A new term has been coined recently: "maskne" -- acne that develops under a mask. Now that more and more people wear a mask, I have been asked about this condition and its treatment many times by my patients.
Acne that is caused by wearing a mask or any other occlusive garment for extended periods of time is called acne mechanica.
Acne mechanica is acne that is caused by friction, rubbing or occlusion by clothing, equipment or other gear that is close to the skin. In the past we have seen it frequently in athletes and soldiers under the helmets, shoulder straps or other protective gear. It is exacerbated by heat and sweat under the occlusive material.
Maskne a combination of gentle rubbing and accumulation of dirt and sebum (oil from the skin) that ultimately causes clogged pores and acneiform eruption. Keratin from skin cells that clogs the pores in combination with oil are natural habitat for the acne causing bacteria (Cutibacterium acnes) which eventually causes inflammation and the breakout.
Men can experience more bumps in the beard area under the mask. I recommend shaving less frequently or to leave some facial hair if it is possible.
In some people the mask can also cause irritation and a patch of rough, red skin similarly to chafing.
People can be also allergic to either the metal in some of the face mask or the other ingredients in it. One can also develop allergies to the detergent that is used to wash the cloth mask. In this case, the rash can be rather itchy and looks more like an eczema.
Prevention and treatment of “maskne” includes more diligent face washing and using active ingredients that clean the pores and accelerate turn over of skin cells (exfoliation). Salicylic acid like to seep into our pores and break up the oily material that clogs the pores. Glycolic acid is one of my favorite exfoliant, because it is gentle and provides a good degree moisturization. There are pads or solutions that contain both of those ingredients and I recommend them to my patients to use once or twice daily. Salicylic acid can be drying however and for prevention I recommend one of my favorite ingredients called azelaic acid. It has excellent antibacterial effect; it is anti-inflammatory and decreases unwanted pigment production in the skin that may develop at the site of acne especially in darker skin individuals. There are products on the market that combine all those ingredients.
For irritant dermatitis or eczema like lesions the best is to moisturize and use gentle anti-inflammatory agents. Harken Derm after sun is excellent for that as it is both anti-inflammatory, antioxidant and moisturizing.
Lastly, although masks filter out some UV rays, even when wearing a mask, I recommend applying sunscreen to the entire face, because it is difficult to treat only the exposed areas. In addition, we may take our masks off when we can distance outdoors. For acne prone skin, I have always recommended mineral sunscreens and now in the age of “maskne” I especially advise using sunscreens with mineral filters and quick drying less oily formulations such as Harken Derm.