Masks and face coverings are crucial in reducing the spread of COVID-19, but they can also cause an unfortunate side effect – dubbed ‘maskne’ or ‘mask acne’ – presenting as spots, redness or inflammation on your mouth, cheeks, and jawline.
You don’t need to wear protective gear for hours on end to experience this unwelcome side effect. However, healthcare and other essential workers are most at risk of suffering from skin issues, due to tighter-fitting masks worn for longer periods of time.
Here, we speak to three dermatologists to find out what causes maskne, how to treat the condition, and the steps you can take to minimise the chance of a mask-induced breakout:
What is maskne?
A rise in stress levels associated with the coronavirus outbreak has, without question, caused flare-ups of pre-existing acne and other related skin conditions – but in addition to this, a new type of acne, dubbed ‘maskne’, has also surfaced, says Dr Faheem Latheef, consultant dermatologist and honorary senior lecturer.
‘This is characterised by little pimples that appear at sites occluded by face masks worn during the pandemic, which have featured heavily in social media posts of healthcare workers who have worn masks for prolonged periods,’ he explains. ‘With the government now having issued guidance on use of face masks for the public as well, this is likely to become an increasing problem.’
What face masks cause maskne?
Maskne can occur with a variety of different masks, including medical, cloth, or paper masks. The term may be new to the public, but among medical professionals, it was well-recognised prior to the pandemic, says Dr Latheef, and is usually seen ‘among professions that have to wear PPE all day, and athletes wearing helmets and baseball caps. As dermatologists, we refer to this as acne mechanica.’
What causes maskne?
Acne mechanica usually occurs when skin is pressed against heavy clothing or bulky protective gear, says Dr Stephanie Munn, dermatologist at Bupa UK. ‘In the early stages, your skin may just feel rough or bumpy,’ she explains. ‘But as acne mechanica progresses, these tiny breakouts can become irritated and progress to more obvious, inflamed blemishes.’
This is due to the environment beneath the mask. Sweat, skin oils, and bacteria become trapped on the skin beneath your mask, which is already irritated due to a combination of the material rubbing against the skin – this breaks down the skin’s barrier – and higher-than-usual moisture levels.
‘The mask’s closed or occlusive environment and lack of oxygen does not allow our skin to function normally,’ explains Dr Sujata Jolly, dermatologist and founder of Clinogen Laboratories. ‘High humidity and heat cause pores to be blocked – as this happens sebum is trapped, this encourages bacterial growth leading to inflammation and spots.’
In more severe cases, mask wearers develop contact dermatitis (dry skin) at pressure points, such as the side of the face, bridge of the nose and behind the ears, Dr Jolly continues, though this is mainly caused by an intolerance to the elastic used in the mask.
How to treat maskne
Before you wear your mask
If you find that wearing a face mask is causing a maskne breakout, you may be able to treat it yourself. ‘Using a moisturiser or protective barrier cream before using a mask and focusing specifically on the pressure points from the masks is highly recommended,’ says Dr Latheef.
‘If you are prone to spots, look for the terms non-oily, non-comedogenic or non-acneiform when selecting your products – the Cetaphil and CeraVe ranges have some very good options,’ he continues. ‘I would also suggest applying these about 30 minutes before putting on the mask to allow them to be effective, while not making it difficult for the mask to stay on.’
After you wear your mask
When you remove the mask, thoroughly wash your face and then apply a hydrating moisturiser. Avoid using harsh products – products containing benzoyl peroxide or a retinol, for example – as these may irritate skin further when combined with the friction from the mask.
‘Avoid wearing make-up until your skin heals, as it can worsen a mask-induced skin problem,’ adds Dr Munn. ‘Make sure you wash your face masks regularly – you can put it in with your normal laundry but try to wash it at 60°C if possible. Use a fragrance-free, hypoallergenic laundry detergent to wash your mask. If you are still experiencing problems, it’s important to consult a dermatologist.’
How to avoid maskne
Prioritise your skincare routine
‘Wash your face with a mild, fragrance-free cleanser and lukewarm water, says Dr Munn. ‘Use your washcloth, mesh sponge, or anything other than your fingertips as they can irritate your skin. It’s important to continue wearing a mask, even when it causes skin irritation.’
Choose your mask fabric
For healthcare workers, the choices of mask are limited, but everyone else should look for a mask that provides as little friction as possible. The fabric of your mask is important – try to avoid synthetic fabrics, such as nylon, polyester and rayon, and opt for washable silk instead.
Get the right fit
‘Make sure your mask fits comfortably – you want a snug fit across your nose, on the sides, and under your chin,’ Dr Munn continues. ‘A comfortable fit may reduce skin problems – if your mask is too tight or slides around, it can irritate your skin.
‘Additionally, you’re more likely to adjust a poorly fitting mask,’ she says. ‘Frequent mask touching can transfer germs from your hands to your mask and your face, which may spread infection of coronavirus, if your hands aren’t regularly washed.’
Skincare and mask fit aside, you should also look after your general health too. ‘Other simple things that you could be doing to prevent spots is to keep well hydrated – which can be challenging if you are wearing a mask all day – and try to eat healthily,’ says Dr Latheef.
Avoid refined sugar and dairy
‘Try to avoid refined sugar and dairy, which have shown some evidence of worsening acne,’ he continues. ‘Anything to help reduce stress and anxiety such as meditation, yoga and mindfulness practices would also help, as there is a strong link between stress and skin disease.’
Take a break
The American Association of Dermatologists has issued guidance to take a break from mask wearing for 15 minutes every four hours, of course bearing in mind if it is safe to do so. This would apply more to healthcare workers but might be relevant to anyone currently wearing masks for many hours of the day.
It is of note that other skin conditions such as eczema, psoriasis and rosacea may also flare up with recurrent mask use so if necessary consult your usual healthcare professional who looks after you for this.
The bottom line
‘Maskne is a relatively new phenomenon and we have seen an exponential growth in the condition due to the coronavirus pandemic,’ says Dr Jolly. ‘It was initially noted in healthcare workers, however the general public are now wearing masks for extended periods of time which has led to a rise in cases of maskne. For now, mask wearing is the new normal, therefore it’s important to learn how to mitigate any skin reactions we may suffer. Maintaining good skin health is essential.’
Last medically reviewed: 24-06-2020
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