliate your face covers the gentler options. The page on baking soda for acne covers another kitchen powder that people rub on the face.

A day in sea water is often a day in the sun, and the sources differ on sun. MedlinePlus says a small amount of sun exposure may improve acne, and that "too much exposure to sun or in tanning booths increases the risk for skin cancer." The AAD says: "tanning damages your skin and can worsen acne."

A deep pimple, and what the AAD, the NHS and the FDA rule support

For a deep pimple with no opening, sometimes called a blind pimple, the AAD describes heat and a drug ingredient. It says to "apply the warm, damp washcloth to your pimple for 10-15 minutes, three times daily." It also says: "Choose a product that contains one of these acne-fighting active ingredients: adapalene, azelaic acid, benzoyl peroxide, or salicylic acid." The guide to ice on a pimple covers cold and warm compresses.

The NHS acne page says to "try acne treatments you put on your skin such as salicylic acid or benzoyl peroxide". The FDA rule for acne drugs sold without a prescription lists benzoyl peroxide, salicylic acid, sulfur, and sulfur combined with resorcinol. Salt is absent from that list. The AAD's acne pages name a maker of prescription acne drugs as their supporter. Skinli's guide to benzoyl peroxide explains one of the ingredients that all three sources name.

When to see a doctor

See a doctor if a popped pimple shows signs of infection. The NHS lists them as "hot, swollen and red skin (redness can be harder to see on brown and black skin)".

For the acne itself, the NHS says to see a GP, which is a family doctor, if "you've tried treating it yourself but it's not getting better", or if "you have lots of spots, or the spots are deep, painful or causing scars". The AAD says to see a dermatologist when acne causes cysts and nodules, which are deep blemishes that can leave scars.