Managing Mask-Related Skin Conditions in C19

Now that the widely-accepted practise of wearing a mask during the COVID-19 pandemic has been made mandatory in enclosed spaces – not just to the shops or on transport, but in galleries, cinemas and places of worship – Britons will be facing a secondary challenge as a result: the skin conditions that arise from wearing them.

Now that the widely-accepted practise of wearing a mask during the COVID-19 pandemic has been made mandatory in enclosed spaces – not just to the shops or on transport, but in galleries, cinemas and places of worship – Britons will be facing a secondary challenge as a result: the skin conditions that arise from wearing them. 

While Derma welcomes the new rules about face coverings, and have been implementing them ourselves since very early on in the pandemic, we know that for most people, accepting this new routine will take some adjustment. We are especially empathetic to those who already struggle with skin conditions that may be aggravated by wearing masks.

For people who don’t have skin conditions, the most common complications of wearing masks are;

  • Soreness or irritation to the skin;
  • Dryness;
  • Rashes; and,
  • Acne.

Wearing a mask for long periods of time can also trigger or worsen existing conditions, like rosacea, eczema, or contact dermatitis.

We can all agree that living in a global pandemic, and navigating the ‘new normal’ following lockdown is almost certainly causing increased levels of stress in the majority of people.

When we are stressed, our bodies release the hormone cortisol, which increases oil production from the body’s sebaceous glands. While more oil might seem to resolve the issue of dryness, a process called transepidermal water loss that occurs when cortisol is being released means the skin has difficulty retaining water, and the skin barrier isn’t as strong. This process is a factor in why the drying effects of stress can worsen conditions like psoriasis, or contribute to premature facial ageing or acne.

Additionally, no matter how soft the mask, wearing one, especially for prolonged periods of time, increases friction (rubbing) on the sensitive skin of the face, and this can irritate the skin, causing soreness, redness, and rashes.

Many people find that the areas of the face that most frequently come into contact with masks are the worst affected – the tip of the nose, the cheeks, chin and behind the ears.  It may cause a similar sensation to the raw, chapped feeling we get when we need to use a lot of tissues during allergy or cold seasons.

Additionally, your breath inside the mask can do more than just fog up glasses – it causes heat and sweat to build up inside the mask, and might cause miliaria – also known as heat rash.

All of the factors listed above – additional oil production, the weakened skin barrier, friction, heat, sweat, trapped dirt and the bacteria that thrive in warm, moist conditions create clogged pores, and the perfect storm for acne under the mask area – which some are calling ‘maskne.’

While some may need to visit their GP for advice, many people can treat these common issues with over-the-counter products available in chemists. We have compiled some techniques that will help to mitigate the common skin issues caused by wearing masks.

If there is soreness, redness, or irritation from the friction of a mask rubbing against your face, you might want to consider using an emollient, which works by forming a layer on top of the skin to traps in the water, and also serves to create an additional barrier. Some emollients can be thicker and oiler, which provide some lubrication between the mask and your face – but you should be careful about applying emollients too liberally across the face, since they may clog pores and create other issues. Additionally, it is recommended to those wearing masks for extended periods of time to take a 15-minute break every 4 hours in fresh non-recycled air, away from other people. This can help to alleviate the soreness of constant friction. 
To treat dryness in the mask area, it will be a good idea to implement or to update your routine to ensure adequate moisturising of the skin on the face. Retaining more moisture will also help to improve and strengthen the skin’s natural barrier. Whether or not you generally have oilier skin on the face, it may be wise to choose a lighter moisturiser for this area of the face instead of some of the heavier creams associated with anti-ageing, since they may clog pores. If you have not used moisturisers before, it can be helpful to try any new products in a travel size, in case they cause irritation. Many brands also offer testers which allow you to see if a product suits your skin. If acne-prone skin is a concern, it’s also possible to find an over-the-counter oil-free moisturiser that has anti-acne medications, but it is important to use them as instructed and keep an eye out for dry, tight skin as a result. It might be valuable to alternate an oil-free anti-acne moisturiser with a light, non-comedogenic moisturiser for sensitive skin, to prevent irritation.
Cleansing is an important step in helping to maintain healthy skin every day, but it is essential in helping to keep maskne under control. Not only does the skin need cleansing to remove cosmetic products, but it needs to be cleansed of the oil, dirt, and debris that accumulate through particulates in the air, or are trapped inside a mask. While some may opt for traditional soap and water, for many people, fragrances and harsh detergents can cause additional irritation to the skin of the face, even if they have previously not experienced a problem. There are many good products widely available to cleanse the skin, and our recommendation is to look for one that is fragrance-free and non-comedogenic, meaning that it won’t clog the pores. If you have not used cleansers before, can be helpful to try any new products in a travel size, in case they cause irritation. We’d also caution that disposable cleansing wipes are not only bad for the environment but can actually push dirt and oil into the pores, where they’ll cause more problems. Wash the face twice a day – once to remove the oil accumulated during sleep, and in the evening, either when you have returned from your day, or before bed. You may choose to use a moisturiser afterwards, to help the skin remain hydrated. Over-the-counter oil-free cleansers that incorporate anti-acne medications may be helpful, but if you are already using other acne treatments, these can cause excess dryness and actually worsen the condition. When you gently cleanse your face, you might consider using an exfoliant to remove dead skin cells that accumulate on the surface. Rather than ‘scrubbing’ the skin, which damages it, it is recommended to treat the skin softly, allowing the products to do their job. If any product causes redness or irritation, discontinue using it. An important step in maintaining good health overall is to ensure your mask is clean, every time you use it – so washing it in a machine, or having several on-hand is essential, so that you’re keeping dirt and germs off of the skin.

When to Call in the Experts

If the skin on your face feels raw and chapped, appears ‘patchy’ or discoloured, or you are developing significant skin issues that worsen or don’t resolve, it could be a sign of a skin condition that requires medical treatment.

If this is the case, it’s a good idea to check in with your GP, in case they need to prescribe medication. While the GP can treat many issues, sometimes they might refer you on to a dermatologist, who specialises in all skin conditions and would be able to offer enhanced treatment options.

At Derma, we are happy to see patients who prefer to see a dermatologist privately, and we’ll be able to identify the issue and what’s caused it; and to provide ongoing support with access to the very best care, the latest research and the most effective treatments.

For more information, or to book an appointment with Derma, please call the clinic or contact us via email here

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