What is maskne and how is it caused?
As more places are opening up and wearing masks have become a regular part of our daily wardrobe, some people are reporting that they are developing maskne. Dermatologists are reporting that maskne is a new term being used in this COVID-19 face mask area to describe acne, redness and/or irritation in the region of the face where the mask is being worn. Maskne can be seen in Image 1.
Dermatologists worldwide are reporting that maskne is a similar acne response which is seen in those who wear thick make-up for prolonged periods and in helmet straps. Facial redness is observed in the geometric region of the mask mostly at the mask's border which results in people developing an outline which is oval and red. These areas are not only tender to touch but also any cream and lotions that one applies causes stings because the skin barrier has been damaged and therefore the sensory nerves have become hypersensitive to any external stimuli stimulating irritation and inflammation. Technically, this kind of breakout has a clinical name: acne mechanica.
When one wears mask, the mask causes pressure, occlusion and friction on our delicate facial skin. Also when we wear a mask the breath is sealed in the mask and this creates a moist and humid environment. This triggers irritation, rashes and acne. In maskne, one irritates the skin getting pore clogging and then getting proliferation of bacteria and sebum under the skin. Furthermore emotional stress related to COVID-19 and our new "normal" may act synergistically to trigger and exacerbate the facial flares of acne. Miliaria also known as "sweat rash" is a skin disease which is stimulated by sweat trapped in sweat glands present under the skin. Miliaria can be seen in Image 2. Miliaria is being presented as a form on maskne. Miliaria is probably going to be one of the commonest skin maskne, which is going to be encountered in Malta since miliaria is linked to hot and humid conditions especially during the summer season.
How do I know it is maskne caused by my mask?
Tiny shallow whiteheads rather than the deep and painful bumps (which are observed in hormonal acne) are observed. Also one should observe the distribution of the acne. Maskne is reported to be observed along the chinstrap, over the bridge of the nose and the cheeks. Also a mask can cause breakouts if the mask is not washed routinely and the mask has a build-up of dirt and bacteria.
How to prevent and reduce the risk of maskne according to dermatologists and CDC
Dermatologists are reporting that one uses a thick emollient in the junction area between the skin and the mask to prevent and at least reduce friction. On the other hand, CDC is also reporting that after one uses a mask they should either throw it away if it is non-reusable and if it is reusable it should be washed at a temperature of 600C. After washing your hands, removing the mask and washing your hands again, dermatologists recommend that people should apply a moisturizer ideally with anti-acne ingredients such as retinol and purified nano-sulfur but obviously if you are on other products, which have been prescribed by your doctor, you should always consult before changing any products. When you remove your mask it is also recommended to gently cleanse and exfoliate your face. Above all before applying any products to the face it is important to ensure that one is not allergic to the product and consult a doctor in case of any queries.
Rebecca Caruana is a medical student