Surprising reasons to take aspirin—and when to skip it

Most people know that the occasional aspirin can reduce a fever or soothe a headache. But you might not know just how versatile—and lifesaving—this little pill can be. Here are some surprising uses for the medicine cabinet staple, plus information on when to consider a daily aspirin regimen and when to skip it altogether.

Yes, aspirin’s readily available over the counter, but that doesn’t necessarily mean it’s safe for you to take every day. The decision on whether to start a daily aspirin regimen should be made carefully between you and your healthcare provider (HCP) based on factors including:

• Your personal health history, including your risk for bleeding
• Your family medical history, including any relatives who have experienced heart disease, cancer, or stroke
• Any other medications or supplements you take or teas you drink
• Your drug allergies, as well as any negative reactions you might have had to aspirin in the past

Your HCP should also weigh in on your potential dosage, including whether a low-dose “baby aspirin” (typically 81 milligrams) makes sense for you. They should also guide you on how often to take aspirin and if you should have it with food. 

Aspirin is considered a nonsteroidal anti-inflammatory drug (NSAID), a category of medication that also includes naproxen and ibuprofen. If you’re allergic to any NSAIDs, you might experience an allergic reaction to aspirin, too. Steer clear if you’re not sure whether you’re allergic or ask your HCP about allergy testing to find out.

People with asthma or nasal polyps are sometimes advised to avoid taking aspirin because it can trigger breathing problems. “People need to be aware that an aspirin allergy can induce asthma or bronchospasm,” says Tara Wickline-Stone, FNP, a nurse practitioner in Moneta, Virginia.

The risks of bleeding stemming from an aspirin may be particularly dangerous for people with certain health issues or those taking other medications to help prevent blood clots. If you have any of the following conditions, your risk of dangerous side effects is especially high:

• Bleeding disorders
• Gastric or peptic ulcers
• Kidney or liver problems
• Low vitamin K levels
• Pregnancy, especially in the third trimester

Aspirin is generally safe for most people, but it can cause mild side effects like heartburn, headaches, nausea, vomiting, diarrhea, and constipation at any dosage. Though less common, some people (especially those with any of the high-risk conditions listed on the previous slide) might experience severe side effects that require immediate medical attention. These include: 

• Difficulty breathing
• Black, tarry, or bloody stools
• Nausea and vomiting (particularly bloody vomit)
• Confusion
• Pain with swallowing
• Severe heartburn or stomach pain
• Yellow eyes or skin
• Ringing in the ears or loss of hearing

Bleeding is another dangerous potential side effect. “Aspirin isn’t advised in people with a history of bleeding disorders such as hemophilia,” says Wickline-Stone. “Also, if you’re currently taking blood thinners, you shouldn’t begin a daily aspirin regimen on your own. This can increase bleeding risk even further.”

Always ask your HCP about the risks, benefits, and your other options before using aspirin. If your HCP deems aspirin safe for you, here are some reasons they might recommend you start taking it.

If you take aspirin daily under medical supervision, it might add an extra candle to your birthday cake. Some large studies that have combined evidence from other studies have found that taking aspirin may reduce overall death risk. But other studies have shown mixed results. More research is needed to learn whether aspirin—and how much of it—may help fend off certain cancers. There are also other factors that may affect the possible benefit of aspirin, including older age and being overweight or obese. 

If you experience heart attack symptoms, first call 911 and if the operator tells you it’s safe and/or your HCP has told you to do so previously, chew a 325 milligram dose of aspirin immediately. (Chewing helps it reach your bloodstream quickly.) The sooner you do both, the better your chances of surviving the heart attack with minimal damage.

Why does aspirin help? Heart attacks start when an area of plaque (a fatty deposit that forms in the wall of a blood vessel) bursts open into an artery. Sticky blood cells called platelets then travel to the area to try to contain or wall off the ruptured plaque. This process causes blood cells to build up, forming a clot that may keep oxygen-rich blood from reaching the heart. If it’s not stopped, this blockage can kill healthy heart tissue. Aspirin helps by keeping the platelets from clumping together.

Note: You should not take aspirin if you experience stroke symptoms because some strokes are caused by brain bleeds and aspirin can make them worse.

After some heart procedures like a coronary artery bypass graft (CABG) or angioplasty, your HCP may recommend you take aspirin daily for life. If this applies to you, it’s essential to stick with this regimen because:

• After a CABG, aspirin can help your graft stay open and prevent complications. (The graft is the healthy vessel that bypasses a blocked artery.)
• After angioplasty, aspirin can keep platelets from clumping together and blocking off your stent, the tiny mesh device that’s inserted in a blocked vessel to help keep it open.

Aspirin is often recommended after a host of other surgeries, as well, since it can help prevent a common complication called deep vein thrombosis (DVT), which is a type of blood clot. (Lying in bed for long periods during recovery raises your risk of developing a DVT.)

Some people find aspirin can be useful for other reasons. Though there’s very little scientific evidence that establishes its effectiveness, it could help address these common complaints:

• Acne: The active ingredient in aspirin, acetylsalicylic acid, is similar to salicylic acid, a common anti-inflammatory ingredient in many acne treatments. Research has not confirmed that aspirin can effectively treat acne, but if you’d like to try this home remedy, crush an aspirin tablet, mix it with a little water or moisturizing lotion, and dab it on a very small area of your skin. If you don’t experience any adverse reaction, you can try applying the paste to a pimple.
• Dandruff: “Salicylic acid is used in dandruff shampoos to decrease flaking,” says Wickline-Stone. Crush aspirin and add it to your shampoo. Let it sit on your scalp for about five minutes, then rinse. (Don’t add to shampoo that already contains dandruff-fighting ingredients.)
• Razor burn: Crush aspirin and mix it with water to form a paste. Place it on irritated areas after shaving to ease stinging and redness or discoloration. Let the paste dry on your skin before rinsing away.

Do not use aspirin to treat a hangover. You may still have alcohol in your bloodstream the morning after drinking. Aspirin combined with alcohol can irritate your stomach’s lining. Some people, including daily aspirin users or regular drinkers, should avoid the combination since it increases their risk of bleeding in the stomach. Consider these safe tips for easing your hangover instead.