On top of our anxiety and pandemic stress, how you wish we didn’t have to worry about the skin irritations caused by wearing the mask. But “maskne” is real and common—men and women, young and old suffer from it.
Since wearing the mask is something we will have to continue doing for as long as this pandemic persists, we asked dermatologists what you should know about “maskne” and how to avoid it as much as possible. The good news is it can be avoided or minimized.
This Q/A is with Dr. Roy Paredes, Dr. Keza Evangelista, Dr. Raissa Pasion. Dr. Pasion and Dr. Evangelista are fellows of the Philippine Dermatological Society (PDS). Dr. Paredes is a diplomate of the PDS. This interview is facilitated by the You+Intelligence Aesthetics, a wellness and aesthetic center at High Street South Corporate Plaza, BGC, Taguig.
What really is maskne? Is everyone—young and old, men and women—prone to it?
Maskacne is a variant of acne called Acne Mechanica. It is an acneiform eruption caused by friction, pressure, stretching, rubbing, pinching or occlusion of the skin in any individual, regardless of pre-existing acne.
It is characterized by the presence of inflammatory papules, pustules that can progress to nodules and cysts around the areas where the fabric of mask is pressed on the skin, such as cheeks, cutaneous lips, chin and jaw line and even upper side of neck.
Are there specific individuals who are more prone to it?
The most vulnerable individuals who can have Mask-acne are those people with acne-prone skin, oily skin, and sensitive skin. It can exacerbate underlying acne vulgaris, rosacea and peri-oral dermatitis. It is also common in very active people, most especially after intense activities which cause heat and friction between sweaty skin and protective gear. Prolonged friction and occlusion may lead to skin irritation.
What are its effects, from bad to really worse?
If it is neglected, patient could develop numerous inflammatory papule and pustules around the area where the mask is pressed on or where the mask fabric rests on the skin. If the lesions are not controlled, it may also lead to post- inflammatory hyperpigmentation and even scarring.
Can one avoid it totally even if one wears a mask? How?
Yes it is possible, first thing to do is make sure to practise proper hygiene. Cleanse and moisturize your face daily. Choose a moisturizer formulated for your skin type. For oily skin and acne-prone skin, choose a gel moisturizer, for normal or combination skin, choose lotion; for dry and very dry skin, choose cream.
Make sure to choose the correct protective masks that are not irritating. Be meticulous in choosing the mask fabric you will use every day. Have a habit of changing your disposable masks frequently most especially if you are using it for several hours.
You let your skin breathe. Minimize wearing thick makeup or foundation that will clog your pores. If makeup is necessary, use only products that are labeled non-comedogenic and/or non-acnegenic. Avoid products that further irritate your skin.
For the active lesions, it would be wise to seek a board-certified dermatologist for proper assessment and treatment of existing acne and acne breakouts.
Use mask made of soft, breathable fabrics
Or how can one lessen its effects?
To lessen having acne break-outs or to avoid development of mask-acne, make sure to have frequent change of masks, especially the disposable ones. To reduce skin problems, look for masks that offer the following:
1) A snug, but comfortable fit
2) Soft, breathable fabrics such as cotton or silk
3) Avoid synthetic fabrics such as nylon, polyester and rayon on the layer that rests against your skin. This fabrics are more likely to irritate your skin and cause acne-flare-ups.
According to the American Academy of Dermatology, it’s safe to take a 15-minute break every four hours. You can remove your mask when it’s safe to do so and after washing your hands. Remove your masks six feet away from people, when you’re alone or at home. Make sure to dispose masks in a proper trash bin to avoid contamination.
It is said that the prolonged use of face masks causes deep lines and hyperpigmentation? What can be done as remedy? Some individuals such as medical frontliners are compelled to wear tighter and thicker medical-grade masks. Can this contribute to sagging of the skin?
Since the start of the pandemic, healthcare workers and people who use masks for prolonged periods have noticed deep furrows and friction lines on their faces after hours of mask use. Some develop red marks from the pressure caused by masks. Mask wearing, despite these side effects, is a necessary protection during these times.
It is important to take steps to improve the skin’s integrity and natural barrier function to lessen these side effects. Hydrate the skin daily with moisturizers containing ceramides and hyaluronic acid. Well-moisturized skin is less prone to the irritation and inflammation (which can lead to hyperpigmentation) caused by the borders of masks. When cleansing the face, use a mild and non-soap cleanser as regular soap can dry out the skin and make it more prone to irritation.
Remember to wear a broad spectrum sunscreen, especially on the upper half of the face, before putting on the mask. The use of “ear protectors”—a thin plastic band that goes around the back of the head so the mask loops are attached to it rather than the ears, may also help to relieve some of the pressure and irritation caused by the mask.
No studies done to suggest that wearing mask causes facial sagging
Facial sagging and wrinkling has been linked to many intrinsic and extrinsic factors— some of which are genetics, age, sun exposure, nutrition, smoking, pollution and stress. Some have suggested that tight fitting masks such as N95 masks may accentuate facial wrinkling due to the compression and distortion of the skin. As of now there have been no studies done nor is there concrete evidence to suggest that wearing mask causes facial sagging. The usual preventive measures to prevent and treat aging skin such as sun avoidance and protection, adequate skin moisturization, the use of topicals to stimulate collagen plus in-clinic options such as injectable toxins, dermal fillers and energy-based devices can be employed.
What are dermatological solutions to maskne?
Use mild, fragrance-free products
Limit face washing to 2x/day and after sweating
Apply moisturizer before and after wearing your mask. Apply petroleum jelly to your lips to avoid dryness
Is there a daily routine one can adopt to avoid or even lessen maskne?
Minimize friction. Don’t continuously touch or rub your masks. Do not manipulate the existing lesions. The more you try to get rid of them using your bare hands, the more you will induce inflammation and inoculation of bacteria into the skin leading to skin dyspigmentation, and even worse, scarring.
Must one resort to drastic procedures? When?
Simple maskacne can be managed at home. But complex cases of maskacne can be treated by board-certified dermatologists.
What types of skin care products do you recommend to help solve maskne?
To address inflammatory lesions, you can choose products or apply topicals such as clindamycin, erythromycin, benzoyl peroxide, niacinamide and azeleic acid in the morning and topical retinoids in the evening. You can also do exfoliation once or twice a week using gentle AHA such as glycolic acid or BHA such as salicylic acid. Application of topical medications must be supervised by a board-certified dermatologist. The above mentioned topicals are used in various combinations according to your skin’s sensitivity and irritant threshold.
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