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Mask wearing is of utmost importance for all of us to protect ourselves and others during this time.  As the world embraces this “new normal “maskne has emerged. Acne and irritation / flare-ups of pre-existing conditions on the area of the face covered by a mask.

Why does it occur? 

“Acne mechanica” is a special type of acne caused by occlusion, friction, excessive trapped moisture, oil build-up and pressure. All of which happens to us these days in the area covered by the mask.

Who gets it?

Though health care workers who effectively need to wear very tightly fitted masks are more prone, the general population is also suffering from it. People / patients with a prior history of rosacea tend to have flares. Patients prone to cold sores or herpes simplex are having recurrences, in addition to the causative – stress factor due to this pandemic. Pre-existing nodulo-cystic acne patients are having no relief. Hormonal acne which tends to be more along the jawline itself is worsened by the friction and moisture.

What happens?

There are additional problems to this phenomenon as well. If the cloth masks have been improperly washed, the detergent residues mixed with sweat are causing Irritant contact dermatitis.  The constant pressure and friction from the bands in the same region are causing dark patches and marks called frictional melanosis. Soreness is an additional factor and red flaring skin can be seen under these regions. Yeast growth called demodex folliculitis results in extremely itchy minute boils over the bears region, mostly for men.

How do we treat it?

A deep cleansing regimen with salicylic acid and application of a benzoyl peroxide 2.5% or 5 % formulation (never 10 %) helps with the oil control and pus-filled acne.
The marks/ patches and brown spots formed can be lightened using AHA creams, Glycolic acid and kojic acid containing creams. This isn’t the time to start your anti-ageing – Do not start retinol now on irritated skin. Use bedtime to let the skin breathe and apply medications. Using an anti-dandruff shampoo containing ketoconazole or selenium sulphide – a few drops as a lather on this region, takes care of the yeast growth / malassezia folliculitis. However, a dermatologist consultation is priceless
at this point as they know exactly how your skin type works and the issues with it. So do not hesitate!

How do we prevent it?

Always wear clean washed masks if you’re not a healthcare worker / not using the N 95. 100 % cotton ones are preferred. Try to have 5 of them to have a good washing schedule. Wash with a mild non-fragranced detergent and also make sure it is rinsed out well with no residues. Always wear the N 95’s when necessary. Make sure the masks are well fitted and change the position every 3 hours with sanitized hands, if possible, to shift the pressure regions. Use only a light water / gel-based moisturiser with pH 5.5 on this region. No make-up is preferred. No heavy creams / oil-based formulations. This is certainly not the time to try new skin care products no matter how tempted you are. The more minimal you are, the better!

By Dr. Sravya C Tipirneni, Consultant Dermatologist and Cosmetologist, Columbia Asia Hospital Whitefiel

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