Dealing With 'Maskne'? Here's How to Help Your Skin

Covering up our faces when we leave the house is a public health necessity during the COVID-19 pandemic, but it's leading to its own unique issue: "maskne."

The term refers to any type of acne or lesion triggered by the long-term use of masks and personal protective equipment (PPE). The most common type of maskne is acne mechanica, which involves eruptions that result from the mechanical friction of an object on the skin, according to Ranella Hirsch, MD, FAAD, a dermatologist based in Boston, Massachusetts.

“A classic example of acne mechanica is the chin strap on a teenage athlete’s protective gear,” Hirsch tells Verywell. 

For some people, maskne manifests as different types of pimples: pustules, papules, nodules, and cysts. Dustin Portela, DO, a dermatologist based in Boise, Idaho, tells Verywell that this could actually be perioral dermatitis or rosacea disguising themselves as traditional acne. These conditions stem from a compromised skin barrier and can lead to redness or small bumps centered around hair follicles.

Luckily, maskne is not a medical mystery. It’s possible to tailor your skincare routine to both prevent and treat it.

How to Treat Maskne

While you may want to coat your skin in acne-fighting ingredients, doctors advise against over-exfoliating your skin with strong chemicals. More powerful products should only be used as spot treatments.

"Some will find that the use of ‘actives’ will cause more irritation than normal," Portela says. "So it may be important to hold off on frequent use of chemical peeling or exfoliating solutions, retinoids, and scrubs."

If you overdo it on these products, your skin can become hyper-sensitized and dehydrated. This can cause your skin to produce more oil to help heal itself from within, leading to more chances for clogging.

“In some circumstances, an over-the-counter acne cream with benzoyl peroxide or salicylic acid could be helpful as a spot treatment," Portela says. "In other circumstances, prescription medications that are designed for rosacea may be needed."

According to Carrie Kovarik, MD, a dermatologist and associate professor of dermatology at the University of Pennsylvania, if you are going to use actives such as salicylic acid, it’s best to use them at night and to make sure you go heavy on the sunscreen in the morning—even if you’re staying indoors.

“Topical medications will become stronger with more potential side effects when worn under a mask," Kovarik, who is also a member of the American Academy of Dermatology's COVID-19 task force, tells Verywell. "If you still have a problem, then see a board-certified dermatologist."

It's important to evaluate your skin—with the help of a dermatologist, if possible—before trying new products. Olena Beley, a skin health coach based in Paris, France, tells Verywell that actives are not a remedy for everyone's acne.

“I’m not a fan of telling people to use certain active ingredients without knowing what’s really going on with their skin,” she says. “Are we sure that people are experiencing actual acne? Or are we taking anecdotal evidence as a fact? In my experience, people are notoriously good at misdiagnosing themselves. What if their existing skincare routine is full of oils or other irritants? What if their skin condition is caused by yeast, or is type 2 rosacea? Both can look like acne, but won’t be healed with this approach.”

Preventing Maskne

There are a number of steps you can take to prevent maskne, like adjusting your mask habits and practicing a hydrating skincare routine.

Adjust Your Mask-Wearing Practices

Though you may feel tempted to find the lightest piece of fabric for your mask, it’s important to find one that’s still dense enough to curb the spread of respiratory droplets. Kovarik says double-layered cotton masks can provide protection while allowing some ventilation and moisture-wicking. (The World Health Organization recommends three layers for fabric masks.)

“Make sure that the mask fits snuggly but comfortably, without excessive friction or uncomfortable rubbing,” Beley says. “It’s possible that people are not washing their masks and using old dirty masks repeatedly, which may be what’s causing the acne.”

Portela says that healthcare workers are more at-risk for maskne given the tightness of their masks and the long hours spent wearing them.

“Some healthcare workers may have to use a tight-fitting mask and will need to be diligent about their skincare to avoid irritation,” he says. “If your occupation allows using a cloth mask, they may be less irritating.” 

He recommends refraining from wearing the same mask every day and making sure to wash or replace it regularly.

If you suffer from eczema or contact dermatitis that's being aggravated by masks, Kovarik suggests you opt for cone-shaped masks that stick out from your face and minimize friction, like KN95s.

Develop an Adequate Skincare Routine

Beley highlights the importance of fostering healthy skin care practices regularly, and not only turning to beauty counters every time your skin needs relief. 

“When skin is properly cared for, it can still get the occasional clog or pimple—it’s an organ that’s alive, after all," she says.

It’s important to evaluate your skincare routine as a whole and strip it of inessential irritants. This can include fragrances, physical scrubs, and essential oils, which Beley says contribute to more clogging.

Any products that aggravate your skin have the opportunity to easily penetrate into deeper layers through a process called occlusion, which occurs when a mask augments product-delivery to the skin. A similar process happens if you coat your hands with a heavy moisturizer and then wear gloves to bed to increase absorption.

For most skin types, a simple skincare routine should include a gentle, fragrance-free cleanser, a proper moisturizing routine, and sunscreen.

“I recommend that people adjust their routine to focus on barrier repair. Avoid cleansers that strip the skin of moisture,” Portela says. “Make sure to use a moisturizer morning and evening. I recommend a ceramide-based moisturizer. These simple lipids are an important part of the skin barrier."

When you’re applying your moisturizer, it’s important that you don’t spread it over parched skin, which exacerbates dryness.

Instead, Beley advises clients to follow her three-step moisturizing method:

• Spray your face with water
• Apply a hyaluronic acid serum while your skin is still wet (she recommends this $6 one from The Ordinary)
• Moisturize while your skin is still damp (look for a moisturizer with emollients such as triglycerides and squalane)

“The best way to treat real acne is to lower inflammation, which can only be done with gentle care," she says. "Wear sunscreen every day—otherwise you’ll get a super attractive mask tan."

What About Makeup? 

Some dermatologists, such as Hirsch, recommend you forgo makeup to prevent any potential for clogging. 

However, as with skin care, it’s all about ingredients: a light layer of oil-free foundation won’t completely derail you, and a tinted moisturizer may work as a good replacement.

“You can wear makeup with your mask, as long as you change your mask daily and cleanse well with a gentle, water-based cleanser,” Beley says.

However, that doesn’t mean you should overdo it with the foundation.

“Go light on the makeup under your mask," Kovarik says. "Thick makeup can clog pores, especially under your mask.

The most important thing to remember is that despite the stress that comes with newly formed-acne, nothing is more important than wearing your mask and protecting yourself and others from COVID-19.

In the grand scheme of things, acne could be the least of your worries.

“There’s not even a comparison,” Hirsch says. “Maskne never killed anyone.”

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.