MASKNE is the new acne

Contributed by Dr. Lim Wenkie

Wearing a mask helps keep you and many others healthy when it comes to covid-19 or any other airborne transmitted disease. But it also means that we are putting our face at risk that may lead to skin irritations or acne. The term “maskne” is becoming such a commonly used term, so much so that is has even been added into the Urban Dictionary.

When we wear face mask for an extended amount of time each day, most of us would see some form of irritation regardless of what skin type you are. Many would see irritation from physical friction and/or pressure of the face mask material on the skin, while others will see acne pop up.

Face masks trap moisture, oil, sweat and dirt close to our skin, that may result in blemishes including acne, small bumps, irritation, inflamed hair follicles, contact dermatitis, pressure sore and even broken blood vessels.

When we breathe or talk in our masks, we produce more moisture. That would end up changing our skin’s natural pH and would result in increased growth of bacteria responsible to cause acne, inflamed hair follicle and a flare-up of rosacea.

To avoid maskne, we need to change our skincare routine and also consider what kind of mask you are wearing.

Changing Our Skincare Routine

Keeping clean is the most important thing you can do to prevent breakouts. So, before we put on our armor (a facemask) to go into the world, make sure to wash your face with a gentle cleanser. Then we could apply a light layer of moisturizer that would help hydrate, restore and protect our skin barrier function, and never forget a thin layer of sunscreen as well. Avoid wearing makeup, which would not only rub off on your mask, but more importantly clog up the pores or hair follicles on your skin.

Next you can also apply a moisturizer containing anti-inflammatory ingredient such as niacinamide. Niacinamide is a type of Vitamin B that supports skin barrier by helping with ceramide production that would further help retain water inside the skin. It also helps regulate the amount of oil produced by the acne-forming unit within the skin.

However, if you already have acne/maskne, try cleansers that contains salicylic acid, benzoyl peroxide or even elemental sulfur. Salicylic acid is a beta-hydroxy acid (BHA), which helps keep your pores clean. Benzyl peroxide is a topical antibiotic that helps decreases bacteria level on your skin. For those with sensitive or rosacea prone skin, elemental sulfur is a gentle option that decreases redness and inflammation.

Choosing the Right Mask

Needless to say, choosing the right mask is paramount, especially if you’re prone to acne. However, if you are a healthcare worker, you might not be able to do much about it.

N95 masks, which could filter out more than 95% of small particles that could contain viruses, are considered essential protection tools for healthcare workers peroforming procedures from their day to day work. When fitted correctly, it creates a tight seal around the nose and mouth. So, wearing these masks for long hours at a time could end up with pressure ulcers and irritant rashes in addition to breakouts. Surgical masks don’t form the same kind of tightfitting seal, so your face is to exposed to as much pressure as wearing the N95 masks. They protect us from droplets, but not small particles.

Cloth masks are also becoming more popular with its fancy patterns and designs. The effectiveness of cloth masks however really depends on the material, the fit and the number and kind of layers. Cloth masks can absorb natural oils on your skin, which may trigger your skin to compensate and overproduce oil that could worsen your acne.

One of the best cloth options for your skin is a mask made from silk or silk-lined materials because silk has antimicrobial properties and has shown to be better for people with sensitive skin. However, they aren’t as effective at preventing the spread of the novel coronavirus because they tend to gap around the edges. Plus, the fabric is porous, so smaller droplets may be able to get through. So if silk is an option, try looking for one that has multiple layers with filter in between.

If you can’t find a silk mask, try to find one with layers of breathable materials such as cotton or bamboo, which would be less irritating as compared to other materials that are heavier and more airtight that could lead to facial sweating. Avoid masks with adhesives or glue that touches your skin directly.

Washing your mask

When wearing surgical masks, it should never be worn for longer than one day. These masks contain filters to trap germs and prevent them from spreading. We should dispose them properly and perform hand hygiene immediately after. This would help avoid increase risks of transmission associated with incorrect use and disposal of masks.

When it comes to cloth masks, regardless of the material, the mask needs to be cleaned often since oils and any dirt on the mask will affect your skin. By doing so, you not only protect yourself from the virus, you also help protect from exacerbating skin irritations. If possible, wash it every time you wear it. The buildup of germs, makeup, oils, and lip balms can actually worsen your acne and skin irritation.

Put the mask in a mesh washing bag to protect the elastic from snagging, and use the hottest water possible to wash. Use the highest setting to dry, and leave it in the dryer until the mask is completely dry.

If you are washing your mask by hand, use 5 table spoons of bleach per gallon of room temperature water as recommended by the Centers for Disease Control and Prevention. Soak the mask in the solution for five minutes before rinsing with cool or room temperature water and drying in direct sunlight, if possible.

Reference:

  1. James WD. Acne. N Engl J Med. 2005;352:1463–1472.
  2. Subramanyan K. Role of mild cleansing in the management of patient skin. Dermatol Titer. 2004;17:26–34.
  3. Dohil M, et al. Atopic dermatitis and other inflammatory skin disease: natural ingredients for skin care and treatment. J Drugs Dermatol. 2011;10(9):S10–S14.
  4. Yamamoto A, Takenouchi K, Ito M. Impaired water barrier function in acne vulgaris. Arch Dermatol Res. 1995;287(2):214–218.
  5. Tang KM, Chau KH, Kan CW, Fan JT. Assessing the accumulated stickiness magnitude from fabric-skin friction: effect of wetness level of various fabrics. R Soc Open Sci. 2018;5(8):180860. doi:10.1098/rsos.180860
  6. Del Rosso JQ, Brandt S. The role of skin care as an integral component in the management of acne vulgaris. Part 2: tolerability and performance of a designated skin care regimen using a foam wash and moisturizer SPF 30 in patients with acne vulgaris undergoing active treatment. J Clin Aesthet Dermatol. 2013;6(12)
  7. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-wash-cloth-face-coverings.html
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5 WAYS TO MAINTAIN GLOWING YOUTHFUL SKIN

As we age, we lose an average 1 percent of collagen on our skin each year. Also, our rate of skin regeneration decreases about 7 percent each decade. Hence, as grow older, ageing gradually sets in –  resulting in dull looking skin.

Aging may result from both intrinsic and extrinsic factors.

Intrinsic factors:

  • Genetic factors
  • AKA chronological aging

Extrinsic aging

  • Lifestyle and environmental factors eg sun exposure, pollutants, unhealthy diet, smoking

 

Here are 5 ways to maintain the glowing, dewy and youthful skin:

  1. Regular Skin exfoliation.
    • With increasing age, the rate of skin regeneration and removal of dead skin cells gradually decline.
    • Leads to accumulation of dead skin cells on skin surface; dull looking appearance
    • Microdermabrasion treatment eg Silk Infusion can effectively exfoliate dead skin cells, stimulate skin regeneration and hydrate skin
    • Chemical peel; active ingredients such as glycolic acid or mandelic acid will dissolve dead skin cells in a controlled manner and encourage new skin growth.
  1. Diet
    • As a general rule of thumb; antioxidants, omega-3 fatty acids and omega-6 fatty acids are essential for good health.
    • Antioxidants
      1. Neutralizes free radicals which damage healthy skin cells and accelerates skin aging
      2. Act as a natural sunblock
      3. Boost collagen production
      4. Reduce inflammation
      5. Example – vitamin C, vitamin E, beta carotene, lycopene
    • Omega 3 and Omega 6 Fatty acids
      1. Keep skin moisturized and fimr
      2. Anti-inflammatory – reduce redness and acne
      3. Protect from sun damage
      4. Note – Important to maintain a healthy Omega 6 to Omega 3 ratio of 4:1
    • Exercise regularly (30 minutes at least 3 times a week) will help to improve our blood circulation.
    • When we have good blood circulation it will increase blood flow to our face, bringing all the nutrients and goodness to our skin, resulting a good and glowing skin.
    • UV exposure can lead to damage to our skin and slow down collagen synthesis process and making our skin looks rough and dull.
    • Apply your sunscreen regularly (4 hourly) during daytime
    • choose sun blocks that contains at least SPF 30 and broad spectrum (blocks both UVA and UVB rays)
  1. Good skin care regime.
    • Makeup remover, Cleanser, Toner, Serum, Moisturizer
    • Exfoliate 1-2x/week
    • Ingredients like vitamin A, C and E, hyaluronic acid and aloe vera can fight against unwanted free radicals and retain moisture as well.
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ABCDEs of Melanoma

Contributed by Dr. Lim Wenkie

Moles are commonly seen on our skin. It is a skin growth that results from the clustering of melanocytes (pigmented cells). Most moles are actually benign and have no severe risk or threat to our health. However, some moles can become cancerous. You should get your moles evaluated regularly by your dermatologist to make sure that it is not showing signs of turning malignant. If so, then your dermatologist would likely remove the mole in its entirety to eradicate the cancer and prevent its spread.

So how does your friendly local dermatologist determine whether a mole is cancerous? As a general rule of thumb, medical professionals will follow the ABCDE visual cues.

Let’s go through the five signs of ABCDEs that would help determine whether a mole requires removal or not.

1. Asymmetrical Shape
Even though no mole is perfectly symmetrical, most benign moles are round and resembles a circle or an oval. If you were to draw an imaginary line going through the middle of a mole, basically both sides should more or less mirror each other. Moles that lacks this asymmetry might indicate irregular cellular activity, which may alert your doctor to think of skin cancer. After careful examination, your dermatologist may conduct a mole biopsy (removing a portion or the entire mole) to be further examine it for cancer. If the result comes back positive, they will recommend removing it entirely.

2. Borders that are ill-defined or irregular
Benign moles are also typically having well defined borders. On the other hand, malignant moles may have borders that are undefined and/or oddly shaped. Irregular borders may not always indicate skin cancer, but they will definitely prompt your dermatologist to have a closer look and also recommend more regular follow ups.

3. Colour and Consistency
Moles usually have different shades of brown, however it all depends on several factors. These factors include one’s skin type and skin tone, and also the amount of clustered pigment cells within the mole. However, while one mole might differ in colour from another, the colour of the mole should be of a consistent colour throughout the mole. If a single mole is darker in some areas yet lighter in others, this suggests an irregularity that your dermatologist will examine further during your mole evaluation.

4. Diameter of the mole
Just as a mole varies in shapes and colour, they also vary in size. Most benign moles are relatively small (less than 6 mm in diameter) in size. There are exceptions, of course. Even still, if a mole is larger than 6 mm, your dermatologist will check for potential of cancer and may suggest for removal of it.

5. Evolution of moles
Lastly, your doctor will take note of any changes in your moles, including its shape, colour, and even the appearance of new moles. We may experience new moles throughout our lives, though it commonly stops after adolescence, while some may even disappear on their own. New moles may be benign, especially if they are regular in shape, colour and size, but they are still worth getting it checked out. But if any of your existing moles have significantly changed in shape, colour and size, your dermatologist might conduct further tests and may recommend removal of them.

The ABCDEs of melanoma are important during a mole check-up. But of course, these aren’t the only reasons your might have a mole removal. You might simply not like the appearance and/or the location of a benign mole and ask your dermatologist to remove it for cosmetic purposes. So, make sure your check with your dermatologist if you have any doubts and concerns about your mole.

 

Reference:

  1. John Breneman ― Towards Early-Stage Malignant Melanoma Detection Using Consumer Mobile Devices‖ Stanford Center for Professional Development, 2012
  2. National cancer institute, what you need to know about melanoma other skin cancers. Visit us at http://www.cancer.gov
  3. Melanoma Symptoms, [Online]. Available: http://www.cancerhelp.org/ help/default.asp?page=3009, National Institute for Health and Clinical Exce-lence, Tech. Rep.
  4. Gambichler, P. Regeniter, F. Bechara, A. Orlikov, R. Vasa, G. Moussa, M. Stücker, P. Altmeyer, and K. Hoffmann, ―Characterization of benign and malignant melanocytic skin lesions using optical coherence tomography in vivo,‖ Journal of the American Academy of Dermatology, vol. 57, no. 4, pp. 629–637, 2007.
  5. Unsupervised segmentation of skin lesions – Research Gate. Available from: http://www.researchgate.net/publication/33418237_Unsupervised_segmentation_of_ skin_lesions [accessed Nov 16, 2015]
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