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Since the coronavirus pandemic took over, masks have become a standard accessory in our efforts to avoid catching and spreading COVID-19.
But since we started donning these fabric and cloth creations, more and more people have found that their skin isn’t quite as clear as it was before. Maskne (or mask acne) is a common condition, but luckily, there are a number of ways to prevent and treat it.
What is maskne?
Since masks became a thing in 2020, reports of mask-related skin problems have been on the rise. Maskne (a clever term that combines the words acne and mask) refers to any type of skin irritation or blemishes that arise from or are made worse by wearing a mask.
For some, this might be raised bumps, redness or itchiness, while others report irritation or breakouts. There are also a number of conditions that can be made worse by masks, including acne, skin allergies, and more.
Causes of maskne
The causes of maskne are diverse. Even though the term refers to clogged pores and zits, masks can cause all kinds of skin problems and exacerbate others, especially if you have sensitive skin.
Many of us haven’t seen a zit since high school, but others battle with their skin daily, using a range of carefully curated products to treat acne-prone skin and avoid clogged pores, blackheads, or full-blown eruptions.
Any disruption in the delicate balance of our skin barrier––whether due to stress, hormones, or eating different foods––can worsen conditions like acne. This is a result of inflammation, blockage, and infection in the follicles that support and nourish the hairs on our bodies (Teo, 2021a).
Pressure or contact with the skin can also cause breakouts. This is known by dermatologists as acne mechanica. In the case of mask-wearing, the material rubs against our skin as we’re out and about, exacerbating underlying skin problems or creating entirely new ones.
Folliculitis happens when there’s an infection in the hair follicles and is often accompanied by ingrown hairs. Folliculitis is commonly caused by shaving. When a hair is cut short, skin can grow over it, trapping skin bacteria inside. As the growing hair tries to push out through the skin, it gets trapped and can start to grow down into the skin instead.
If you’re prone to developing ingrown hairs on your face, you may have noticed a mask makes it worse as the rubbing of material on your skin can make irritation worse.
If just putting on a mask leaves you with red, itchy skin, you might be experiencing contact dermatitis. This is a type of allergic reaction that typically gets worse the longer you’re in contact with whatever is the irritant.
Contact dermatitis can be caused by a long list of things like detergents, metals, and fabrics. As soon as you figure out the cause and avoid it, the rash usually resolves quickly. Some people are more susceptible to contact dermatitis and experience it frequently (like whenever they wear a watch or try a new fabric softener). That means wearing a mask can cause flare-ups, too.
Blackhead vs. whitehead vs. pimple: what’s the difference?
How to get rid of maskne
No matter the cause of your maskne, you shouldn’t wear the same mask for days at a time. If you’re opting for disposable masks, change them daily and steer clear of that crumpled, slightly dirty mask wedged between the seats in your car. And no––flipping the dirty side in so no one sees it’s got leftovers on it from lunch isn’t a good idea.
If cloth masks are your vibe, be sure to wash them frequently. Make sure you have enough masks in the house to switch daily and try to wash them between every use. You can throw them in with your regular laundry, just make sure to use a mild detergent. Since the skin on our face is more sensitive than skin elsewhere, some people develop reactions to certain products.
If contact dermatitis resonates with what you’re seeing on your face, a little trial and error may be necessary before finding the right product. Baby detergents are usually a safe bet but if you find you’re still itching after that, try an all-cotton mask and wash in hot water without detergent, if you can. Beware of shrinkage, though, and start with a larger size than you need.
If you’re noticing blackheads, whiteheads, and pustules in the general mask region, it’s likely a regular old acne breakout. Treatment starts with prevention. Keeping up with mask hygiene and getting into the habit of a skincare regimen can help.
Starting up a skincare routine
Three products should be enough, but if you love a host of little bottles on your counter who are we to judge? Here are some basic recommendations when it comes to treating acne and keeping skin feeling fresh and healthy.
Start with a gentle cleanser. Those harsh, abrasive cleansers that we once thought were our friends have filled the ocean with microplastics and done not much more.
Our skin has protective oils that should stay in place, so if you’re getting that “squeaky clean” feeling from your face wash, it’s time to tone it down a notch. Instead, opt for something like a squalene cleanser or cream cleanser that leaves your skin feeling soft and supple. Aim to wash your face twice a day––right after you wake up and right before you go to bed––and pat skin dry with a clean towel (Del Rosso, 2013).
For those staring at blackheads in the mirror, your best bet might be a combo treatment that contains salicylic acid and benzoyl peroxide. That winning pair is great for preventing and treating blackheads, clogged pores, and breakouts. Other great ingredients include niacinamide and retinoids. Keep in mind that a little goes a long way, especially with retinoids. Avoid putting treatment creams on open pustules or anything you’ve picked at (Fox, 2016).
If your face is irritated rather than clogged, opt for more mild treatments like zinc or sulfur-containing products, which are typically available over-the-counter (Teo, 2021b). If you’re not sure which topical treatment is best, consult with a dermatologist for advice.
Slather on the moisture in the evening, especially if you’re using a drying treatment that contains retinoids or salicylic acid. Moisturizers that contain ceramides are particularly hydrating and can improve the skin barrier.
No matter what products you use, don’t step outside without an SPF sunscreen. Even if it’s cloudy or rainy or you have darker skin and never get a burn. The sun is the best way to get yourself a fancy set of fine lines and wrinkles, and your skin is more sensitive to sunlight when using zit-clearing products like retinoids, so cover up.
How to build a skincare routine: basics, steps, products
If you usually wear full coverage makeup, it may be time to pull back on the area under your mask. Makeup can trap dirt, sweat, skin cells, and bacteria on your face and wearing a mask on top of that can make it worse.
Bacteria from your mouth gets trapped in the mask’s fabric, and the constant contact between that and your skin makes it easier for breakouts to happen. Aim for non-comedogenic products (products that don’t clog your pores). No need to worry about the science, it explains it right on the label.
It may seem silly, but there’s actually an optimal way to take your mask off and put it back on.
Some experts recommend that while you eat, you should pull your mask down under your chin rather than letting it dangle from one ear. This reduces the chance that particles from your food will get trapped in your mask and irritate your skin further (Teo, 2021a).
When you remove and replace your mask, avoid touching the inside. Your hands are covered in bacteria that can contribute to skin irritation. Make sure your mask fits properly and for the love of Louis Vitton, don’t touch your face. It’s hard. We know. But the more you touch your face, the worse it gets. And when it comes to protecting yourself from the coronavirus, touching your face is a big no-no.
Get a mask that’s snug at your nose bridge and under the chin but a little looser on your face. This ensures optimal protection for those around you from any sneezes or coughs and doesn’t require constant adjustment and touching on your part.
Wash your hands before touching your mask and after every time you use the restroom. Keeping a handy bottle of hand sanitizer in your bag is also a great trick.
Despite its challenges, wearing a mask has proven to be a valuable tool to protect against the coronavirus. Though pimples and acne can certainly be annoying, it’s a small price to pay for staying healthy and preventing the spread of disease.
- Centers for Disease Control and Prevention (CDC). (2020, June 28). Use Cloth Face Coverings to Help Slow Spread. Retrieved July 27, 2020 from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html
- Del Rosso, J. (2013). The Role of Skin Care as an Integral Component in the Management of Acne Vulgaris: Part 1: The Importance of Cleanser and Moisturizer Ingredients, Design, and Product Selection. The Journal of Clinical and Aesthetic Dermatology, 6(12), 19-27. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997205/
- Fox, L., Csongradi, C., Aucamp, M., Du Plessis, J., & Gerber, M. (2016). Treatment Modalities for Acne. Molecules, 21(8), 1063. doi: 10.3390/molecules21081063. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273829/
- Teo, W. L. (2021a). The “Maskne” microbiome – pathophysiology and therapeutics. International Journal of Dermatology, 60(7), 799–809. doi: 10.1111/ijd.15425. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33576511/
- Teo, W. L. (2021b). Diagnostic and management considerations for “maskne” in the era of COVID-19. Journal of the American Academy of Dermatology, 84(2), 520–521. doi: 10.1016/j.jaad.2020.09.063. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013758/#ijd15425-bib-0001
- Van Rensburg, S. J., Franken, A., & Plessis, J. L. (2019). Measurement of transepidermal water loss, stratum corneum hydration and skin surface pH in occupational settings: A review. Skin Research and Technology, 25(5), 595-605. doi: 10.1111/srt.12711. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/srt.12711
Dr. Mike is a licensed physician and the Director, Medical Content & Education at Ro.