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.


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