Dermatologists know skin better than anyone. And derms, like other doctors and essential workers, have to stay masked up for hours at a time due to COVID-19. Like most people who have struggled wearing face masks for prolonged periods, they can tell you that skin can truly take a beating ― there are breakouts, irritation and even bruising that can result from necessary mask wearing.
HuffPost spoke with dermatologists to see how they’re treating mask acne (aka maskne). Some of the fixes involve prescription-strength topicals, but most are affordable over-the-counter solutions, and one is a product meant to treat diaper rash in babies.
Dr. Adeline Kikam
“It was the first week, for me.” That’s when Texas-based board-certified dermatologist Adeline Kikam started noticing breakouts from wearing a mask.
In addition to bruising from the mask straps, she experienced contact dermatitis, which can cause irritation, especially around the bridge of the nose. Other common issues she’s seen in her patients are acne flare-ups from tight-fitting masks and humidity created around the mouth.
“I have acne-prone skin and what I use already targets breakouts from masks,” Kikam said, but she’s also added a prescription-strength cream and one over-the-counter product she says creates a “barrier” between her skin and the mask.
Her go-tos, even before the pandemic, include a salicylic or glycolic acid cleanser, serum and a moisturizer with ceramide, like La Roche-Posay Double Repair Face Moisturizer or CeraVe PM Facial Moisturizing Lotion.
But more importantly, Kikam occasionally applies a few creams that protect her irritated skin, and they’re super affordable.
“I sometimes apply a zinc-containing barrier cream to create a protective seal layer over compromised skin and to lock in moisture, like Desitin.” Yes, Desitin, the product that’s normally associated with diaper rash. But it contains the aforementioned zinc, which can help with inflammation and irritation.
Another product she uses sparingly is Cortizone 10 to help reduce itching or inflammation with contact dermatitis. “I rub a thin layer to the affected area twice daily as needed either before or after removing my mask for about a week or two for relief.”
Her nighttime routine is similar to the morning, but with the exception of sunscreen, and the addition of a prescription Retin-A, which Kikam says “keeps breakouts at bay.”
Dr. Melanie Palm
Melanie Palm, board-certified dermatologist and medical director of Art of Skin MD in California, doesn’t just spend nine hours wearing a mask during weekdays in the office, but an additional six hours doing volunteer work at a vaccination site.
While her major issue has been dry hands (she can wash them up to 80 times a day!), she also started noticing some skin concerns on her face.
“For me, the acne started to develop several months into mask wearing,” she said.
Though she has treated a few cystic lesions with in-office injections, the rest of her maskne routine is something anyone can incorporate, no visit to the derm necessary.
Her daily changes have been simple, like changing her cleanser and moisturizer to control oil production and soothe the skin. Instead of her usual glycolic wash, Palm said a wash with both glycolic and salicylic acids can “calm breakouts and combat perioral dermatitis from maskne.”
One of her go-tos is SkinMedica AHA/BHA Exfoliating Cleanser, which contains the aforementioned acids to cleanse and exfoliate the skin.
AHAs can increase sun sensitivity, and Palm always adds a moisturizer and sunscreen before applying her mask. She likes EltaMD for its noncomedogenic formula that doesn’t clog pores. It also contains two key ingredients that help fight breakouts.
“Zinc oxide and niacinamide are anti-inflammatory and do not promote oil production,” she said. That anti-inflammatory nature can help with acne, but also rosacea and frictional dermatitis from prolonged mask wearing.
Dr. Jessie Cheung
Chicago-based dermatologist Jessie Cheung has also experienced skin irritation that has led her to incorporate additional products to her everyday routine, including a few she uses throughout the day.
“I’ve definitely noticed an increase in acne in the areas that my mask covers,” she told HuffPost. “I also have dry lips and occasional irritation where the straps rub against my skin.
“I cleanse my face twice a day with washes containing either benzoyl peroxide, salicylic acid, lactic acid or glycolic acid ― these ingredients have the potential to dry out the skin while fighting breakouts, so I prefer using them as short-contact cleansers.” Cheung says these “short-contact” products, which means they can be washed off, are less irritating to the skin than acne treatments that are left on the skin all day.
Cheung has nixed wearing makeup under her mask, which she says contributes to breakouts, but she also takes a few moments to calm irritated skin, dry lips or any possible breakouts.
“I use Avène Thermal Spring Water. The minerals and microflora instantly calm the skin while restoring the skin barrier,” she said. And for acne breakouts, she dabs on prescriptions like Tazorac or BenzaClin. But for an accessible over-the-counter option, she also likes Neutrogena On-the-Spot Acne Treatment.
To soothe dry lips, Cheung said, “I get some of my exfoliating wash on my lips when I wash my face, and I’m applying Aquaphor ointment several times a day.”
At night she performs her usual skin care routine with the addition of a once- or twice-a-week application of prescription Tretinoin to prevent new breakouts. “I’ve also added in fading creams, as I am prone to hyperpigmentation as my acne heals.”
Though she applies a hydroquinone cream that’s only available with a prescription, another option she likes is Differin Dark Spot Correcting Serum.
A great skin care routine is only as great, and clean, as the mask covering the skin. All the dermatologists we spoke to use disposable masks while working, but for reusable ones, Palm suggests “washing the material in hot water and dry on high heat to kill any microbes/viral contamination.”