How to Deal With Irritation From Face Masks and Coverings

Face coverings can protect you from getting or spreading airborne diseases like COVID-19. For some people, this protective measure may result in some skin irritation. This can be a real problem, especially for people who must wear face masks all day.

Face coverings don't let air flow around the face. This is one reason why irritation occurs. When you breathe, moisture becomes trapped on your face. The dark, warm environment can contribute to skin problems like acne.

Masks and facial coverings can irritate the skin in other ways, too. They may expose the skin to allergens, or they may simply cause irritation because they rub against the skin.

This article looks at mask and face covering-related skin issues. It also discusses treatments that can help and ways to stop these problems from happening.

Dry, Itchy Skin

When you wear a face covering for long periods of time, it can make your skin itchy. It may even cause peeling. If your face covering is made out of fabric like cotton, it can absorb the natural oils on your face. This could cause your skin to dry.

The Centers for Disease Control and Prevention recommends you wash your reusable cloth mask daily. Residue from laundry detergent and fabric softeners can also irritate your skin, however.

How to Treat Dry, Itchy Skin

• Use gentle, non-abrasive cleansers to wash your face. Examples include Dove, Cetaphil, or CeraVe.
• After you wash your face, pat your skin dry. Don't rub.
• Apply moisturizing cream. This will help rehydrate your skin. Look for products that contain ceramides. These are molecules that help create a barrier that retains moisture. Ingredients like glycerin and hyaluronic acid can also help draw moisture into the skin.

How to Prevent Dry, Itchy Skin

You can help stop your skin from becoming dry and itchy or peeling under your mask by using a good moisturizer. Other prevention measures include:

• Avoid moisturizers that contain mostly water. You can identify these products by reading the label. Skip those that list water as the first ingredient. These products may make dry skin worse.
• Avoid products with alcohol. They may burn and sting the skin. This can cause more dryness and peeling.
• Avoid products with retinoids. Anti-aging products often contain these.
• Avoid peels or scrubs with hydroxy acids. These may irritate dry skin even more.

Dermatitis

A skin rash that happens after wearing a face covering for long periods is probably irritant contact dermatitis. This is the most common form of dermatitis. It is caused by direct contact with something that irritates the skin. Symptoms include:

• Red rash
• Itching, which may be severe
• Dry, cracked, scaly skin
• Bumps and blisters, which may ooze and crust over
• Swelling, burning, or tenderness

Dermatitis can also be caused by an allergic reaction to material in the mask. For example:

• Rubber
• Glue
• Metal
• Formaldehyde

This is called allergic contact dermatitis.

How to Treat Contact Dermatitis

The American Academy of Dermatology lists some simple ways to treat a mild case of contact dermatitis:

• Take antihistamines like Benadryl (diphenhydramine)
• Use a gentle skin cleanser and rinse with cool water
• Avoid harsh scrubs, retinoids, and hydroxy acid products

How to Treat Allergic Dermatitis

An over-the-counter hydrocortisone cream can help relieve the itch. To help the rash clear up, however, you need to eliminate the thing that's causing the allergy. In this case, you need to use a different type of facial covering.

If you usually wear a surgical mask, consider wearing a cloth one instead. If you wear a cloth mask, try one made from a different type of fabric. Cotton is usually considered less allergenic than polyester. Wash your mask with hypoallergenic, fragrance-free laundry detergent before you wear it.

Note that medical-grade surgical masks are best for healthcare settings. Cloth masks work well outside of these settings, but they need to fit well. Choose one that has several layers and does not leave any gaps when you put it on. A metal nose bridge can improve the fit and prevent your eyeglasses from fogging up.

Once your skin rash starts to clear up, slowly taper off the hydrocortisone cream, if using. Keep using a moisturizer to help prevent a recurrence. 

Acne

If you're prone to acne, you may have more breakouts when you wear a face covering. This is because bacteria on your skin can become trapped within the mask. Any dampness that happens when you breathe or sweat can also contribute to clogged pores and breakouts.

How to Treat Acne

Standard acne treatments may not be the right choice for mask-related acne. Treatments like benzoyl peroxide and retinoids may take a while to work and can be irritating.

Instead, you should:

• Wash your face twice a day with a gentle, non-comedogenic cleanser. This is a skincare product that does not clog pores.
• If you can, limit how much time you spend wearing your mask. If you aren't usually prone to getting acne, your skin should clear up as you spend less time wearing a face covering.

How to Prevent Acne

• Use moisturizers that don't clog the skin, such as CereVe.
• Wash your face before going to bed. Never sleep with makeup on.
• Acne breakouts can cause post-inflammatory pigment changes. Sunlight can darken these spots. Try to avoid excessive sunlight exposure and wear SPF 30+ sunscreen daily.
• Avoid foods high in sugar and foods high on the glycemic index like processed snack food, fast food, and white bread. Some studies have found a link between acne and high-sugar diets.

Rosacea

Rosacea is a skin condition that can make the nose, cheeks, forehead, and chin appear flushed. The condition can also affect the chest. It has many triggers, including heat. Wearing a face covering increases the skin's temperature. This can potentially cause a rosacea flare.

How to Treat Rosacea

Your healthcare provider can prescribe medication to treat rosacea. Like acne treatments, though, most take time to work. The best way to address rosacea that's related to wearing a face covering is to prevent flare-ups.

How to Prevent Rosacea

• Keep your face cool as much as you can. Take your mask off whenever you don't need it. It can also help to splash your face with cool water.
• Use fragrance-free skincare products. Avoid ingredients like alcohol, camphor, and sodium laurel sulfate.
• Don't use products like toners or astringents.
• Avoid caffeine and alcohol.
• Avoid spicy foods and other foods that cause flare-ups. This includes yogurt, chocolate, and soy sauce.
• When you're wearing your mask, avoid activities that trigger excessive sweating, if you can.

Sore Spots on the Ears or Nose

You can get sore spots over your ears and nose if you wear a mask or face covering for long periods of time. This happens when your mask rubs on your skin and creates friction.

How to Treat Sore Spots

Whenever it's safe, take a break from wearing your face covering. This is the best way to help sore spots heal. You may also want to change the type of face cover you're using. For example, try a well-fitting mask with a head strap or ties instead of ear loops.

How to Prevent Sore Spots

You can help reduce friction with a product called Duoderm. This is a gel-like substance that helps wounds heal and can prevent additional skin damage. Apply it to the areas where the sores appear.

Duoderm can be purchased over-the-counter in drugstores. You can also use products like Vaseline or zinc oxide.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.