How to keep your skin as healthy as possible under that face mask!

Face masks are a crucial measure in helping reduce the spread of COVID-19 — no question — but that doesn't change the fact that for some, they can cause skin issues, like dryness, irritation and what some experts are calling "maskne" (mask acne).

"When we started initially seeing cases coming into our clinic, it was a lot of health-care workers and that was occupation-related," says Dr. Sonya Abdulla, a dermatologist at Dermatology on Bloor in Toronto. "Now, it's happening in the general population as well, and as mask use continues … it's going to become more relevant."

First off, what exactly is maskne?

Acne mechanica occurs when hair follicles become irritated and inflamed due to friction, pressure and occlusion. "We see acne mechanica in response to cosmetics, particularly heavy cosmetics or makeup. We also see it in the context of repeated pressure, for example, like a cell phone … on the side of the face, or if you're studying or working at a desk and you have a tendency to lean your face on your hand," explains Abdulla. 

Aside from pressure and rubbing, acne mechanica can also be triggered when the skin is contained in a warm, moist environment — like a face mask. Hello, maskne. "Warmer weather and humidity causes increased sweating and oil production that clogs pores, making 'maskne' more likely to develop," says Dr. Monica Li, a dermatologist and clinical instructor in the department of Dermatology and Skin Science at the University of British Columbia. So, if you've noticed a few more whiteheads around your nose, mouth and chin, it may be maskne.

It's important to note, however, that mask-wearing can also trigger other skin conditions. "Not everything that looks like acne is actually acne," says Abdulla. Inflammatory skin conditions that can easily be mistaken for acne, such as rosacea and perioral dermatitis (which causes a red rash around the mouth), can be triggered by increased mask use. Likewise, those with a genetic predisposition to other inflammatory skin conditions, such as eczema, seborrheic dermatitis or psoriasis, may also be affected by increased levels of friction from mask-wearing. Li adds that some people may experience allergic reactions to mask components (think: fabric dye) or abrasions and tears on the skin from prolonged use. 

Avoiding issues can be simple

Luckily, you can prevent skin conditions that may be caused by your mask. Friction from mask-wearing can compromise the integrity of the skin's barrier, explains Li, so it's important to help repair it and keep it in good working condition. Opt for gentle cleansers and moisturizers that contain hydrating ingredients naturally found in the skin barrier, like ceramides and hyaluronic acid. It's also important to moisturize the areas that'll be coming in contact with your mask (generally around your nose, mouth and cheeks) at least 30 minutes prior to wearing it.

As for products to avoid? Facial and cleansing oils tend to be occlusive and can lead to further breakouts, says Abdulla, so eliminate those if you're experiencing what you think is maskne. Limiting the use of harsh toners and exfoliants is also a good idea, as these may irritate the skin and trigger more inflammation. And lastly, since nobody will be seeing what's underneath your mask, both experts suggest ditching the makeup. "You really want to keep things simple," says Abdulla. "Less is more."

And if you still experience mask-related skin issues? Here's what may help

For acne: If you're prone to acne, look for cleansers and spot treatments that contain salicylic acid, benzoyl peroxide or retinoids — these ingredients can help reduce oiliness and unclog pores. One caveat, though: "Acne treatments can dry and exfoliate the skin," says Li. Try using them on non-consecutive days and before bedtime to start. 

For eczema and seborrheic dermatitis: Mask causing flare-ups? This is where anti-inflammatory prescriptions are helpful, like stronger hydrocortisone creams, says Abdulla. It's also important to consider avoiding or using fewer products and ingredients that can further irritate the skin (think: salicylic acid, topical vitamin A and aftershave), adds Li. 

For cuts, sores and abrasions: If you're finding that your skin is becoming raw or irritated at sites of pressure from your mask, Li suggests applying white petroleum jelly to the affected areas before bedtime to help with healing. 

The type of mask you're wearing can definitely play a role in skin issues. Safety is the most important concern — wear any mask you can get your hands on! "I think both fabric masks and surgical masks are appropriate," says Abdulla. "Ultimately, it depends on what you have access to." However, if you have a choice, know that certain materials may be the cause of your skin issues. Synthetic fabrics like nylon, polyester and rayon tend to be more irritating on the skin. They can also cause increased sweating as they're less breathable than natural fibres, says Li, which may lead to breakouts and contact dermatitis. Look for masks made of cotton or silk to avoid these issues.

A properly cleaned mask is a must. If you've been guilty of reusing your surgical mask or rewearing your non-medical mask without washing it, you may want to think twice. "Just because the inside lining is not visibly dirty, or [they have been] worn only for a short period of time, doesn't mean fabrics … have not absorbed oils and debris from your skin, and also germs with breathing," says Li. Both Li and Abdulla advise cleansing cloth masks using a fragrance-free detergent. It's also a good idea to have some back-up masks on hand for when you're in a pinch or exercising. "If I'm at a group workout and I'm sweating very heavily, [and my] mask has become saturated with moisture, it won't be doing its job in terms of protecting you, but also at that point, it's going to increase irritation on the skin," says Abdulla.

D'Loraine Miranda is a Toronto-based editor and writer. Follow her on Instagram @dlorainem