Daily Mask Wearing Is Hard on Skin: What To Do for ‘Maskne’ and Facial Bruises

“Maskne” is the new term that was coined during the pandemic to describe acne under facial masks. It is at an all-time high with the general public and healthcare providers.

So what causes it? This type of acne is called acne mechanica.

“This term refers to skin irritation from excess pressure, heat and rubbing against the skin caused by a mask,” says Cleveland Clinic dermatologist Shilpi Khetarpal, MD. “When the skin is constantly rubbed it becomes rough and forms acne-like bumps. Masks can worsen existing skin problems or cause new ones. Additionally, hot, humid weather can create the perfect storm for bacteria, causing acne to grow on the skin.”

Dr. Khetarpal recommends these simple steps to improve skin health under your mask:

1. Wash your face with a gentle, mild soap-free cleanser. This will remove excess dirt and oil that clogs the pores and causes breakouts.
2. Apply a fragrance-free moisturizer to keep the skin hydrated, which will act as a barrier between your skin and the mask and reduce friction. Look for ingredients like ceramides and hyaluronic acid, which can provide additional protection.
3. Avoid wearing makeup under the mask as this can contribute to clogged pores and leave residue on the mask.
4. If wearing a cloth mask, wash it daily. For medical masks, ensure that they are changed daily. Sweat, bacteria and oil accumulate on masks. If you have the option for a cloth mask, choose 100% cotton, which allows the skin to breathe and are less likely to cause breakouts when compared to blended or synthetic materials.

“If you do end up with acne despite these simple measures, you can try some over-the-counter remedies first,” says Dr. Khetarpal. “But keep in mind, all products that treat acne can be drying and irritating. So start with one medicated product at a time. Ingredients in these products that can treat acne include salicylic acid, adapalene, retinol and benzoyl peroxide.”

Other Issues

Masks and other personal protective equipment can also cause pressure injuries on the face and head. Areas at risk for pressure injury development include the forehead, cheek bones, bridge of the nose and behind the ears. Pressure injuries may appear as non-blanchable reddened areas on the face, blisters, and/or open wounds. Cleveland Clinic’s Wound Care team recommends using some type of transparent dressing each day to protect at-risk skin and/or open wounds. They recommend cutting squares, rectangles or circles and applying the dressings where the mask sits over the irritated facial prominences. Note that the dressing adheres best on clean dry skin. Leave in place for entire shift or reapply as needed, and gently remove at the end of the day.

Dr. Khetarpal says contact dermatitis is another mask issue. This is an allergic reaction to any of the components of a mask, such as dyes, rubber and fabrics. This presents as a rash and can be very itchy. If this occurs, using a mild topical steroid like hydrocortisone can be helpful. Rosacea also can be flared by the heat and humidity under the mask.

If your skin issues persist despite trying these steps, it is important to seek medical attention of a dermatologist for additional treatment options.