First and foremost, it is important to be gentle with your skin. While there might be nothing like an acne outbreak to remind you of the importance of a good daily skin routine, it’s important not to strip your skin’s protective barrier by using harsh products that could lead to a worsening of the problem. There may be an obvious temptation to break out the face masks, scrubs, washes and toners, but too much abrasion will simply cause further damage. It’s important to use a gentle cleanser, and avoid any products containing alcohol that could have a drying effect. 

The focus from most experts appears to be on moisturising and hydrating the skin. Soothing emollients can help to calm the irritation caused by friction, and non-comodeogenic moisturizers (those that will not clog the pores) might be a good choice. 

If outbreaks continue, over-the-counter acne treatments that help to unclog pores can be beneficial – for example, adapalene gel, other retinoids or azelaic acid. Azelaic acid has antimicrobial and anti-inflammatory properties, while retinoids increase the cell turnover rate and minimize the build-up of dead skin cells. Unfortunately, both options can have a drying effect on the skin, so they should be used sparingly (in small amounts, and possibly even on alternate days).

As more of the world embraces the use of face masks, in efforts to behave responsibly during the ongoing COVID-19 pandemic, ‘maskne’ is the term being used to refer to acne breakouts forming behind the masks. It is generally defined as acne or other skin irritation that results from wearing a mask, especially a medical, N95, or cloth face mask. It develops in areas covered by the mask, especially where the mask touches the skin. This means that it primarily affects the bridge of the nose, the cheeks and the chin.

Technically, maskne is a form of ‘acne mechanica’ – a well-defined form of skin irritation that is caused by excess pressure, heat and rubbing against the skin. When the skin is constantly subjected to these assaults, it can develop acne-like bumps. Before the COVID-19 pandemic and the widespread use of face masks, this type of irritation was most likely to be seen in athletes due to the sweat, heat and friction exerted by helmets and straps. 

There are three key factors contributing to the condition:

• Bacteria: Under the mask, your skin pores are clogged by sweat, oil and makeup (especially in warm weather), all further combining to make a perfect home for bacteria, which can cause an immune response that leads to acne. 
• Humidity: When your breath is confined under the fabric of a mask, moisture builds and creates a perfect breeding ground for acne-causing bacteria.
• Friction: Every time your mask moves across your face, it has the potential to damage your skin’s protective layer, making it more vulnerable to bacteria.

The problem can be exacerbated by wearing the ‘wrong type’ of face mask. Aside from avoiding abrasive materials that will increase friction, remember that masks made of fabric that are non-breathable, retain moisture, and create an environment in which bacteria can thrive, are more likely to cause acne. 

Considering the omnipotence and omniscience of Amazon, I probably shouldn’t have been surprised when my very basic ‘experiment’ of typing “Maskne” into the Amazon search engine returned a multitude of results. Top of Amazon’s list came Alva-Amco’s Prosacea, which was specifically described as controlling maskne rosacea symptoms of redness, pimples and irritation. Popular Korean skincare brand Dr Jart also has a special ‘Maskne Essentials’ category on its site - offering products such as its ‘facial barrier mask’ and an ‘anti-blemish patch’. If I needed confirmation that maskne was a ‘thing’, then the internet easily provided the proof I needed. 

In fact, the choice of products is already so extensive, as proven by another ‘experimental’ search on Google, it is difficult to know which ones to choose. Fortunately, organizations such as Flare (Canada’s guide to pop culture, fashion and beauty) have been ready to recommend their top five products for treating and preventing maskne:

1. Epionce Purifying Wash, formulated with salicylic acid
2. Vichy Deep Purifying Cleansing Gel, also formulated with salicylic acid, is an oil- and soap-free cleanser specifically formulated for acne-prone skin
3. Cetaphil Gentle Skin Cleanser, a non-conodogenic product that is soap- and irritant-free and hydrates skin as it gently cleanses
4. CeraVe Salicylic Acid Lotion for Rough & Bumpy Skin
5. Glossier Solution unclogs pores and sloughs off the built-up dead skin cells that can cause acne breakouts. 
   
   

Speaking to Beauty Horizons last month, Sharon Garment, a respected Beauty Industry Consultant based in New York, commented that, ”Beyond launching new products, which generally takes a year or more to develop, especially when it necessitates validating serious skin care claims, many brands are rushing to re-position existing products that address this new phenomenon. This allows them to maintain their customer loyalty by selecting products already in their arsenal, rather than lose them to a competitor’s brand or product that is championing this new challenge.”

While maskne might be contributing to a boom in certain skincare products, the cosmetics industry as taken more of a hit during the COVID-19 pandemic. I’m quite sure that I’m not the only woman in the world who woke up a few months into lockdown and thought, “Wow, I haven’t worn make-up for about 4 months now…”  As we all worked from home and avoided leaving our houses, demand for many colour cosmetics plummeted in the first half of 2020. 

Now, as lockdowns across the world are lifted, demand for make-up is expected to rise again as life returns to normal, businesses begin to re-open, and more people start going back into work. As most people wear masks covering just the lower halves of their faces, the initial market recovery appears to be focussed on products that show up above people's face masks – that is, mascara, eyeliner, eyebrows and eye shadows. However, there is still some demand for other products, for those times when the masks come off. 

Reflecting her expertise in product development, Sharon Garment noted that, “Brands are rushing to develop or promote transfer-resistant products, such as skin foundation and lipstick or lip gloss, which are usually compromised by wearing a mask. Lip colour products are in a decline due to the reality of so many people working from home, or being hidden by masks, but as we emerge from lockdowns there will be an increased demand for products that accommodate wearing a mask without disrupting the product underneath.“ 

Unfortunately, she explained, in the case of skin foundation and other face products, these ‘transfer-proof’ formulas are, by their nature, more occlusive, and can potentially exacerbate the skin conditions. Therefore, it may ultimately be a decision between wearing little or no face makeup on that area of the face, or using products that resist transfer but then be more diligent about cleansing and moisturizing the skin properly, and taking additional precautions to minimize possible irritation.

Wearing a face mask is essential in many countries right now – especially in social settings where physical distancing is difficult to maintain. Nevertheless, remember that you can remove your mask outside of those settings. Doing so can give your face a much-needed break from the assaults of friction, humidity and bacteria, and might help reduce the resulting immune responses leading to acne and other forms of skin irritation. 

Wearing colour cosmetics is something that many women are keen to resume, not only for appearance’s sake but also in order to feel more ‘normal’ again after such a tumultuous year. However, as face masks continue to be part of our everyday lives, our make-up will probably revolve around them, meaning a focus on bold eyes, transfer-proof lip colours and lighter foundations that are less likely to cause or exacerbate maskne. 

Most cases of maskne can be managed with a good skin care routine that is gentle to your skin. As the world braces for yet more waves of the pandemic, the habit of mask wearing will inevitably grow, seemingly making maskne a fad not to be missed by on-trend skincare brands.

However, if your condition should worsen, or becomes unmanageable to a level that concerns you, please make an appointment to see your healthcare professional who may be able to prescribe stronger forms of treatments like antibiotics or prescription strength gels and creams. 

Whatever you do, don’t give into the temptation to squeeze or pop those zits! Be kind and gentle to your skin, and – as with other challenges arising through COVID – we’ll get through it.