MASKNE REFERS to the combination of the words “mask” and “acne,” a new word that was coined to describe the skin irritation people experience as a result of our current mask-dependent lifestyles. Ever since February 2020, people have started to wear masks wherever they go to protect themselves from the COVID-19 pandemic. Masks have now become an inseparable part of our lives and are the #1 thing we bring with us every time we leave our homes. With warm weather and the prolonged monsoon season, many have expressed the increasing discomfort and irritation they experience from wearing masks. The question now arises: what is the dermatological explanation behind this condition?

Maskne?

   This mask-wearing lifestyle has lasted for over half a year, and there has been a noticeable increase in the number of patients experiencing maskne. Symptoms include irritation, acne, dermatitis*, and folliculitis** around the area where masks are worn, according to Kim Doyoung (Associate Prof., Department of Dermatology, College of Medicine, Yonsei Univ.). According to CNN Health, maskne is medically known as acne mechania, “the result of mechanical friction of fabric against our skin,” and is not a new condition. This maskne response is also a common occurrence for athletes who play sports wearing helmets, and actors who wear thick makeup for long periods of time***. Though they are all in different circumstances, they all share one similarity—their skin is masked by an external substance.

The mechanism behind maskne

   How then, do masks damage our skin? According to an interview with The Yonsei Annals, Associate Professor Kim introduces the two main ways masks give rise to maskne. First, friction and stimulus from our masks can lead to changes in our skin condition. Because our facial muscles move, direct contact with masks can result in itchy skin. This condition could be worsened by the thin fiber threads within masks. When the irritation gets severe, scratching the area would then result in dermatitis. The problem with reusing masks can also be explained by the same theory. Although the main concern is the potential COVID-19 virus on the polluted mask, reusing masks could also wear out the mask’s surface, leading to an increase in the fiber threads. These fiber threads intensify the itchiness we experience, and in turn, the chances of getting dermatitis become higher.

   Second, with masks covering the lower half of our faces, respiration and sweat secretion often lead to an increase in both the temperature and humidity underneath our masks. As the surface of our skin gets hotter, sebum secretion is known to increase. This rise in humidity causes edema, or swelling, near the pores’ entrance, blocking the pores. These conditions will aggravate underlying acne and trigger secondary bacterial symptoms, resulting in inflammation of the skin, and ultimately superficial folliculitis****. This explanation also helps describe how masks are more detrimental to our skin on a hot summer day or during exercise. With the rise in temperature and humidity, the mask provides an environment for bacterial growth and makes our skin a lot more vulnerable. Not only this, but with mask use, the covered skin will be subjected to higher carbon dioxide levels and more microorganisms from the mouth. This change in the skin microbiome can also lead to miliaria, also known as heat rash*****.

What can we do?

   Wearing masks should still be mandatory in order to keep each other safe from the devastating pandemic, but we must also protect our skin from various skin diseases. Associate Professor Kim explains that the different hygiene masks (KF80, KF94) only differ in thickness, and that all types of masks (hygiene mask, dental/surgical mask, cloth mask) are theoretically not toxic to our skin. However, he recommends those diagnosed with contact dermatitis to use dental masks which are thinner and lighter than the rest. He also recommends frequent renewal of masks, as the inner surface polluted by saliva, sweat, and makeup could be very detrimental. Dermatologist Dr. Whitney Bowe also discusses in her interview with CNN that our masks are easily contaminated by sweat, makeup, moisturizer, or sunscreen throughout the day. If we do not change our mask, it will breed more acne.

   Associate Professor Kim goes on to explain that for those with folliculitis, doctors and pharmacists would prescribe topical antibiotics or topical liniments consisting of substances that dissolve comedo (clogged pores). Additionally, since there exists the possibility of maskne aggravating atopic dermatitis****** or other underlying diseases, it is crucial to consult with doctors for further treatment.

   He highlights the importance of thoroughly washing our faces with minimal pressure, and applying gentle moisturizers that are characterized for their skin barrier recovery. He further stresses the significance of applying sunblock, for even though masks block the sun, Ultraviolet A could still partially transmit through the thin masks, resulting in uneven tanning. These everyday skincare routines will lessen the effect of the stimulus and help with our skin’s regeneration. Health24 recommends wearing a mask after the sunblock and moisturizer are fully soaked in the skin, as this would minimize the friction and the blocking of pores.

   Many also point to makeup products for exacerbating this condition. Bowe explains how putting on a mask pushes the makeup on the skin surface to go deeper down the skin layers, causing inflammation. She recommends avoiding products with fragrance and those made of heavy ingredients like butter or coconut oil. She also advises to stay away from using facial scrubs, washcloths, and loofas as they can further damage the skin barriers, and instead only use our fingertips to gently wash our face.

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   We are living in a time when wearing masks is not a choice, but an obligation. Being mindful of the potential detriments masks bring to our skin and the steps we could take to protect it is the least we could do to maintain healthy skin.

*Dermatitis: Diseases that result in inflammation of the skin

**Folliculitis: Skin condition where hair follicles become inflamed or infected, resulting in bumps and rashes around hair follicles

***Healthline

****Superficial Folliculitis: Affects the upper part of the hair follicle and the skin nearby

*****Healthline

******Atopic Dermatitis: Also known as eczema, a chronic condition that makes the skin red and itchy