Even when other health issues have become less important during these testing times of the COVID-19 pandemic, people still experience dermatological problems like acne. However, the widespread use of face and respirator masks for proper protection has even increased dermatological issues in people around the world. Sure, face masks provide limited viral exposure, but we cannot ignore other related problems and say they don’t contribute heavily to the increase of severe acne cases.
The reason masks are creating a new acne problem lies in several factors, including increased skin surface humidity, changes to surface sebum, and overall changes in the skin microflora. Therefore, the term ‘maskne’ (mask+acne) has come to be one of the most used in regards to acne issues relating to mask-wearing.
So, to provide proper information, and useful preventive recommendations, we’ve decided to tackle the issue of maskne. In the following paragraphs, we’ll in detail about maskne, what they are, how you can handle them, and what can you use to prevent their occurrence in the first place. So, without further ado, let’s get started!
Maskne – Explained
Before we even start discussing possible treatment and preventive methods, we need to understand what maskne is. Maskne is a recently created term for a condition where facial breakouts or acne occur due to COVID-19-related mask-wearing. However, maskne as a concept isn’t new; it did occur even before the pandemic in medical professionals who are required to wear medical masks during certain procedures, for example, or sports professionals who are required to wear helmets.
But, maskne as a global problem, occurring in general public is a new concept. The reason for this is that people are wearing face masks on a scale never seen before. So those who are generally prone to facial breakouts or acne now experience incredible difficulties caused by mask-wearing.
Why Does Maskne Occur?
When face masks are worn for a long or prolonged time, they act as insulators. This creates an environment where the exhaled air is trapped between the mask and the skin surface. The air becomes trapped as we breathe, speak, cough, or sneeze, which adds moisture and humidity to an already humid area. Because of these factors, the area between the mask and the skin surface creates a perfect storm, setting the ground for the microbes to live, thrive, and grow.
Now, this doesn’t have to happen when we wear masks for a short time. But, the way people nowadays wear masks creates the perfect environment for acne and facial breakouts. The environment inside the mask and between the mask and the skin creates a so-called tropical microclimate. This microclimate triggers all sorts of inflammatory acne, red and bumpy rashes (perioral dermatitis), rosacea, bacterial and yeast infections, seborrheic dermatitis (rashing with greasy, yellow scaling), etc.
What Increases The Risk Of Maskne?
So far, experts and dermatologists have a largely observational understanding of maskne. They define it as a disorder of follicular occlusion, related to mechanical stress of mask-wearing (like pressure, friction), and microbiome dysbiosis (moisture from biofluids, heat, and humidity). Therefore, taking into consideration what we know about maskne, we can say the following factors increase the risk or maskne development;
Preventing (And Dealing With) Maskne
1. Skincare Consideration
Special consideration for skincare during the COVID-10 pandemic is essential to keep and maintain a healthy skin barrier against harmful particles.
Utilizing anti-bacterial gentle cleansers, moisturizers, spot acne treatment, and similar products can help prevent the occurrence of maskne, or help deal with maskne after they occur.
For example, the writer of this article (a pretty weird way to refer to myself) uses the following products to keep the skin healthy and maskne-free for several months now;
- La Roche-Posay Toleraine Face Wash – this face wash is incredibly gentle but works very thoroughly in regards to dissolving oil and excess sebum. The face wash does all of this without stripping the skin off its protective barrier. The face wash should be used at least once a day, or as I do it, after a long day of mask-wearing. The face wash will do wonders for both preventing or clearing the skin of acne. It will leave the face feeling smooth and soft, without drying it out and causing more problems.
- THALGO Gentle Cleansing Milk – this cleansing milk is probably one of the best on the market. It does such an incredible job in regards to removing makeup and cleansing the face after a long day of mask-wearing. The cleansing milk can be used in the morning, and before bedtime, but you can use it after you come home and finally remove the mask. The milk will leave the skin feeling clean, fresh, and soft, preventing bacteria buildup and removing the accumulated bacteria on the skin surface. The cleansing milk is suitable for sensitive skin and works for all types of skin in general. Because it is very hydrating, it is recommended to follow the La Roche-Posay face wash.
- Eucerin DERMOPURE Facial Toner – now, this toner does a great job to clean the skin and prevent the occurrence of blemishes and acne. It provides intensive cleansing of the problematic zones and clears the pores. It is recommended for oily and blemish-prone skin, as well as for people who experience mild to moderate maskne. It is great for all forms of acne overall, especially acne vulgaris. The toner contains lactic acid which unblocks pores, prevents bacterial growth, and prevents acne occurrence. It is recommended to follow with the toner after the face wash and the cleansing milk.
- Vichy Mineral 89 Hydrating Serum – to complete the anti-maskne skincare routine, I recommend you use a serum. The best serum in the fight against maskne has been the Vichy Mineral 89 hydrating serum. This one does an exceptional job in keeping the skin hydrated, moisturized, and protected against bacteria, temperature fluctuation, humidity, etc. The serum keeps the skin hydrated throughout the day, keeps it plump and radiating. It is also very lightweight and soaks into the skin almost immediately after application.
This skincare routine should successfully prevent the occurrence of facial breakout or acne for sensitive to normal skin.
Important for dry skin: In the case of dry skin, it is recommended to use additional moisturizers, especially after the face wash and the toner. However, do not overdo it with moisturizing, because they can make the skin oily and sticky, and you don’t want that, especially late into the day when the skin wants to breathe without obstruction. It is also recommended to not overdo the skin with cleansers containing salicylic acid, since they can dry out the dry skin even more.
Moreover, in the case of the existing maskne, you should still follow your skincare routine regularly. However, there needs to be an addition of acne treatment with products containing benzoyl peroxide, salicylic acid (for normal skin type), sulfur, alpha-hydroxy acids, or retinoids. Some of the best products containing these ingredients include;
- CeraVe Salicylic Acid Cleanser – this cleanser is incredibly effective but very gentle to the skin. It is created to give you the necessary salicylic acid exfoliation to get rid of the maskne, while preventing skin damage and sensitizing. The cleanser also contains niacinamide, which is exceptional against acne, acne scars, pigmentation issues, and wrinkles.
- Neutrogena Oil-Free Acne Wash Cream Cleanser – in case of dry skin, salicylic acid cleansers aren’t usually recommended since they can dry the skin out even more. However, the Neutrogena Acne cream cleanser does an amazing job using salicylic acid to treat acne for dry skin. The reason for this lies in the fact that the cleanser has a creamy, hydrating formula, which leaves the skin hydrated and moisturized rather than dry and dehydrated.
- PanOxyl Acne Foaming Wash – this cleansing wash is recommended by almost every dermatologist out there. It contains benzoyl peroxide, so it is great for people who don’t tolerate salicylic acid. The cleanser is great for people who deal with persistent maskne or acne in general, or who want to handle their acne scars. It is recommended, however, to heavily moisturize after the use of benzoyl peroxides cleanser since they’re very intense and tend to dry out the skin.
Note: All of the aforementioned products have anti-inflammatory and anti-oxidant properties. They’re great for sebum regulation, and have anti-microbial properties too, which is what you want when dealing with maskne.
However, if you have exceptionally sensitive skin or the majority of the skincare products don’t work for you, you should consult with your dermatologist before you utilize any of the mentioned products.
2. Dealing With The Issue Source – The Mask
Since the source of the maskne is the very mask that’s protecting us from the virus transmission, I cannot advise you to simply stop wearing the mask. You should be wearing your mask according to the CDC and the WHO recommendations. But, you can always adjust the mask-wearing to your abilities, needs, and preferences. Here are some tips on how you can turn the mask to work for you, and not against you;
- Choose the right mask – if you experience frequent maskne or facial breakout, that means you should wear a mask that gives your skin room to breathe. It is recommended to wear 100% tightly woven cotton face masks to get proper protection against the virus, but also to leave the pressure off the skin. Cotton masks have a higher thread count and minimalize textile-skin friction, which is essential for those with acne and breakout issues. Keep in mind that cotton face masks need to be regularly washed, otherwise wearing them would be counterproductive, since they can get dirty pretty fast.
- Pay attention to the fit of the mask – the way the mask fits your face can be essential to the maskne problem. If the mask is fitting too loosely or too tightly, it is increasing the risk of chafing and textile-skin friction. This unnecessary friction against the skin surface aggravates it and transmits all the microbes from the mask onto the skin. So, make sure to always adjust the earloops by shortening them (you can do this by creating a little knot at the end of the earloops). Or, utilize the bendable nose piece to keep the mask fitting on the top of the nose. However, do not use the nose piece if it doesn’t have the cushion support, since it can chafe and graze the nose.
- Wash the mask – if you’re using a washable mask (N95, KN95, and surgical masks are NOT washable), then make sure to wash it frequently. This way you’ll remove all the oil, saliva, sweat, nasal mucus, and the microbes from the mask, preventing them to cause maskne or facial breakout. You can wash your mask using a non-irritating, gentle soap, and warm water. Once you wash the mask, leave it to dry and store it with your other clean masks, preferably in a closed bag. It is recommended to wash the mask every day.
- Replace the mask regularly – if you’re not wearing a washable mask, then your only option to avoid maskne is replacing the masks you wear regularly. Masks like N95, KN95, and surgical masks can be worn regularly for only a few days (provided they’re clean and haven’t been exposed to coughs and sneezes). So, every few days (up to 5 days max), make sure to get a new, clean mask. This way you can avoid maskne, facial breakout, and further virus transmission.
3. Stay Away From Makeup (Temporarily)
Even though it accentuates your beauty and makes you feel good, makeup isn’t a good friend of your skin (especially when you’re wearing a mask every day). Makeup clogs the pores and prevents your skin from breathing without obstruction. Now, imagine having a layer of makeup as one obstruction, and then a whole mask over your face as the second barrier. Well, that alone calls for a maskne or facial breakout. But, if you do have to wear makeup, here’s how you can do it to avoid maskne issues;
- Skip the foundation – the foundation is the biggest issue here; it directly clogs the pores and leads to acne and other types of pimples. However, if you must wear foundation, try to simply apply it a little bit to the parts of the face which are not covered by the mask. Use a tiny little pump of foundation and cover the exposed areas with a thin layer. Use a foundation that has a lightweight formula to avoid issues with the exposed skin. But, it is recommended to skip the foundation overall, since it is the main issue when it comes to makeup and mask-wearing.
- Skip the lipstick – wearing lipstick doesn’t seem harmful at first. However, when wearing lipstick, you’re going to stain your mask, inevitably. The lipstick residue will eventually end up back on your face as you wear the mask, and this becomes a vicious cycle. Not to mention that you’ll ruin a clean mask, and will need to get a new one asap. And, in a world where there’s a mask shortage, you don’t want to be wasting masks because of makeup.
- Focus on the eyes – because the eyes are not covered by the mask, this is a perfect opportunity for you to experiment with eye makeup. You can go all-in and try out some bold eye looks. That alone can make you feel like you’re wearing a full face of makeup, increase your confidence, and make you feel better overall.
4. What If Maskne Persists?
If you’ve followed the aforementioned recommendations (or your own skincare steps), and the maskne persists, then there are few more things you can do;
- Change your diet – it is a very common thing to go after some comfort food, snacks, and fast food during these testing times. However, such food can deeply affect your skin. Make sure to change your diet, and lean towards fruits, vegetables, and lean meats for the source of comfort. Not only will healthy food keep your skin maskne free, but it will also improve your immune system against the coronavirus. So, it’s a win-win situation.
- Consider face brackets for masks – face mask brackets are silicone plastic frames designed to keep the face mask from touching and irritating your facial skin. The brackets feature small hooks you can use to attach them to the masks. The upper part of a bracket fits over the nose, while the lower part fits nicely against the chin. The face mask brackets have proven to be effective in preventing skin irritation, skin rashes, and acne breakout, and keeping the mask clean when one is wearing makeup.
- Drink plenty of water – water intake is essential for healthy and glowing skin. Regardless of whether or not one is wearing a mask, if you don’t drink enough water, your skin won’t be strong enough against harmful particles, microbes, bacteria, humidity, stress, and the bad food we all eat sometimes. So, make sure to have at least 8 glasses of water every day.
- Try to calm down – stress is never good for you; it lowers your immune system and gets your body all worked up. That is why stress can trigger all sorts of acne and pimples. So, even though it may seem hard, try to calm down. Go for a long walk, start painting, writing, cooking, or find something where you can convert the stress into good energy (like a good workout or exercising). Lowering stress will also help you get better sleep, develop a healthy appetite, make you feel less moody, and of course, have good skin.
- Call your doctor/dermatologist – if the maskne issue persists or worsens, try calling your doctor. Getting a professional opinion can be crucial in your fight against maskne and facial breakout. Some skin conditions require professional evaluation and treatment, so don’t be afraid to pick up the phone and call the people who know what they’re doing.
Getting acne because of wearing mask protection sucks. Luckily, there is a way to deal with such an issue. Try to focus on your skincare and your overall health.
Make sure to eat healthy food as much as you can, drink plenty of water and enjoy the good things in life, even though it may seem hard to find joy in anything nowadays. Make sure to wash your masks regularly, and change them if they’re not washable. This step alone will reduce the risk of maskne drastically. If nothing seems to work, call your dermatologist and consult with them about your next steps in treating maskne.