Dr Vikas Sharma

Wearing a face mask has become a part of our daily routine and looks like it will be the norm for the foreseeable future. As the summer temperature goes up and humidity levels rise - wearing a mask increases the chance of skin irritation and a new disorder – ‘maskne’.

Maskne, coined during the coronavirus pandemic, is a variant of acne mechanica, previously associated with headgear or personal protective equipment. Scientists worldwide have co-related the use of masks and their impact on the skin microenvironment and mechanical factors (ie, textile-skin friction) which is a new evaluation. Maskne is a disorder of follicular occlusion and directly related to mechanical stress (pressure, occlusion, friction) and microbiome dysbiosis (heat, pH, moisture from biofluids). Both of these are affected by increased duration of mask wear. Tropical climates and outdoor exposure (increased sweating) are risk factors for acne-susceptible populations (active young adults, seborrhea, genetic predisposition).

Clinical criteria proposed for maskne include onset of acne within six weeks of start of regular face mask wear or exacerbation of acne over the masked area, distinct pattern, referred to as the O-zone. Distinct acne patterns are seen in the T-zone in physiologic acne, the U-zone in adult acne, while it’s the O-zone in maskne.

Special consideration for skin care should include antibacterial gentle cleansers and moisturizers formulated as prescription emollient devices, which help maintain a healthy skin barrier/microbiome. Botanical actives with anti-inflammatory, antioxidant, sebum regulation, and antimicrobial properties are preferred.

Hydrogel carrier formulations of combination topicals can minimize local irritation by ensuring better drug tolerance and efficacy. Allergic contact dermatitis and transcutaneous absorption of potential carcinogens can occur from textiles used for fabric face masks, which is currently unregulated.

Risk group

Healthcare and other front-line workers are most at risk because their masks are tighter-fitting and they are wearing them longer. That’s because masks can worsen skin issues that already exist or cause new ones. Add in the summer heat and humidity and you’ve got a petri dish for breakouts.

What to do

Modifying the daily skin routine is the need of hour to reduce chances of having maskne. Choose mild cleansers made for sensitive skin.

One should avoid sunscreen in the areas that are covered with the mask, because that can clog your pores under your mask.

Switch to the most basic skin care routine: a gentle non-soap cleanser and a mild, fragrance-free moisturizer. The moisturizer does double duty here. Besides, well, moisturizing the skin, it can protect it from mask friction.

Lighten up your moisturizer: After cleansing your skin, you want to use moisturizers that are light. Moisturizers contain hyaluronic acid, so serums are nice. Serums are light and thin and they aren’t going to occlude the pores.

Give your lips some love: In the heat of summer, we sometimes forget about our lips but by wearing a mask, your skin and lips are brushing against it all day and can get dry. A lip moisturizer that is non-greasy will keep the lips soft and prevent dryness and disorders like cheilitis.

Break up with makeup: This is the time to really tone it down. The more layers of product you have on your skin, the more opportunity there is for bacteria to grow.

Consider the type of mask you wear: There are lots of masks in the market now, try and find one with more structure to it so it sits away from your skin to minimise friction. Cotton is more breathable, which means less moisture and humidity under your mask, and it’s gentler on your skin.

(Dr Sharma is a Chandigarh-based dermatologist)