What is maskne and how to control face mask acne?

The skin issues that are caused by wearing personal protective equipment (PPE) are unique. While this struggle is all too familiar for frontline healthcare workers, even those of us wearing non-medical masks can end up with abnormally irritated skin, increased breakouts, dryness, and/or peeling (1). To help ease the pain and frustration, we’ve gathered pro tips to combat your PPE-related skin concerns.

How Masks and PPE Affect Skin

With tight-fitting masks, there’s potential for the pressure and friction to lead to chafing over the areas of skin that the mask directly touches and rubs against. Another challenge is that masks create an occlusive environment for excessive sweat and salt to build up on skin, which can result in sensitised skin, peeling skin or breakouts. When these factors combine, the irritation multiplies exponentially, creating the perfect storm for flare ups if you’re prone to conditions like rosacea or eczema.

With all of these potential complications, it’s crucial to assemble a skincare routine that is as gentle as possible and remove any of your current products that may aggravate skin, including:

• Fragranced skincare.
• Sensitising ingredients such as alcohol (SD or denatured), menthol, witch hazel or essential oils of any kind.
• Harsh scrubs or stiff cleansing brushes.

Prepping Skin for Masks or PPE

Protecting and reinforcing skin’s barrier is critical if you’re going to be wearing a mask for extended periods of time.

• Prep skin with a protective moisturiser over the areas that the mask will encompass. If your skin skews more on the oily/combination or breakout-prone side, prep with a lightweight serum instead.
• If you need an even richer barrier along the outer rim of the mask that rubs against facial skin, add a layer of petroleum jelly (Vaseline) in those areas to prevent skin damage (2).
• Chafed skin over pressure points (like the bridge of your nose) is common among those who need to wear N95 masks (3). Silicone scar sheets can help – cut a small strip and apply to that area to add a thin cushion that protects skin from being rubbed raw. You can find these through online drugstore sites. (Of course, if you’re in the medical field, double check to make sure this follows your PPE safety guidelines.)

What not to do?

• It’s best to not wear makeup in the masked area.
• Don’t prep skin with your more potent or “bio-active” skincare treatments (save those for at night, as we’ll discuss further down).
• We’ve seen tips circulating that recommend using a layer of gauze over pressure points, but we don’t suggest that due to the slightly rougher texture of the fabric that can end up being abrasive as it rubs against skin.

Skincare Tips While You’re Wearing a Mask

The steps you take while you’re wearing your PPE gear are equally important for protecting skin.

• Safely remove the mask and splash skin with cool (but not extremely cold) water whenever you get the chance. This helps cool skin down and rinses away the buildup of sweat and salt excretion caused by the occlusive, humid environment of a face mask. Lightly dab skin, but don’t aggressively wipe or rub – that will make your problems worse.
• Before putting your mask back on, reapply the same protective product(s) that you prepped your skin with.

Post-PPE Skincare

Once you’re unmasked and safe at home, immediately cleanse with a gentle cleanser to remove the buildup of moisture, salt and sweat. Then go into repair mode.

• There’s no single best miracle product to apply – it takes a mix of hydrating, restorative, barrier-repairing, replenishing, and soothing ingredients. If you’re unsure of how to put together a routine with those elements, check out the ultra-gentle skincare routine at the end of this article.
• What about maskne (aka your skin breaking out more in the masked area)? Try to be extra good about removing your mask and dabbing cool water over skin as much as you can while you’re wearing your mask. At night, use a 2% salicylic acid exfoliant over the affected area.
• To get extra sensitive skin or rashy-looking skin under control, it can be worth experimenting with an over-the-counter hydrocortisone cream to see if applying occasionally (no more than once per week) can help you. If you can, choose a cream that also contains ceramides to help improve skin moisture retention.

Should you stop using retinol? This is a common question among PPE wearers, but retinol actually strengthens skin, so there’s no reason to stop unless your skin seems to be reacting to it (4). Of course, if your skin is raw or peeling, avoid those areas.

The same goes for other powerful ingredients (think concentrated niacinamide, vitamin C, bakuchiol, benzoyl peroxide, etc.). You don’t have to give them up, but scale back or hold off if it’s too much for your skin for the time being.

Have other questions? Learn more about how to treat sensitive skin.

Reference for this information:
1. Journal of the American Academy of Dermatology, March 2020, pages 1,215-1,216.
2. Journal of Wound Care, May 2020, pages 245-259
3. Ear Nose and Throat Journal, January 2020, page 1
4. Journal of Cosmetic Dermatology, March 2016, pages 49-57