Recently an increasing number of clients of every age are breaking out with acne mechanica, recently dubbed as “maskne” due to their wearing of masks as important PPE against the Corona Virus.
In my forty plus years as an esthetician I have treated many young clients who have experienced breakouts due to the masks they wore while playing sports.
While some are describing this as little white bumps found in the area underneath the mask, it also presents as a red rash, irritation where the mask rubs against the skin, rosacea and larger inflamed blemishes around the mouth. I first became aware the phenomena when my daughter called me from California and said her boyfriend was suddenly breaking out around his mouth. So now I am hot on the trail to find the best ways to treat "maskne". You can identify maskne pimples as tiny little whiteheads that pop up after wearing your medical, cloth, or paper face mask to prevent the spread of coronavirus.
The culprit is the breakdown of the barrier layer that protects our skin from the outside world. This makes skin more vulnerable to bacteria and inflammation. The increased heat and moisture makes skin more permeable where bacteria can get in. The increased carbon dioxide from exhaling into the mask means less oxygen to keep bacteria in check. Dilated capillaries from increased heat makes skin become more easily inflamed. The perfect storm for breakouts, redness and rashes.
Some of us are becoming more lax about taking care of their skin during this time. It’s important to wash your face twice a day to keep bacteria and excess oil in check. Drier skins should choose a gentle cleansing milk while oilier skins experiencing breakouts need a salicylic based cleanser. Moisturizing is important as it reenforces the protective barrier layer. It’s particularly important to choose the right moisturizer as to not over moisturize. If the moisturizer is too occlusive you’ll only increase the problem. An oil free moisturizer that contains humectants that reduce dehydration is a good choice. If you’re feeling dehydrated and sensitive you might want to try a calming light weight moisture fluid or add an oil free hydrating serum containing hyaluronic acid to your moisturizer to better attract moisture to your skin. During the day use a sunscreen that also works as your moisturizer to cut down on layers. Too many layers will only add to the problem of trapping everything in your skin.
It’s time to baby your skin. Do not over exfoliate to get rid of your breakouts. Over exfoliating destroys the barrier layer and leaves you more vulnerable to breakouts. The same goes for overly aggressive acne products which contain benzoyl peroxide, alcohol or drying agents. Choose to spot treat with a mild salicylic acid serum which also contains calming agents like licorice root or sea whip. The key as usual is to know your skin type. Seek out the help of a skin care specialist if you're not sure about which skin type you are.
Take off your mask whenever possible. If in the appropriate environment aim for 15 minutes, every few hours. Oxygen in the air helps to kill acne bacteria to keep acne breakouts to a minimum. Don’t just wash with cleanser. A gentle salicylic based toner completes the cleansing process. Avoid drying clay acne masques unless you have thick, very oily skin. A calming masque is more appropriate.
If you're wearing a washable mask make sure you wash it every day. Keep a collection of masks so you can rotate them, always wearing a clean one. This reminds me of the fact that acne clients should have a stash of clean, white, cotton pillow cases so they can change them every night. This reduces bacteria, oil and dirt buildup that then rests upon your skin at night, increasing the chances of irritation and breakouts. Unfortunately the problem here might be your detergent. Make sure to wash your mask with a mild, fragrance free laundry detergent and double rinse it in your washing machine. Another thing, a dark colored mask is more likely to hold in heat and harbor bacteria.
You also need to keep up with your retinol treatment. A mild, non prescription retinol is your best choice as it is less likely to cause irritation. If you are just starting with retinol, start with a low (.25) percentage. Start with no more than twice a week. You can slowly work up to three or four times a week if your skin shows no signs of irritation. Acne is more than clogged pores. It is an inflammatory condition. We always say, "treat the inflammation first”. The mild exfoliation from this product may take a couple of weeks to notice. This is because retinol is a bottom up exfoliant. It penetrates to the lower layer of the skin where new cells are formed. Retinol remarkably stimulates production of newer, healthier cells. As these cells rise to the surface they push off the older cells that might be clogging your pores. It takes about two weeks for this effect to occur. Most don’t notice it because it is at a microscopic level. If you do experience irritation cut back on the number of nights per week you use it. Many of us though have been using retinol for years and their skin is quite comfortable with it. If this is the case your can step up your retinol to a (.40%) slightly stronger formula. Remember, our goal is not to inflame the skin our goal is to create healthier cells and an intact barrier.
If you can go makeup free a couple of days a week that is a good idea. Even though your skin is not a respiratory organ it still uptakes oxygen and releases waste through your circulatory system. However, oxygen that touches your skin from the environment is going to kill bacteria. Makeup creates a layer that prevents the surface benefits of oxygen. If you are breaking out and still want to wear makeup try a mineral foundation, which is less clogging because it stays nearer the skin's surface. Better yet, try a mineral powder that acts like a foundation. These formulas allows your skin to “breathe”.
I hope this information and tips helped you get your maskne under control. Please leave comments and tell us what you have found that helped relieve this condition.