Get in touch!
(310) 571-8435
drsalar@hazanyderm.com
The Dual Fight Against COVID-19 & “Maskne”
Salar Hazany • Jun 07, 2023
"Maskne" is Mask Induced Acne
As our country navigates the uncharted territory of the COVID-19 pandemic, healthcare workers and the general public are working together to ensure the highest safety level for vulnerable community members. One necessary precaution to maintain well-being is wearing a mask to protect and prevent transmission of the novel coronavirus.
As people continue to follow governmental guidelines and recommendations, many are experiencing an increasingly prevalent problem called maskne (a play on words of “mask” and “acne,” meaning mask-induced acne). Everyday mask use makes this a common topic in the dermatology community.
The team here at Dr. Salar Hazany’s private practice located in Beverly Hills believes in beauty, healthy skin, and protecting our community! Let’s discuss why this phenomenon happens and what we can do to prevent maskne through awareness and proactive skin care.
The Science Behind Maskne
Maskne is a phenomenon where patients experience increases in acne breakouts, specifically in areas where a mask is worn: nose, mouth, and chin.
There are several reasons why maskne happens. One of these reasons is that masks are a physical barrier preventing outside air droplets from entering and keeping already present air droplets inside. In doing so, this causes a humid, moisture-rich environment for bacteria to grow because pores can get clogged from excess oil, sweat build-up, and dead skin cells.
There are two primary skin conditions associated with maskne: acne mechanica and perioral dermatitis.
Before the pandemic, acne mechanica was ordinarily present in athletes, soldiers, or anyone who uses protective face equipment. The reason being is that this acne develops by prolonged chafing and heat on the skin. The masks’ rubbing against the face causes micro-tears on the skin, allowing undesirable bacteria, sweat, and dirt to accumulate.
This acne develops in pustular form as white or yellowish bumps of pus. They are typically present on the back, shoulders, or buttocks from bras and clothing, backpacks, and heavy bags, as well as chair friction.
The second is perioral dermatitis, which appears as a scaly or bumpy rash centered mainly around the mouth and philtrum (between the lips and the nose). While this is not technically acne, this skin condition has similar signs and looks highly inflamed, causing severe skin redness. Even before the pandemic, the exact cause of perioral dermatitis was unknown. Many factors could contribute to it: bacterial or fungal infections, hormonal changes such as birth control pills, sunscreen use, rosacea (another serious skin condition), as well as non-prescribed corticosteroid medications and cream applications.
Questions, Considerations, and Tips Regarding Maskne
There are some essential questions to ask yourself when practicing safe mask use to prevent maskne proactively.
1. Is your mask breathable, safe, and clean?
Your mask needs to be easily breathable but also virus-safe in that it covers your nose and mouth. Highly regarded researchers have displayed support for homemade cotton masks, which may be easily machine-washed. Many who use cotton masks have also remarked that they tend to be more breathable and more comfortable to wear.
Disposable masks should be frequently replaced, especially after prolonged use or after intensive activity (exercise or sweating). With that said, you should regularly clean reusable masks to remove residue from skin products (e.g., sunscreen, makeup, creams, moisturizers, and more). When left unwashed, a mask continuously traps and reapplies an accumulation of bacteria to the face making you prone to inflammatory acne outbreaks.
2. What are you applying to your face under the mask?
While makeup is a wonderful and beautiful art practiced by many people, dermatologists do not recommend applying makeup if possible when wearing a mask during these times. Many dermatologists have attributed simultaneous makeup and mask-wearing to acne since the extra oil from products can lead to clogged pores. If patients want to continue their makeup use, they should use non-comedogenic, oil-free, water-based, and fragrance-free products.
3. Can I still practice my regular skincare routine with my everyday products?
While many find comfort in their 10-step Korean skincare regimen, many dermatologists encourage patients to practice more straightforward skincare. Since masks create additional everyday problems that were not once present, such as irritation and micro-tears in the epidermis, a gentle moisturizer along with a soft cleanser is enough to maintain a good skincare routine.
Many dermatologists encourage patients to apply moisturizer on their skin before using a mask. This helps decrease the friction that occurs while also protecting the skin from dryness and irritation. Dermatologists recommend that you only apply a small layer of moisturizer to the skin. A little bit goes a long way!
Common Treatments for Maskne
There are many common over-the-counter medications and home remedies that Dr. Hazany recommends (see article Top Home Remedies and Treatments for Acne).
Products commonly used before the pandemic, such as facial washes, retinol, and creams, may or may not work well with masks depending on your skin’s sensitivity. Common ingredients in most of these remedies, such as benzoyl peroxide, salicylic acid, or glycolic acid and lactic acid, can help serve as affordable treatments to maskne.
However, it is important to use these products with caution. Some are kinder to sensitive skin and less likely to promote inflammation or irritation than others. Dermatologists also advise against thick creams and advocate more for water-based, thin lotions or gels.
Reaching Out to a Skin Health Professional
Remember that everyone’s skin is different, and the use of masks can also change your skin’s physiology. Skin physiology changes that occur due to frequent mask-wearing might alter the effect of various skin care products and can potentially exacerbate acne.
If you are experiencing maskne, your skin situation does not improve, or you would like to learn more about how to achieve healthy skin, seek help from a professional who cares about your well-being.
Dr. Salar Hazany, a board-certified, highly-skilled dermatologist, will work with you to individually address your concerns and needs during this challenging time. He will be able to craft a solution and create a detailed treatment plan to resolve your maskne.
The team here at the Salar Hazany MD dermatology practice continues to follow the necessary guidelines and precautions to keep our community and its members safe. Let’s all continue to do our part in wearing a mask to fight COVID-19 and practicing safe skincare steps to fight maskne!
Psoriasis: Beyond the Flare-Ups
The Ultimate Glow-Up: Discover the Benefits of Red-Carpet Lasers
Eczema: A Stubborn Skin Condition
Learn More About the World of Warts
Learn More About Non-Surgical Face Lifts!
A Comprehensive Guide to Hair Loss: Understanding, Treatments, and Finding the Right Solution for You:
A Comprehensive Guide to Mohs Micrographic Surgery: Choosing the Right Surgeon and Preparing for Success
Discover the Magic of Fotona 4D Laser – Let's Dive In!
With the advancement of acne therapies through extensive research, technology, and pharmacology, the market for acne treatment products has become extremely saturated. This market saturation has made it hard for consumers to identify the best products for their skin. While each patient’s skin is different and requires a unique combination of treatments, there are a couple of widely available over-the-counter (OTC) home remedies that have proven to be effective on a majority of skin types. Dr. Salar Hazany, a board-certified and well-established dermatologic surgeon, recommends exploring some of the following treatments and remedies to see which is the most compatible with your skin. Since every skin type responds differently to treatments, there is no particular ranking of efficacy for the following: #1 Benzoyl Peroxide Benzoyl peroxide is a popular recommendation backed by dermatologists. It is a highly effective ingredient for killing bacteria and clearing the skin of waste and dead skin cells, all of which clog pores and cause acne. It is also a very strong exfoliating agent that works synergistically with other products to treat acne-prone skin. Benzoyl peroxide, however, doesn’t work for all types of acne. Specifically, non-inflammatory acne, including comedones and whiteheads generally do not respond much to benzoyl peroxide’s mechanism of action. Other topicals, such as salicyclic acid (as described below), are better alternatives to benzoyl peroxide. There are many forms of benzoyl peroxide available, including topical gels, foams, and creams. It is important to apply a small amount only on the affected areas, unless otherwise instructed, as this is a strong chemical. Before doing so, however, it is important to test the product on a few spots first to see how your skin reacts. Because benzoyl peroxide is an exfoliant, it can cause extreme dryness and redness on the skin. Patients should adhere to the most minimal dosage recommended, as higher doses are not necessarily going to yield better acne reduction. In addition, benzoyl peroxide is a bleaching agent that can discolor fabrics that come into contact with the treated skin. #2 Salicylic Acid A comparable alternative to benzoyl peroxide is salicylic acid, a topical peel that is especially effective against comedonal acne, such as blackheads and whiteheads. Salicylic acid is a beta hydroxy acid, a more penetrative version of alpha hydroxy acids that goes deep into clogged pores. Beta hydroxy acids are oil-soluble, meaning they can pass through the lipid layer of the stratum corneum, the top layer of the epidermis, to remove dead skin cells and excess oil trapped in the pores of the dermis. Although salicylic acid is an efficacious treatment for comedonal acne, benzoyl peroxide is still more effective for treating acne lesions that are more pustular in nature, due to its unique potent anti-inflammatory and antimicrobial properties. However, it is generally not recommended to use both products at the same time, as this could lead to severe dryness and redness. It is best to apply a sparing amount of each product on different days to avoid these side effects. Benzoyl peroxide and salicylic acid are found in many over-the-counter medications sold at local pharmacies. Benzoyl peroxide and salicylic acid medications come in concentrations of 2.5%, 5%, and 10% and 0.5% to 2% respectively. It is best to speak with your dermatologist to see what concentrations are optimal for treating your particular skin issues. #3 Glycolic Acid Glycolic acid is a type of alpha hydroxy acid that gently exfoliates the skin. Its mild effects make them great treatment options for acne-prone patients who also struggle with sensitive skin. These are plant-derived acids often utilized in anti-aging serums and creams marketed to older patients who want to treat their age/sun spots or just general discoloration of their skin. Because glycolic acid is not as strong as most facial chemical peels, it is quite limited in its application. It can surely prevent acne breakouts by clearing pores and removing impurities on the skin, but it is not potent enough to treat acne scars. At most, it can treat any hyperpigmentation associated with scars but will do little to the actual texture. If you are looking for an even more gentle alternative, lactic acid is also a good exfoliant as well as a hydrator. One downside is that the results will not be as noticeable at such a low strength. However, with multiple sessions, you can expect to see a considerable difference in your skin. #4 Vitamin C Vitamin C serums have also gained tremendous momentum as a skincare oral supplement. While benzoyl peroxide is considered the holy grail of acne treatment, more recent research suggests that Vitamin C serums are a much better alternative for certain skin types. Because Vitamin C is a 100% natural ingredient, it can lead to better results for people with sensitive, easily inflammable, or irritable skin. While benzoyl peroxide is praised for its antiseptic and exfoliating properties, Vitamin C is a potent antioxidant, protecting your skin from oxidative damage from the sun while also boosting collagen production at the same time. Regular Vitamin C supplementation is thus one of the most important habits to develop to prevent not only premature aging of the skin but also skin cancer. #5 Ointments, and Lotions (Hydrocortisone) Hydrocortisone is an FDA-approved drug for inflammatory skin conditions that cause swelling, itching, and irritation of the skin. For patients that are currently experiencing psoriasis, eczema, or other irritable skin conditions, hydrocortisone (1%) OTC medication is a safe, low-dose, topical steroid medication that can provide temporary relief to the symptoms listed above. At the biochemical level, hydrocortisone essentially mimics cortisol, a natural hormone released during periods of high stress. Cortisol plays a major role in the regulation of carbohydrates, fats, and proteins as well as other sympathetic nervous system fight-or-flight responses, including the body’s natural inflammatory response to high-stress situations. Hydrocortisone can act as a hormone replacement to treat other cortisol deficiencies, like adrenal insufficiency and hypopituitarism. In low concentrations, hydrocortisone is an effective measure against dry, rashy, and irritable skin. In addition to hydrocortisone, there are other commonly used topical corticosteroids available for patients to buy OTC, including triamcinolone, fluocinonide, and clobetasol. Before starting these medications, however, it is recommended that you consult a board-certified dermatologist to ensure proper application and dosage of the topicals listed above. Honorable Mentions and Alternatives #1 Tea Tree Oil While there are many conventional methods of treating acne, especially with creams and prescribed medications, essential tea tree oil is a natural remedy that really works! While there are still clinical trials being completed to extensively study the effects of tea tree oil, many researchers have concluded it is an effective antibacterial and anti-inflammatory remedy. In particular, its anti-inflammatory properties are conferred by its primary constituent, terpinene-4-ol, a known suppressor of pro-inflammatory mediators released by a specific kind of white blood cell, called monocytes. These monocytes are naturally activated when bacteria accumulate in clogged pores, resulting in vasodilation and inflammation. When tea tree oil is applied to the affected area, it penetrates deep into the dermis to kill the bacteria and calm the body’s naturally prolonged immune response. #2 Aloe Vera Another common herbal home remedy for skin is aloe vera, a topical gel-like substance derived from plants. Acting as a natural antibacterial and anti-inflammatory agent that can reduce the appearance of acne and prevent acne outbreaks, it is a popular alternative to conventionally prescribed medications. Because aloe vera is derived from a plant, it naturally contains a lot of water and is an ideal moisturizer for people who get dry skin from the usage of other non-compatible acne products. While there are many home mixtures of aloe vera and tea tree oil with other moisturizers, it is important to get a consultation with qualified professionals and see which one might work the best for you. Key Takeaways and Reminders While these remedies are often advertised as easy quick-fixes, it is important to recognize that each individual skin type is different and requires specialized treatments. Here are some recommended tips that should be practiced for all skin types. It is important to practice regular everyday skincare routines, such as washing your face twice a day, applying sunscreen before exposure to sunlight, avoiding touching your face with dirty hands, or following a dermatologist-recommended skin care regimen. In addition, regular exfoliation is helpful to not only improve skin tone but also reduce the appearance of dark spots, scars, and other irregularities over time. Regular exfoliation will also help in removing dead skin follicles, bacteria, and oil. There are many facial wash options on the market, so make sure to do your research before committing to a purchase. Before taking any medications, over-the-counter drugs, supplements, or herbs, consult a physician for a thorough evaluation. We do not endorse any medications, vitamins, or herbs. A qualified physician should make a decision based on each person’s medical history and current prescriptions. The medication summaries provided do not include all of the information important for patient use and should not be used as a substitute. Remember that although acne is a persistent and stubborn problem for many patients, we truly believe that every case of acne can be cured. Schedule your consultation today to achieve your desired skin results and let our team help you!
Maskne is Mask Induced Acne. Read about the science behind Maskne and how to treat it here.
Insights about recovery and scar management
Superficial Radiation Therapy (SRT) or Mohs Micrographic Surgery (MMS)?
Prevention, Detection, and Treatment
World-Renowned Mohs Micrographic Surgeon