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My Face Covering Is Causing Acne. What Can I Do?

September 13, 2020

Wearing a face covering has become a necessary way of life as we continue to combat COVID-19. Unfortunately, this risk reducing measure can result in ‘maskne’—acne, breakouts, and skin irritation caused by prolonged wearing of a face covering.

Andrew F. Alexis, MD, MPH, Professor and Chair, Department of Dermatology; Mount Sinai West and Mount Sinai Morningside; and Director of the Skin of Color Center at Mount Sinai, explains what you can do to prevent breakouts while staying safe.

I think my face mask is irritating my skin. What can I do to prevent this?

Wearing a mask can inflame or irritate the skin in a number of ways. First, the pressure and friction on the bridge of the nose and behind the ears can lead to redness, soreness, bruising, and even erosions—erosions are particularly prevalent when N95 masks are worn for long hours.

Strategies for prevention include hydrating the skin and protecting the skin barrier with a gentle cleanser. After cleansing, use a non-comedogenic moisturizing lotion—a moisturizer formulated to not block pores—that contains hydrating and skin-protective ingredients such as ceramides, hyaluronic acid, glycerin, and dimethicone.

Ceramides are natural lipids that help support the skin’s barrier while hyaluronic acid attracts water and therefore, helps to hydrate the skin . Another moisturizing agent—glycerin—attracts moisture into the skin and dimethicone helps to seal the moisture by preventing it from evaporating from the skin surface.

Is there a material that is better for skin and more ‘moisture wicking’ that should be worn in warmer weather?

Fabric-based face coverings made of 100 percent cotton are breathable and recommended for the summer. They should be washed daily to prevent the build-up of oil and bacteria that can contribute to acne and related skin conditions. It is also important to wash the face twice daily—morning and evening—with a gentle cleanser. Unlike traditional soaps, gentle cleansers have mild surfactants (they are synthetic detergents or “syndets”) and have hydrating ingredients like glycerin.

I have to wear a face covering for hours each day. What else can I do to relieve irritation?

For health care, essential workers, and others who may wear N95s for long hours, placing a thin prophylactic silicone foam dressing to the bridge of the nose and behind the ears is a helpful tip—but one must ensure the seal of the mask is not compromised. If irritation does occur, applying a thin layer of healing ointment—like petroleum jelly—to the affected areas can help.

Also, when possible and in a safe/socially distanced environment, periodically removing the mask can provide extra relief and reduce the risk of heat rash or irritation from prolonged mask wearing.

Do you have any other advice about keeping skin healthy while wearing a face mask?

To avoid breakouts, I recommend doing without makeup – at least under the mask.

Additionally, ‘maskne’ sufferers may want to try using a benzoyl peroxide gel (5.5 percent or less). This is a useful non-prescription treatment for mild acne.

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