- Best Results1-4 weeks
- Treatment RecoveryNA
- Procedure TimeNA
- Skin SpecialistDermatologist
- Duration of ResultsLong-term
- AnaestheticNA
- Back to WorkNA
- Cost$ Medicare
Acne- Maskne
Maskne is the new pandemic of acne secondary to mask wearing. It is a form of mechanical acne. Friction, occlusion, bacterial infection & changes in humidity are all contributing factors. Modifying your skincare routine can help reduce maskne, as can the proper use of face masks. Read more to understand.
FactsFacts on Maskne
- This form of acne is the most common subtype in adults following the pandemic
- Maskne is more common with cloth masks compared to disposable masks
- Maskne can resemble other skin conditions that also flare up with mask wearing
- Perioral dermatitis resembles maskne & effects the nose & perioral area
- Rosacea resembles acne & flare up with skin irritation & humidity
- Seborrheic dermatitis can co-exist with maskne
- A dermatologist can effectively treat maskne
What is maskne?
This form of acne is one of the most common variants due to the pandemic. It occurs secondary to mask wearing and is secondary to acne mechanica. Occlusion, hygiene, friction, moisture, humidity & stress all contribute to maskne.
What causes maskne?
Many factors contribute to acne flare ups including occlusion & increased humidity under the mask, proliferation of bacteria, friction on the skin coupled with stressors of the Covid pandemic.
What types of masks are notorious for maskne?
You can get maskne with any masks however it is more common with non-disposable cloth masks. The primary reason is that even though these types of masks keep out viruses, they allow for breeding of bacteria. Coupled with occlusion from residual make up, sunscreen & moisturizer, they get easily contaminated. The solution? Change your mask twice a day & remember to wash them after one use. Consider disposable cotton masks as an alternative.
Why is a proper fitting mask essential?
Apart from the obvious (keep Covid/viruses out), a comfortable fit helps with skin health. A snug fit reduces skin problems. Too tight & it causes skin irritation, too loose & it causes friction. Additionally, you are more likely to adjust a poor fitting mask, addition to more chances of infection & contamination.
I prefer cotton masks with a mouldable nose piece & cotton tie; however I have been wearing masks for over two decades as these are required for surgery & laser. Use what fits you best/most comfortable.
Why is mask fit & care important?
There are many steps in preventing maskne, they all add up. The American Academy of Dermatology recommends using masks for 4 hours on, with a 15-minute break, taking into account your situational scenario.
Mask hygiene & selection:
- Mask application: proper fit, not too tight or too loose as this increases friction.
- Cotton over cloth/silk fibre masks.
- Short breaks from mask wearing.
- Have 6-8 non-disposable masks, wash after each use.
What is the best cleanser to help prevent maskne?
A gentle one, preferably without harsh chemicals like benzoyl peroxide, salicylic acid scrubs, microbeads or oils. La Roche Posay Tolerane or Rosaliac are good cleansers, Cerave makes good ones as well.
Use your fingertips, to wash, avoid mechanical brushes, sponges, washcloths, or loofahs.
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What is the best moisturizer for maskne?
A light oil free, non-occlusive moisturizer is best. La Roche Posay makes an Ultralight range. Moisturisers are important in establishing skin barrier function that has been compromised with mask wearing. Avoid occlusive products- see below.
What skincare should you avoid?
Avoid occlusive moisturizers, oils, harsh scrubs (microbeads), & any new skincare actives that could irritate your skin. These include alpha hydroxy acids, salicylic acid, benzoyl peroxide & retinol products.
Products labelled as natural are not necessarily the best as they frequently contain essential oils & plant based ingredients, including fragrance. Think of simple skin care. If in doubt, look for washes made to treat eczema. Even better still, eczema in babies.
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Dermatologist
Brisbane🇦🇺
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Acne a complex interplay of genetics & extrinsic factors, can’t control much non-pharmacologically bar diet & lifestyle
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🍧Diet: I am quite surprised by how much of an impact diet makes, but unlike a weight loss diet, an anti acne diet is hard to follow, it means a total elimination of flares such as dairy, sugar, hormonal fed produce & refined foods. With caloric restriction, you can have cheat days, or make it up by burning more calories, you can’t do that with an acne free diet. Kudos for the motivated, it’s such a discipline 👊🏻
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
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#dermatology #skincare # #drdavinlim #davinlim #brisbanedermatologist #acne #acnediet #acetips #acnecure #acneremedy #naturalacneremedy #pimples #acnefree #acneskincaretips
What is the best makeup tip to reduce maskne?
Don’t wear any, you are behind a mask all day. Masking & make up is like double occlusion, so one has got to go (it’s the make-up). Makeup is more likely to clog your pores and lead to breakouts. If makeup is necessary, use only products labelled “non-comedogenic” or “won’t clog pores.” Another compromise is to let your skin breathe three days a week. Mineral over oil based.
What are over the counter treatments or DIY solutions for maskne?
The two key ingredients that you can try are niacinamide, also known as vitamin B3 & azelaic acid. Niacinamide is anti-inflammatory & helps re-establish skin barrier function. It has a low skin irritant potential. Look for 5-10% formulations. Azelaic acid is also anti-inflammatory. Formulations range from 10-20%.
How do dermatologists treat maskne?
My colleagues will prescribe topicals & anti-inflammatory medications if your mask acne is persistent & resistant to steps that you have already taken prior to the appointment.
The fast no bullsh*t solution is a course of oral anti-inflammatories including doxycycline, minocycline, erythromycin, azithromycin, & occasionally sulphur based tablets. Resistant cases (or severe) may be candidates for oral isotretinoin /Oratane/ Accutane.
The slow (let’s bring you back every 2 weeks and see) solution include topicals such as erythromycin, clindamycin, topical minocycline (US), azelaic acid, & sodium sulfacetamide – sulphur washes coupled with LED therapy. Some cases can respond to a very short course of steroid or better still pimecrolimus/tacrolimus. Be guided by your dermatologist.
Disclaimer: I do not treat any rashes. My work is entirely procedural. For skin rashes, please consult a medical dermatologist.
What is acne mechanica & how is it related to maskne?
Technically maskne is acne mechanica. This occurs when mechanical friction between fabric & skin occurs, as in mask wearing as well as protective eye shields that rest on the forehead area. Friction & occlusion leads to irritation of the hair follicles & associated pilosebaceous units (oil glands).
What other conditions can mask wearing cause?
Other conditions that resemble mask acne include perioral dermatitis, rosacea & seborrheic dermatitis. They each have their own treatments however clinical overlaps are frequently seen. These conditions flare up with friction & occlusion.
- Perioral dermatitis: Red acne like dots around the nose & mouth, infrequently eyes.
- Rosacea: Acne like areas on the nose & cheeks, flares with foods, irritants & UV.
- Seborrheic dermatitis: scaly dry rash around the nose & nasolabial folds + dandruff.
What is the go with masks & rosacea?
Mask wearing flares up most rosacea patients as it increases environmental humidity, leading to occlusion & inflammation. This also leads to increases in demodex mite & bacterial populations. The solution is along the same lines as treating maskne, however early intervention with oral anti-inflammatories & pulse dye lasers are often required.
How to tell the difference between maskne & rosacea?
It can be really difficult to tell the difference as overlaps exist. Papular pustular rosacea causes pimples, pustules & zits, however blackheads are absent. Additionally, rosacea has flare ups with foods, heat (as can maskne), wind & sunlight. Eye irritation is frequently seen in rosacea, which is absent in maskne.
What about face masks & dermatitis/eczema?
The three types of dermatitis that can flare with mask wearing include perioral dermatitis, seborrheic dermatitis & contact dermatitis.
Perioral dermatitis or POD is the most common & presents as tiny bumps around the nose, mouth & eye area. Fortunately, this responds well to simple skin care & a short course of anti-inflammatory prescription medication, such as doxycycline.
Seborrheic dermatitis presents as a red, scaly rash that affects the nose, nasolabial folds, eyebrows & scalp. It is due to a yeast infection known as malessia & can be treated with simple ketoconazole shampoo. Resistant cases are treated with itraconazole tablets.
Contact dermatitis is complex. It can be irritant contact dermatitis, secondary to skin care actives like benzoyl peroxide, retinol, retinoids, skincare acids & a whole lot more. Stopping your actives & repairing skin barrier function can lead to fast resolution. Allergic contact dermatitis is rare. Patch testing by a medical dermatologist can fix this.
Disclaimer: I do not treat any rashes. My work is entirely procedural. For skin rashes, please consult a medical dermatologist.
Can lasers or LED phototherapy treat maskne?
Yes, however there are much better, cheaper & more effective ways of treating mask related acne, namely medical therapy. If you are risk averse to taking oral or prescription medication, you can have a go at phototherapy & or lasers.
Lasers are best for treating background redness. They can also be used to temporarily suppress acne lesions. They are invaluable in the treatment of inflammatory rosacea. LEDs can do the same, albeit less effective compared to vascular lasers.
Disclaimer: My work is concentrated on complex procedural cases, simple cases like acne are treated by my clinical team at Clinic Cutis.
What does a simple maksne treatment program look like?
AM: La Roche Posay Rosliac wash. Moisturiser, Cicaplast Baume or Lipikar AP+
PM: La Roche Posay Rosliac wash. Moisturiser, Cicaplast Baume or Lipikar AP+
Option for azelaic acid 15% nightly to areas or niacinamide topically.
Who to see if your acne is resistant to treatment?
Consider seeing my colleagues if your acne is resistant to treatment, failing the simple steps outlined. Remember, dermatologists prescribe medications, not fairy dust, so be prepared for this. Chemical peels are best for blackhead or comedonal acne. You do have the option of lasers, LED & in some cases PDT therapy.
We have hold-for-urgent slots, so you will be seen within 48 hours. A referral from a GP is required to claim a Medicare Rebate.
Disclaimer: I do not treat acne as my work is procedural. I am occasionally asked to give second opinions, but will not take up any medical management.
Davin’s Viewpoint on Maskne
The new pandemic of skin rashes is maskne. It affects the entire globe thanks to Covid. All ages are affected, including the young to old, however it is more common in females around the ages of 15 to 30. Makeup makes maskne worse, more on that later.
There are strict definitions of maskne in the dermatology literature, namely ‘an eruption of acne mechanica with a distribution of an O, as compared to T zone eruption within 6 months of mask wearing.’ We all need definitions to categorize things, but from a practical standpoint, there is a huge overlap between maskne, normal acne, hormonal acne, stress related acne, acne rosacea, perioral dermatitis or steroid induced acne, as well as atypical variants of dermatitis. Dermatologists, like normal people, want a simple diagnosis to hang a hat on, but in practical terms, the most common presentations are overlaps. Treatment is more or less the same, however prognosis can be skewed according to secondary rashes. POD secondary to corticosteroid use or excessive skin care carries a much better prognosis compared to say, rosacea, which is lifelong- chronic.
Simple mask wearing tips include change your mask twice a day, washing your masks after one application. Using cotton over cloth masks, reduce rubbing your face or touching it through the mask (reduces friction). A proper fitting mask is vital. Too tight & occasion can result. Too loose & friction comes into play. Taking regular breaks to let your skin breathe is super helpful. Dermatologists recommend taking a 15-minute break after 4 hours of occlusion.
If I can summarise skin care in one phrase- keep things simple, namely an inert cleanser & a banal moisturizer to repair skin barrier function. Cut out all mechanical methods of face washing. This includes towels, loofah, brushes, sponges & devices. Use your fingertips.
Your dermatologist will have their own algorithm of treatment, depending on the clinical picture, your previous attempts to treat mask acne, the degree of overlap between other forms of acne, & many other variables.
