Maskne Is Real: Face Mask Breakouts And How To Prevent Them

Wearing protective face masks to help prevent the spread of COVID-19 might cause or exacerbate acne, redness, and skin irritation. Tatler speaks with top dermatologists to find out exactly what type of skincare you should be using to prevent and treat "maskne"

Wearing face masks to help slow and prevent the spread of the new coronavirus, COVID-19, may have unintentional side effects—on your skin. Whether you're using store-bought disposable paper masks, washable fabric masks, or home-made masks fashioned out of scarves or bandanas, the constant friction against your face, as well as trapped breath and moisture can create or exacerbate existing skin problems.

"Unfortunately, face masks are becoming a regular part of our daily wardrobe," says Dr Viseslav Tonkovic-Capin, MD dermatologist and editor of DermBoard.org. "With it, a host of skin problems can occur. I've seen allergic contact dermatitis, worsening acne, new onset of rosacea, seborrheic dermatitis, friction dermatitis and new patterns of skin wrinkling."

Tatler reached out to top dermatologists to get their professional tips on how to prevent and treat "maskne"—redness, irritation and acne caused by face masks. Turns out, derms knew exactly what we were talking about, first hand—because most of them wear face masks all day long. Here's what we learned.

What is maskne?

Skin irritation caused by face masks can be any of a number of things—triggered by any of a number of factors, including but not limited to bacterial overgrowth and yeast overgrowth.

"When talking and breathing with a mask in place, there is a good amount of humidity that builds up between your mouth and the mask," says Dr Erum Ilyas, a US board-certified dermatologist and the CEO and founder of Montgomery Dermatology. "The heat and humidity concentrated around the mouth can alter the pH of your skin and make you more prone to three issues–bacterial overgrowth can result in folliculitis or infected hair follicles; yeast overgrowth can result in perleche or cheilitis, which can present as persistent chapped lips or dry cracked corners of the mouth; and, lastly, perioral dermatitis, a variant of rosacea that can present as dry patches around the mouth and painful deep cystic pimples."

Why do face mask breakouts occur?

In addition to factors like trapped bacteria and yeast, there are a number of other factors to consider, including but not limited to how wearing a face mask alters how often you touch your face and whether or not you have sensitive skin to start out with.

"The constant rubbing of a mask on oily, sensitive skin, can cause more acne breakouts," says Dr Yoram Harth, a US board-certified dermatologist and medical director of MDacne. "The friction of the cloth of the mask on the skin damages the outer protective layer of the skin and makes it more sensitive, causing more oil gland clogging and more acne."

There's also the constant adjustment of the face mask—especially when you're first getting used to wearing one.

"There's a good chance you've been touching your face even more with a mask," Dr Ilyas says, "manipulating it to breathe at times, adjusting it to avoid fogging up your glasses, or just to talk on the phone."

Which types of face masks are better for your skin?

So if you're shopping for face masks or thinking of making one yourself, which types of face masks are better for your skin? According to doctors, using a fresh, clean paper mask is probably the safer bet—and cloth masks are OK if they're washed frequently.

"The best masks are regular, disposable paper masks," Dr Harth says. "These can be frequently replaced, they will not collect oil and dirt and will not make acne worse. To avoid rubbing and skin damage, the mask should not be too tight. If you choose to use a cloth mask, you should wash it every day or two.

Skincare products to avoid

Before putting on your face mask in the morning and heading out the door, it's worth considering how to alter your everyday skincare routine to avoid heightened irritation or sensitivity. For example, if you frequently use anti-aging and anti-acne products during the day, consider switching that skincare regimen to nighttime.

"Wash your face with a gentle cleanser and use a good moisturiser," Dr Ilyas says. "Apply a lip balm to protect the delicate skin of the lips. Avoid products intended for anti-aging or acne—this is not the time to use these as most focus on exfoliating or drying the skin which can become very uncomfortable with a mask. Rethink the need for pigmented cosmetics under a mask because most will not survive."

Speaking of makeup, make sure to choose non-comedogenic cosmetics if you're concerned about breakouts.

"Choose a lighter foundation than what you would typically use," Dr Harth says. "Preferably mineral-based, to prevent clogged pores."

Skincare ingredients to look for

After taking off a face mask, treat your skin with gentle care—and look for ingredients in beauty products that are pampering and healing.

"Wash with a gentle cleanser," Dr Ilyas says. "Focus on products with hydrating properties that have added antioxidants and anti-inflammatory effects. Antioxidant and anti-inflammatory ingredients to look for include vitamin E and niacinamide, while hydrating and skin protective ingredients include ceramides, squalene and glycerin."

This is also a good time to consider upgrading your serum collection—or investing in a good face oil.

"Using serums can help as they are lightweight and non-greasy," Dr Ilyas says. "Face oils can be helpful if dry patches are persistent. Non-alcohol based toners can help soothe the skin, especially ones containing rosewater."

What should you do if you have maskne?

After just a few days of wearing a protective face mask, you might notice some irritation, blackheads, breakouts or redness along the outline of where the mask sits on your face or around your mouth. Don't despair! Sometimes the solution can be as simple as a quick trip to the pharmacy or... a tin of Vaseline.

"If problems develop, then your approach would depend on the type of problem that has occurred," Dr Tonkovic-Capin says. "For allergic contact dermatitis—red, itchy, flaky skin outlining the shape of the mask—you will need to test some other masks made of a different material. For worsening acne—use facial pads pre-soaked with two-percent salicylic acid, which will keep pores open before you put the mask on. These pads could be the first step before applying any cream mentioned below (or makeup) and after you are done wearing the mask. For rosacea, consider applying azelaic acid—which is available over-the-counter in some countries—before wearing masks.

"For seborrheic dermatitis—red, flaky skin on the sides of the nose, along eyebrows and/or behind your ears—consider applying miconazole cream or ketoconazole cream before wearing masks, or wash skin with ketoconazole shampoo," Dr Tonkovic-Capin says. "For friction dermatitis, you will need a better-fitting mask. Alternatively, you may apply a small amount of plain vaseline along the contact points—Vaseline will not clog pores or cause acne. For skin-wrinkling caused by a mask, gently massage your face with any bland moisturiser, like plain Vaseline, and apply anti-aging antioxidants (e.g. resveratrol) or retinol before sleep."

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