Dr. Sandra El Hajj - MSc, N-MD, DHSc
The world has witnessed another upsurge of COVID-19. Beginning in China and spreading to Europe, the United States and every other country, it’s obviously changed the way everyone goes about their daily life. As a response to this virus spread, nations adopted stay-at-home orders for everyone. Cases were on the decline in some countries, while others remained steady with higher (and even increasing) numbers.
Four months following the beginning of this bio-disaster, nations are still struggling with high numbers of cases and going through a “second wave.” Despite all of this, officials, especially in the United States, have decided not to impose another stay at home order; instead, they agreed on a set of rules to keep people safe and try to halt the spread of cases.
Many of these rules began to become laws, which lead to tickets and jail time for those who do not abide. Among the many rules are two golden ones: Wear a mask and respect social distancing.
With the new rule adopted worldwide, including the United States, everyone who goes into a public place must wear a mask. Whether you are shopping, at work or just walking in public places with other people, you need to wear a mask. Some people are wearing surgical masks, others are going for the N-95 and some opt for a washable cloth mask.
So, among them all, which masks are the most effective in avoiding the spread of COVID? It is essential to note that while infected people are being quarantined, about 80% of transmitted cases are the result of asymptomatic carriers of COVID-19(1).
Wearing a mask will help prevent the spread of the virus by those who are not feeling any symptom but still carry it. When you are not wearing a mask, you are not only more likely to spread the virus to others, but you are also putting yourself at risk of contracting the virus.
With everyone wearing masks on a daily basis, a new observation has been made: Most people with masks on seem to have some breakouts around their nose and mouth. So, yes! Masks can lead to acne (akaMaskne).masks! Maskne comes fromacne mechanica,which is a specific type of acne that results from friction caused by wearing any heavy clothing or gear.
Everyone has likely had to wear a mask at some point. So, we all know the sweaty, sticky humid feeling that you get when you have to wear the mask for a couple of hours. While some only need to wear them for a short period of time, others need to wear them all day. Those wearing masks regularly are noticing widespread breakouts around the nose, cheeks and chin. Maskne could even lead to eczema, which is dry, itchy skin.
When you wear a mask, it collects sweat, dirt, oil as well as humidity. Since you may have to wear a mask for long periods of time, these collected elements get stuck on your skin, just under the mask, staying on you throughout the day. Bacteria can also collect on masks and microorganisms get into the skin, causing inflammation acne.
According to the Cleveland Clinic, maskne is not an imaginary condition. It is very real and has been already been a problem faced by most professions that require daily mask use. Now, with COVID-19, it has become everyone's problem(2).
When your mask is on and you are talking and breathing, the mask traps hot air that creates the perfect environment for microorganism growth. The warm and humid setting helps the multiplication of yeast, bacteria and other skin mites like Demodex that are normally found on our skin at a normal healthy level. When these organisms grow, causing bacterial imbalances, flare-ups happen such as rosacea and perioral dermatitis. That’s when you notice small pimples and pustules on the skin around the mask(3).
With the various levels of mask-wearing regulations, many fallacies and misconceptions arise, especially when it comes to skin flares under the mask area.
Yes, you can. As long as you are not overusing it, makeup can still be worn under the mask. Just make sure that the layer applied is thin.
Having sunscreens and lotions applied on your skin, under the mask area, can help prevent friction from happening. So, they can help prevent the development and introduction of microorganisms into the skin. That being said, it is essential to keep the application thinly spread.
Yes. Having facial hair will surely aggravate the acne problem by trapping more warm air and moisture from sweat. If you can wash your face regularly, it will help prevent maskne; if not, you should use some toners like witch hazel that help freshen the skin. If that is the case, you have to wait until the beard and skin are dry before wearing a mask.
While masks come in different materials, lightweight ones can be looked at as better for your skin. They are cooler and help you breathe easier. These, however, do not offer the best protection against COVID-19. For an effective protection, the thicker the mask, the safer you are (and unfortunately, the more acne-prone you are).
Inflammation and infections can occur on your skin, under masks. There are many ways to prevent these flare-ups and keep yourskin radiant and healthy. Here are a few.
If you are not quarantined and have to go out to run some errands, have a break or go to work, here is one golden rule to follow: Wash your face. Before putting your mask on, and after taking it off, wash your face. This helps lower bacteria counts that are on the skin leading to flare-ups. Make sure the product you are using is not irritating to the skin. You do not want to dry your skin either. You may need to read the ingredients of your facial wash to make sure it does not contain chemicals that have been linked to adverse effects on the skin, such as aluminum, parabens, retinyl acetate or polyethylene.
Exfoliating your skin removes dead cells and bacteria. Removing these cells and whatever is lurking in them is a great way to prevent the development of maskne. Make it a habit to exfoliate once a week, helping clear your pores and remove any buildup. While some look for exfoliants targeting sensitive skin, others many go for homemade ones.
All you need to do is mix some sea salt, brown sugar or ground oatmeal and add to some coconut oil. Mix it all together use massage your face gently with the mixture. Following the massage, rinse your skin and dry it. Make sure you wait for your skin to be fully dry before wearing the mask.
Having a moisturizer applied on your face, prior to wearing a mask, will help prevent your skin from drying out and itching. When you have a tightly fitted mask, which is what is recommended to prevent the transmission of COVID-19, your skin has a higher chance of flaking.
A moisturizer becomes a barrier between your mask and your skin, protecting it from bacterial growth. It may also help to add specific essential oils to your moisturizers that are antibacterial, such as lavender oil. Read the label for any moisturizer you pick to make sure no harsh chemical is being used in it.
Everyone has heard, at some time, of some food options that may trigger or calm an acne flare-up.
First, you may want to get rid of refined carbohydrates such as pasta, white rice and noodles, breads and crackers, sweeteners and soda. A study, published by the Journal of European Academy of Dermatology and Venereology, explained that consuming refined grains and sugar increased the risk of developing acne by 30%. This link was assumed to be the result of higher insulin and blood sugar levels caused by refined carbohydrates(4).
Dairy products have also been linked to severe acne. It is not clear how dairy products cause a flare-up, but a study showed that people who consume milk regularly were four times more likely to have acne(5).
One more reason to stay away from fast food is its strong link to acne flare-ups. Burgers, nuggets, fries and sodas are all factors in acne formation. A study showed that men who were frequently eating fast food were at 24% more risk of developing acne(6); a study on Chinese adults showed a 43% increased risk(7).
Other foods that trigger acne formation include food that are rich in omega-6 fatty acids, corn and soy oil, chocolate, whey protein powder found in dietary supplements, as well as food choices that you are sensitive to. These can trigger inflammatory responses, making your skin under the mask more likely to develop acne.
While some food can lead to acne formation, others can prevent its development. Many foods and nutrients can help keep your skin healthy and acne-free. These include omega-3 rich food like salmon, flaxseeds and others.
Probiotics that help keep your gut healthy and help balance your microbiome can reduce inflammation thus lowering your risks of developing acne.
Green tea can be a great drink to opt for any time, but is particularly helpful furing COVID-19 and regular cold and flu season. It is rich in polyphenols that have an inflammation controlling power leading to a less chance for acne formation.
Some vitamins can also help, such as vitamins A, D, E and zinc.
Turmeric can also have anti-inflammatory effects due to its polyphenol curcumin. This can help regulate insulin sensitivity while preventing the growth of bacteria promoting acne formation (8).
COVID-19 has certainly changed the world the past few months. While no treatment or vaccine has been proven effective yet, and with the opening of states and countries, rules and regulations have been crafted to ensure a safer return to what is considered as the “new normal.” Among these regulations are mask-wearing and social distancing.
Covering most of your face, on a daily basis, everywhere you go can help promote acne formation due to the accumulation of bacteria and viruses as well as the provision of a warm moist environment. Moisturizing your skin, eating well and keeping your skin and mask clean are great ways to prevent such outbreaks.