The agony of the ‘maskne’: why our skin rebels against wearing a mask

Wearing masks for hours on end can disrupt the skin barrier and cause irritation. Photo/Brett Phibbs

Masks seem like they should be a part of life for a while yet, but some Kiwis’ facial skin just isn’t making it. Jane Phare looks at ways mask wearers can protect their skin from rashes, infections and “maskne”.

They’ve become part of streetwear now, choking noses, fogging up glasses, hiding smiles and littering gutters. Masks are here to stay, at least for the foreseeable future. But not everyone is happy with it.

My teenage son and his friends complain of not being able to breathe in class, and of “maskne” flare-ups on the lower cheeks. The driver who dropped us off at the Auckland airport terminal from the parking company complained of sores that became infected on both sides of his face due to irritation from the mask. And beauty therapists say they have been busy, when not in lockdown, treating clients for breakouts at an age when acne should be a distant, unpleasant memory.

So what causes mask mess? Turns out they can be dirty, bacteria-laden, wet germs that we repeatedly put on and take off, and stuff in our pockets, purses, car consoles, and sometimes on the floor. It may be part of the family wash from time to time, but more often than not it’s worn over and over – sweat, makeup, lipstick and all.

No wonder the skin barrier rebels, say skin experts. They are seeing more and more Kiwis developing what one therapist calls a “face mask” as a result of long-term use of face masks. Skin specialists and estheticians are seeing more and more rashes, acne, sores and allergic reactions on the faces of clients who wear masks much of their day. And pre-existing conditions like rosacea, small red, pus-filled bumps on the face, get worse.

The DermNet New Zealand website, which is affiliated with the New Zealand Dermatological Society, states that facial itching, redness, rash, dryness and scaling, swelling and numbness, pain and tingling and oily skin are commonly reported symptoms related to face mask use, particularly when a mask is worn for more than four hours per day.

Workers like healthcare professionals who have to wear masks for long periods of time are more likely to suffer from skin irritations and infections.  Photo / Provided
Workers like healthcare professionals who have to wear masks for long periods of time are more likely to suffer from skin irritations and infections. Photo / Provided

Auckland dermatologist Denesh Patel says wearing a mask all day can compromise the integrity of the skin barrier. The skin becomes hot and clammy under the mask, upsetting the delicate balance of microorganisms on the skin. This in turn can cause problems, causing flare-ups of conditions such as eczema and dermatitis, and clogged pores leading to acne-like rashes.

Patel’s advice is to keep the skincare regimen as simple as possible. Cleanse the skin with a mild cleanser or just water, then follow with a light, fragrance-free moisturizer. Makeup, facial scrubs, perfumes and a range of lotions and potions will further irritate the skin, he says.

Wear a clean mask every day and wash cloth masks with mild soap, not harsh detergents or disinfectants. Patel, who is president of the New Zealand Dermatological Society, says he and his colleagues have noticed a sharp increase in patients with skin irritation following the addition of laundry antiseptics containing the chemical benzalkonium chloride.

Since the pandemic, people think they need extra additives for the family wash to make sure it’s clean, he says. Instead, some have broken out into rashes where clothing is in close contact with the skin.

“There has certainly been a huge increase in the number of patients we dermatologists are seeing as a result.”

One of the problems faced by Kiwis with skin conditions is the shortage of dermatologists. Waiting lists last up to eight months and some practices are not accepting new clients. And there is a dire lack of dermatology services in the public system, with many parts of New Zealand having no access to a dermatologist.

But Howick skin specialist Dale Chandler says there are steps sufferers can take before they need to see a dermatologist, including diet and lifestyle for skin conditions. like acne. Chandler sees hundreds of clients at her business, House of Aesthetics, and at a medical clinic in Albany.

Dale Chandler, skin specialist in Auckland.  Photo / Provided
Dale Chandler, skin specialist in Auckland. Photo / Provided

She, too, sees mask-wearing clients with skin conditions including redness, dryness, itching, rashes, acne, and sometimes sores caused by friction from an ill-fitting mask. Even those who have never been prone to acne now find themselves dealing with the disease. The environment behind the mask is an ideal breeding ground, she says.

“If you’re looking to grow bacteria in a Petri dish, you add humidity and heat and the bacteria will grow.”

It is important to wear a clean mask every day and to take a break from the mask whenever possible.

“If you’re using cotton masks, you need seven to 10 to make sure they’re washed regularly.”

Wash them with a mild soap and don’t use fabric softeners, she advises. Keep makeup light and choose mineral-based makeup, not makeup that contains talc.

Kohimarama beautician Astrid Delaney has noticed a marked increase in clients showing up with what she calls a “face mask”. Normally fair-skinned men and women complain of acne they haven’t had since adolescence.

She is not in favor of too frequent washing of disposable masks because the fibers begin to degrade.

“These simple blue and white surgical masks are made to be disposable, they are not made to be recycled,” she says. “If we were to look under a microscope at the inside of a mask, you would be shocked.”

Skin experts advise wearing a clean face mask every day to help guard against skin conditions.  Photo/Brett Phibbs
Skin experts advise wearing a clean face mask every day to help guard against skin conditions. Photo/Brett Phibbs

Ten tips to guard against the face mask

• Wear a clean mask every day; change more often if you can

• Wash cloth masks well with mild soap and dry in heat or in the sun

• Wash disposable masks by hand with mild soap and discard after two or three uses

• Cleanse and apply a light moisturizer to the skin before wearing a mask and after removing it

• Use lip balm to keep lips moist

• Use a skin barrier repair cream in the evening if needed

• Keep makeup to a minimum. Heavy makeup will clog pores

• Make sure the mask fits snugly so it doesn’t chafe. Take the mask off, even for five minutes, whenever you can take a break

• Change the type of mask or fabric if you experience an allergic reaction

• If specific materials cannot be avoided, place two layers of gauze or cloth inside the mask where irritation occurs

About Sally Dominguez

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