By Dr. Marianna Blyumin-Karasik, dermatologist and co-founder of Precision Skin Institute

Dr. Mariana Blyumin-Karasik

The term Maskne has made a sadly popular debut during Covid-19 pandemic in the Spring of 2020. Although it was a new concept for most of the public, the dermatologist quickly recognized it as well-known medical condition, Acne Mechanica. Like most of skin practitioners, with alarm, we at Precision Skin Institute noticed the rise of acne due to occlusive and frictional properties of the PPE masks for prevention of coronavirus infection. Initially, we diagnosed and treated mostly in frontliners, essential workers and our colleagues, health-care providers. However, as the use of the masks expanded to the general public, the Maskne incidents increased. And then we noticed that some patients that came in with complaints of “Maskne breakouts” actually had other mask-induced skin conditions that flared with regular wear of the masks. Such skin conditions included rosacea, eczema, seborrheic dermatitis, perioral dermatitis, etc., which can look similar to acne, but the treatment approach is very different. We would like to share some tips regarding cause, prevention, and treatment of Maskne to help to mitigate the worsening of acne during these necessary mask-wearing times.

Cause

  • Occlusion of tight-fitting mask causes increase in humidity and sweat, leading to increase in oil production that results in clogged-pores, increase in skin bacteria, and inflammation – an unfortunate synergy of acne production.
  • Friction of the mask disrupts skin barrier and creates irritation and spread of micro-organisms.
  • Life-style impact (e.g., occupation in hot or stressful-environment, exercise with masks).
  • Cosmetic factor (e.g., previously accustomed use of make-up or multi-layer skin care).
  • Masks types matter (e.g., some heavier material, synthetic masks are more occlusive, and more likely to predispose to acne).

Prevention

  • Choose your mask wisely. This may depend if you have an option. As a frontliner, the main concern is Covid-19 prevention, so very tight/occlusive N-95 respirators are necessary. However, if there is an option, try to wear a lighter, hypoallergenic, cotton-based masks.
  • Keep a great cloth-mask hygiene by daily washing it with hypoallergenic detergent (e.g., Arm and Hammer Sensitive Skin Liquid detergent) or consider disposable masks.
  • Keep good facial hygiene by cleaning your face with gentle facial cleanser at the end of the day (e.g., Cerave Hydrating Facial Cleanser).
  • Provide barrier protection with oil-free, non-comedogenic, light moisturizer before applying the mask. (e.g., Avene Clean AC soothing cream).
  • Avoid using or try switching to lighter or alternative make-up, such as tinted mineral sunscreen moisturizer such as Elta MD Clear. Try minimizing use with only spot concealers for few complexion corrections (e.g., Neutrogena Skin Clearing Blemish concealer).
  • Simplify your skin care to few steps: sunscreen moisturizer in am, cleanser, and moisturizer in pm. Multi-layered skin-care approach is not ideal under the masks; it may be causing more acne.

Treatment

  • The use of Hypochlorous acid-containing sprays on the face (e.g., Hyclodex spray) several times per day can have excellent anti-acne benefits via anti-microbial, anti-inflammatory, and wound healing capabilities.
  • Nightly anti-acne cleansers that clean the pores and minimize the bacteria can also reduce breakouts (e.g. Glysal Cleanser, Benzoyl Peroxide Wash, Joseph’s Soap).
    Anti-acne treatment applications nightly to acne-prone areas can help to diminish pimples and black-heads, white-heads, and blemishes (e.g., La Roche-Posay Dual Action Effaclar or Glytone Enhance Brightening Complex).
  • Repair the skin nightly with sensitive skin moisturizer (PCA Clear skin or Avene Tolerance cream).
  • If Maskne is not improved after following above recommendations for several weeks, seek the help of your board-certified dermatologist. Your acne may be compounded by other factors (e.g. stress, hormonal influence) and you may need prescription-strength medications or adjunct laser/peel treatments (e.g., Vbeam PDL laser, Salicylic acid peel) for optimal results. We can also help to precisely differentiate if your Maskne breakout is alternate or compounded skin condition that requires a different therapy.

We wish you lots of health and safety during these challenging times. As always remember, Healthy Skin means Healthy You.

Sincerely,
Precision Skin Institute

Source: https://www.aad.org/public/everyday-care/injured-skin/burns/face-mask-skin-problems-treatment