Wearing a face mask is vital to prevent the spread of COVID-19, but the practice may cause acne for some. Many teens and young adults find that masks make their acne worse – or even give them acne for the first time. This mask-related acne, called "maskne," can make wearing a mask uncomfortable and irritating.
Your teen can't avoid wearing a mask, but they might be able to avoid maskne. Nnenna Agim, M.D., a pediatric dermatologist at Children's Health℠, explains why acne occurs and how you can care for your skin when you have to wear a mask for long hours.
How face masks cause acne
To understand how to prevent maskne, it's important to understand why it's happening in the first place. Dr. Agim explains that acne begins with the formation of micro-comedone – skin cells at the opening of a hair follicle, which become sticky. As the cells stick together, they block the opening of the follicle, forming a ‘whitehead' or closed comedone. Natural skin oils accumulate behind the plug triggering bacterial overgrowth and inflammation, which cause the cascade of pain, redness and swelling associated with acne.
"When you wear a mask, you are physically blocking those pores, and that can trigger the first step in the pathway that causes acne," Dr. Agim says.
Other factors may also increase the risk for maskne. There are millions of microorganisms, including bacteria on the skin. Some bacteria are good, helping care for your skin, while others can cause acne breakouts.
"The types of microorganisms you have and the ratio of good versus bad may vary based on how humid or dry your skin is in a given area," Dr. Agim says. "When your face is covered with a mask, you are changing the local environment of your skin and creating a more humid environment; this may influence the development of acne."
How to prevent maskne
Your teen can't control all the factors related to maskne. They still need to wear a mask and wear it correctly over their nose and mouth. But when they aren't wearing a mask at home, they can take steps to care for their skin.
- Wash your face every day. Make sure your teen uses a gentle cleanser on the skin each day. Avoid products that are too harsh, as this may disrupt the balance of bacteria on the face and damage the skin.
- Avoid heavy face products. Avoid any products that could cause more acne, including makeup and moisturizers. If your teen is using moisturizers, make sure they pick the lightest moisturizer possible. Encourage your teen to skip the makeup or use an oil-free product if makeup cannot be avoided. The same goes for sunscreen. Dr. Agim recommends choosing light, chemical-free products with as few ingredients as possible. Many of these products may be marked as "non-comedogenic." When your teen applies these products, they should wait 15 minutes before putting on a mask so that the mask doesn't soak them up.
- Take care of your mask. Teens should care for their masks well. Masks should be washed regularly. If the mask is 100% cotton, it will help the skin breathe. Before putting on a face mask, teens should brush their teeth and clean their faces. After wearing a cloth face mask, it's a good idea to wash it in hot water using a fragrance-free, hypoallergenic detergent. Make sure to check the fitting of the mask after washing, and if it doesn't fit tight on the face, you'll want to use a new one.
- Clean your face at the end of the day. At the end of the day, any product that goes on your skin should be completely washed off. Dr. Agim recommends using over-the-counter products that contain keratolytics, which are medications that unstick the cells and unblock pores. Common keratolytics include benzoyl peroxide, salicylic acid, lactic acid, glycolic acid and retinoids. Azelaic acid may also help, with the added benefit of reducing skin discoloration. Dr. Agim recommends using these products even if no acne has formed. "If you are using these products regularly and keeping pores open, acne is less likely to form," Dr. Agim says. "Whether or not acne has formed, I never recommend spot treatment. All of the skin on the face is at risk, so a thin layer of the preferred product should be applied to the entire skin surface, avoiding the eyes and mouth."
- Talk to a dermatologist if severe acne doesn't go away. If your teen's maskne has gotten severe, even painful, despite regular washing, there are prescription-strength topical and oral treatments that can help resolve the problem. A dermatologist can help your teen make a personalized plan for better skin health.
Children's Health is committed to remaining a trusted source of health information and care for you and your family during this time. See more resources to keep your family healthy at the Children's Health COVID-19 hub.
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