While a lot of the days may seem the same as we stay at home and socially distance in the COVID-19 era, one thing has changed: It’s summer now, and a big part of the country isn’t having the same weather they were when the CDC first issued its recommendations for wearing a face covering. Unfortunately for the face on our skin, that means irritations and “maskne” have an even better host environment in which to rear their ugly heads.
“Maskne can be caused by several different factors—such as contact dermatitis from friction, preexisting acne that becomes inflamed, clogged pores from the occlusion of the mask, and a buildup of bacteria on the skin’s surface,” explains Glenn Dale, MD dermatologist Valerie Callender, MD. “The most important thing you can do is to keep skin clean.” Count on these expert-approved tips to avoid disrupting your complexion:
Take a Cue From Athletes
As Miami dermatologist Annie Gonzalez, MD points out, at its very core, maskne is a subtype of acne mechanica, commonly seen amongst athletes who wear helmets and straps resulting from friction, occlusion and sweat. “The friction and pressure between your mask (or face shield) and your skin leads to inflammation, clogging of the pores and compromise of the skin barrier. Once the skin barrier becomes compromised, the skin can’t maintain proper hydration inside nor provide adequate protection from external pathogens like bacteria and yeast. Additionally, the moist, warm environment trapped inside the mask favors the growth of these pathogens.”
Check the Ingredients
This advice doesn’t apply to skin care, but the actual mask you’re wearing. “I find that 100-percent cotton masks are the best,” says celebrity aesthetician Nerida Joy. “I wear a mask everyday now that I’m back at work and cotton masks allow the skin to ‘breathe,’ and not sweat underneath. They are softer on the skin and more hygienic, too.”
Wash and Rotate
Regardless of what kind of mask you use, Montclair, NJ dermatologist Jeanine B. Downie, MD—who prefers a washable cloth or silk mask—says to wash them and to rotate their use. In addition, Dr. Gonzalez advises using hypoallergenic, fragrance-free detergents on the washable-mask varieties, both before use and at least once weekly to maintain dirt and bacteria at bay. “Prevention is easier than a cure, that’s for sure, and the key for prevention is to keep your mask clean or, if it’s disposable, change it frequently,” she says.
Assess Your Cleanser
The summer heat, plus mask usage, can equal pore problems, says plastic surgeon Ruth L. Hillelson, MD, and calls out the culprit of not having the right cleanser as something that can easily exacerbate the issue. The American Academy of Dermatology (AAD) recommends using a mild, fragrance-free one and following up by applying a moisturizer. “Cleansing the face with a hydrating, pH-balancing cleanser before and after removing the mask is key,” advises Dr. Gonzalez, and says she likes La Roche-Posay Toleriane Hydrating Cleanser ($15).
Mind Your Moisturizer
The hydration step of your skin-care routine may seem like a simple one, but the AAD gets pretty specific in what they think you should look for: Ceramides, hyaluronic acid and dimethicone (which can also create a barrier that helps reduce irritated skin) top their ingredient-list recommendations and they give gel moisturizers the passing grade if you have oily skin, acne or if you tend to break out.
…And the Humidity
Besides getting the support from the AAD for oily and acneic skin, gel moisturizers are also on their recommendation list for when the weather is hot and humid. Something that doesn’t make the cut, specifically if you are experiencing mask-related irritations: Certain skin-care products like leave-on salicylic acid, retinoids and aftershave.
Apply an Anti-Inflammatory
Many patients of Rocio Romero, chief aesthetic PA at Yager Esthetics in New York, are medical providers, and—just like the rest of us—they suffer from acne from wearing face masks all day. “Besides wearing a clean, fresh, mask every day or every three hours if you are out in public for long periods and avoiding makeup around the area covered by your mask, I recommend applying a moisturizer with an anti-inflammatory ingredient like nicotinamide,” Romero says.
Lay Off the Lipstick
Dr. Downie says this no-makeup move is a must in her book right now: “Do not wear lipstick or anything too hydrating, as the mask can cause the lip moisturizer to smear on to other parts of your face and cause acne,” she says, but advises not to skip the use of oil-free sunscreen (SPF 30 or greater), oil-free moisturizer and oil-free makeup.
Reapply Sunscreen—and Often
Besides exacerbating irritation, oiliness and breakouts, the mere act of putting on and taking off a mask means the “rubbing off” of sunscreen. “I continue to caution my patients that mask-on, mask-off means removal of some sunscreen,” says Dr. Hillelson. “Reapplying sunscreen during the day has become even more necessary.”
Protect the Barrier
Dr. Callender recommends using a protective barrier cream under your mask—she likes Cerave Cream ($13.50)—and a gentle cleansing cloth to clean skin at least twice daily. “If acne flares up, consider chemical exfoliation at night. SkinBetter Science has Exfoliating Peel Pads ($95) that I recommend.”
Mist and Go
New York dermatologist Marina Peredo, MD says that besides irritation, you may also be contending with the lesser-discussed issue of facial indentations. Her secret: The collagen-rich PrimaSkin Mist ($60), which she initially used for calming skin post-laser, but is now relying on for mask-related complexion issues as well. “It’s especially good because you can spray it from a distance and you don’t have to use your hands.”
Consider Another Type of Mask
A different kind of masking can be helpful to curb the pesky maskne. “Try a purifying face treatment mask with clay, sulfur and/or BHAs like Peter Thomas Roth Therapeutic Sulfur Acne Treatment Mask ($52) to unclog pores and an overnight hydrating masks like Kiehl’s Ultra Facial Overnight Hydrating Masque ($36) or Paula’s Choice Radiance Renewal Mask ($36) with arbutin and niacinamide once weekly to keep your skin healthy and strong,” Dr. Gonzalez says.
This is a pretty solid skin-care rule during any season but Dr. Downie is stressing it a lot right now: “Do not pick at your pimples or they will cause scarring and make your acne much worse. Dot on topical prescription antibiotic creams or a topical over-the-counter benzoyl peroxide, depending on what you have, as an acne spot treatment.”
Call Your Doctor
If you can’t keep the maskne controlled with over-the-counter ingredients, you should go see your board-certified dermatologist or plastic surgeon for further treatment options, advises Dr. Gonzalez. “In recalcitrant cases, topical and oral antibiotics may be needed, and in-office procedures like chemical peels and lasers can be extremely helpful.”