It is now common knowledge that wearing a face mask is an important and effective tool to protect ourselves and our loved ones from getting sick during the COVID-19 pandemic. All you have to do is leave your home and you’ll be greeted with a sea of masked faces wherever you go. Given that this is our new way of life, you should be aware that prolonged mask-wearing can have some detrimental effects on your skin health. Prolonged mask-wearing can cause anything from acne with or without dermatitis, to pressure injuries and skin sores. Any of these can leave you with long term scars if they are not treated properly. Our goal is to give you some tips on how to prevent and treat these skin conditions if you develop them during the pandemic to help you preserve the health and appearance of your skin.
‘Maskne’ is how skin specialists and dermatologists call the spectrum of skin conditions that result from wearing a face mask over a long period of time. Although they do an excellent job at protecting us and others from contracting the coronavirus, face masks trap heat, sweat, and saliva on our face that accumulate when we breathe and speak with the mask on. This combination of heat, sweat, and saliva creates the perfect environment for skin germs (bacteria and fungi) to thrive, which can lead to the clogging and infection of skin pores. This chain of events leads to acne formation and the exacerbation of other skin conditions that irritate the skin of the parts of your face covered by the mask.
Some of the many skin conditions that can be caused by prolonged use of the face mask include acne, dermatitis, pressure sores and ulcers, allergic reactions or a combination of any of these. If you are unsure of what is affecting your skin, we recommend that you consult with your dermatologist or skin care specialist so that you can start the process of treating your skin condition as soon as possible to prevent further exacerbations and long term scars.
Is your face mask causing acne?
Acne develops on your skin when your pores become clogged with oil, dead skin cells and dirt. This accumulation causes inflammation to the skin glands allowing bacteria to thrive. The moisture trapped under a face mask is the perfect breeding ground for acne. Wearing a face mask for prolonged periods of time can promote the formation of acne in non-acne sufferers and worsen breakouts in people who already suffer from acne. Given that all of us must wear the mask for our protection during the pandemic, the best way to treat acne caused by prolonged face mask use is to keep your face clean and minimize the accumulation of oil, dirt, pollutants, and sweat on your face.
Start and finish your day by cleansing your skin well and using products that keep the pores open. When you are wearing your mask, avoid using makeup that covers your pores because it can clog your pores further and exacerbate ‘maskne’. You should also try to wear a clean fabric mask or a new disposable mask every time you change your mask to prevent dirt further clogging your pores. If you use topical acne medication, we recommend our own patients apply it at night and not while they are wearing their face mask. We do advise that you contact your own dermatologist or skin care specialist to discuss your care and recommendations specific to you.
Is it dermatitis?
If you develop a rash on your face in the distribution of your face mask, your skin may be reacting to chemicals or ingredients used to fabricate the mask. This is called contact dermatitis and given that fungus thrives in moist environments, it is reasonable to suspect fungal dermatitis. With fungal dermatitis, you will experience itchy skin and your skin may look flaky and red with tiny bumps on your face over the area covered by the mask.
While exposing your skin to the air is a good first step, it is best that you contact your dermatologist or skin care specialist. They may treat you with prescription topical antifungal medications and guide you on how to treat your symptoms. If you wear a fabric or cloth mask, your skin can be irritated by the detergent or fabric softener you used to wash the mask. Take the appropriate steps to use gentler detergents or soaps until your skin no longer reacts to your cloth mask.
Could it be a pressure sore on your face?
Whenever you wear a face mask, especially when you are wearing an N95 or a mask that creates a tight seal on your face, you have to be mindful that the area that touches your skin, and particularly your nose, can cause pressure sores or tissue injury. These skin sores are caused by continuous pressure from the mask on your skin tissues. Pressure sores will look different on different people depending on skin color and the degree and depth of the tissue that is injured. They can look pink, red or darker in color and the area may be painful to touch.
If the area is pink or red this likely means that you are dealing with a stage 1 pressure sore. These will likely improve once you allow the skin to breathe and remove the mask which is causing pressure to that area of your skin. If you do not remove the mask at this stage, these can progress to stage 2 pressure sores which will typically develop blisters. If you do not relieve the pressure causing a stage 2 sore, these can develop into deeper tissue injuries with ulcers and will heal with a scar on your skin. The sign to look out for is bluish discoloration of the skin which can be difficult to see on darker skin tones. Bluish discoloration is typically a sign of deep tissue injury (DTI) and can develop in as little as two hours from constant pressure of a tight face mask. If you notice signs of DTI, you must immediately remove the mask, away from other people, and switch to a less tight mask if it is possible and safe to do so. Next, contact your dermatologist or skin care specialist to discuss the next steps in treatment.
Tips to prevent ‘maskne’
Here are some tips to help you reduce ‘maskne’ and to optimize your skin health when you are wearing your face mask frequently or for prolonged periods of time:
– Always use a new and clean face mask on a freshly cleansed face
– Apply a non-comedogenic cream to your face 1 hour before wearing your face mask. Using an appropriate moisturizer will reduce friction from the mask that may decrease the risk of skin abrasions and irritation on your face.
– When changing your face mask, always change it to a new and clean face mask if possible
– Before you remove your mask, be sure to wash your hands with soap and water or hand sanitizer first
– Cleanse your face after removing your mask at the end of the day. When cleansing your face, you must always use a gentle cleanser that is appropriate for your skin type. At all costs, you must avoid using an abrasive cleanser that could irritate your skin. After cleansing your skin, apply a non-comedogenic moisturizing cream. Non-comedogenic creams contain ingredients like ceramides and hyaluronic acid that will not clog your pores.
– Make sure your mask fits properly on your face without pressure points or being too tight. This will help you avoid DTI and pressure sores.
– If you use makeup, we recommend that you give your face a break, especially if you already have ‘maskne’. Don’t wear makeup especially in areas covered by the face mask. Wearing makeup under your mask will contribute to clogging your pores, which can cause breakouts.
– If you use reusable cloth masks, you should wash your mask daily. Use warm water with a mild detergent after every use to get rid of the oil, dirt and germs that accumulate during the day. The best cloth masks for your skin health are masks made of cotton or silk fabric because these materials will allow your skin to breathe. They are also less likely to cause an allergic reaction or dermatitis. Furthermore, they create less friction and are less likely to cause skin abrasions and irritation.
– If you have ‘maskne’, we recommend that you supplement your nutrition to enhance skin healing. Include a multivitamin in your diet. Vitamin C, vitamin D, Vitamin B5, Omega 3 fatty acids, Zinc, Selenium, and probiotics are all great vitamins and nutrients that boost the immune system and optimize healing.
– Don’t forget to apply your sunscreen, SPF 30 or above, particularly to areas affected by ‘maskne’ before you leave your home.
Make sure that when you have ‘maskne’, you consult a dermatologist or skin care specialist to discuss your care and the best treatments available for your specific skin condition. Mismanaging your ‘maskne’ could lead to long term consequences and unsightly scarring which may not be so easy to treat.
With the COVID-19 vaccine soon becoming available, hopefully at some point in the not so a distant future, daily mask wearing and ‘maskne’ may become a thing of the past. Let’s all try to make it to the finish line with healthy skin and in good health!
I hope this helps!