Mask Acne Mistakes That Make It Worse: How to Calm and Clear Maskne

Hello. I am Dr. Lee Hae-han, a dermatologist. It has already been two years since we started living with masks due to the COVID-19 pandemic. Many people are likely concerned about new skin troubles appearing or existing ones worsening due to prolonged mask-wearing. Mask troubles require different treatments depending on their type, so incorrect self-diagnosis and treatment can worsen symptoms. Therefore, receiving an accurate diagnosis and proper treatment from a dermatologist is paramount.

Skin troubles caused by mask-wearing can largely appear as contact dermatitis, bacterial folliculitis, or acne. It is important to be familiar with each symptom.

Itchy and stinging? Contact Dermatitis

If the skin in the area covered by the mask is itchy, stings, and has a rash or oozing, it could be contact dermatitis caused by the mask.

White troubles and inflammation? Bacterial Folliculitis or Acne

If small, white troubles or inflammatory troubles accompanied by erythema appear around the mouth or on the chin, bacterial folliculitis or acne caused by the mask can be suspected.

If these symptoms appear while wearing a mask for a long time, we recommend visiting a nearby dermatology clinic with a specialist for an accurate diagnosis and treatment.

Mask-wearing affects the occurrence and worsening of acne in several ways.

• Physical pressure: The mask can strongly press on the skin, blocking pores, hindering sebum excretion, and potentially causing acne. In particular, the more skin contact a mask has, the more acne may appear.
• Hot and humid environment: The sealed environment inside a mask is very hot and humid, which increases sebum secretion and makes acne more likely to occur. Research also suggests that sebum secretion increases by 10% for every 1-degree Celsius rise in temperature. Furthermore, a hot and humid environment is conducive to the proliferation of acne bacteria (C. acnes) and Staphylococcus, among others.
• Forehead acne: When wearing a mask, hot air can rise from the gap between the nose and cheeks to the upper face, increasing the skin temperature on the forehead and causing excessive sebum secretion. Many people visit the clinic because they develop forehead acne, which had not appeared since puberty, even though it is not in the mask-wearing area.

In addition to acne, mask-wearing can cause contact dermatitis and bacterial folliculitis.

• Causes of Contact Dermatitis Chemicals in mask filters, such as synthetic materials, non-woven fabrics, and adhesives, can irritate our skin, leading to damage to the skin barrier. However, since some skin is irritated and some is not, it is difficult to say that specific chemicals in masks necessarily irritate the skin. Individual differences exist.

• Causes of Bacterial Folliculitis The hot and humid environment created by masks helps skin commensal bacteria, such as Staphylococcus, proliferate. It can also occur when hair follicles are irritated by micro-injuries or pressure from skin rubbing, leading to bacterial infection.

Mask troubles require different appropriate treatments depending on their cause and type. Be careful, as incorrect treatment can worsen symptoms.

• Acne Treatment For severe acne, various combination treatments, including Gold PTT, which destroys acne bacteria and sebaceous glands (the root causes of acne), can be effective. If not severe, applying ointments like Epiduo gel or Duac gel, or retinol-based medications prescribed by a doctor, may be helpful.

• Contact Dermatitis Treatment Generally, anti-inflammatory treatment is performed with steroid ointments or ointments like Protopic gel to reduce inflammation.

• Bacterial Folliculitis Treatment Antibiotic ointments are primarily prescribed for treatment.

Points to note:

• If you mistake contact dermatitis for acne and apply acne ointment, your skin may break out.
• If you mistake acne for contact dermatitis and apply steroid ointment, it may seem to improve initially, but symptoms can worsen later.

Therefore, for any trouble, you must consult sufficiently with a dermatologist, receive an accurate diagnosis, and then begin treatment.

The following lifestyle habits can help prevent mask troubles and prevent existing ones from worsening:

• When in a safe place, temporarily remove your mask to give your skin a break.
• Replace your mask frequently to improve the hot and humid environment inside the mask caused by breathing and saliva.
• To minimize physical and chemical irritation from the mask, avoid excessive pressure on your skin and find the mask that best suits you, one that doesn't cause itching or stinging when worn.
• After returning home, thoroughly cleanse your face with a mild acidic cleanser instead of an overly alkaline one.
• It is advisable to carefully use lightweight, hydrating moisturizing creams or mask packs to soothe skin that has become hot from prolonged mask-wearing and to replenish damaged skin barrier components.
• If you suspect you already have mask troubles, avoid touching them as much as possible and seek an accurate diagnosis and treatment at a dermatology clinic with a specialist as soon as possible.

We have discussed the causes, treatments, and prevention methods for mask troubles. If you are concerned about mask troubles, do not worry alone; consult with a dermatologist to regain healthy skin.