COVID19 & Maskne

One day going with one of my colleagues for the lunch during office hours, I noticed she feeling very uncomfortable wearing mask but at a time she denied to take off mask until food arrived. As soon as our order arrived, she took off her mask and I noticed a visible circle of red acne around her mouth. She was feeling very uncomfortable and I saw her feeling awkward because of those acne. So, I thought not to ask about those acne.

After few days, I saw another young lady in the office with the same problem; acne around mouth and she was repeatedly telling her friends that her acne is getting more worse wearing mask after COVID19. This made me think whether these acnes are associated with wearing mask or it’s just a coincidence. Later on, I went through different articles at Internet and got to discover that those acne were maskne, which is significantly associated with wearing mask.

What is Maskne?

Technically Maskne is a type of ‘acne mechanica’ as simple as acne caused by the result of mechanical friction of mask against skin. The mask we often wear exhibits friction against our skin resulting into inflammation and irritation of skin impacting skin pores ultimately resulting into acene and is also exacerbated by moisture absorption by mask from humidity and sweating. Maskne is mainly due to continuous textile skin adherence and friction, which creates hot-humid environment within mask modifying skin microbiota and sebum production. Maskne is mainly due to occlusion blocking facial pores and lack of enough oxygen needed for healthy skin resulted by mask as blockage. It happens when people wear tight/very tight mask for longer period of time comparatively. Maskne includes several skin conditions like acne, rosacea, irritant contact dermatitis, atopic eczema, folliculitis, urticaria

It may be embarrassing for many individuals having a significant circle of acene around nose and mouth.

Causes of Maskne

Maskne may be acne breakout or just an irritation and itching around areas wearing mask.

1. Mechanical Force- Friction of mask irritates small hair follicles triggering inflammation and resulting into an acne. Maskne may be result of clogged pores triggered by friction caused by mask.

2. The humid and occlusive environment- When we breathe out and talk, mask acts as blockage to some level creating humid and warm environment within it, which favors natural growth of yeast, bacteria and other skin flora (demodex- a natural skin flora a kind of mite).

3. The material of mask also can be allergic to some skin and can result into mask acne.

These friction and humid occlusive environment can result into acne (maskne), rosacea flareups and other skin conditions like perioral dermatitis, atopic eczema, folliculitis, urticaria and seborrheic eczema. Researches showed that high temperature created due to prolonged mask can affect rate of sebum secretion and increased humidity can cause increase in squalene in the skin resulting into maskne.

Common Symptoms

Mostly maskne can found on chin area (O-area) than on cheeks and can appear as mild popular eruptions, with seborrhea and comedones along with irritation.

Management

1. As of now, wearing mask is an essential for protecting yourself from COVID19 and for preventing transmission of COVID 19 even after you are fully vaccinated or completed dose cycle of vaccine against COVID19 so the only option is choosing the best quality of mask for maskne and COVID19.

Follow mask hygiene for preventing maskne

Change your surgical mask in every 4-6 hours at least.

Choose cotton cloth mask, if you prefer wearing cloth mask (100% cotton)

Regular wash your cloth mask after you use with hypoallergenic or fragrance-free detergent.

2. Use gentle cleanser for removing excess oil, sweat and bacteria. Cleanser with alcohol and fragrance perfume should be avoided. The type of cleanser you need to use can depend on your maskne nature, if it is severe dermatologist recommend benzoyl peroxide and salicylic acid but always before using and applying any skin products it is necessary to have consultation with your dermatologist.

3. After cleansing, use oil free or noncomedogenic moisturizer to keep skin hydrated and apply sun screen for protection before 10-15 minutes wearing mask.

4. Follow regular healthy skin care routine; washing face early in the morning, after taking off mask and before going to bed. Dermatologist recommend lukewarm water for washing face and request people to gently dry face with clean towel.

5. Use of skin lotion or moisturizer can minimize friction between skin and mask.

6. Those who are experiencing irritation only due to friction caused by mask, can use occlusive products like Vaseline.

7. Avoid putting heavy makeup on your face, mostly on mask wearing area if you are experiencing symptoms of maskne.