How to heal ‘maskne’ and other skin problems

Dermatitis, eczema, maskne — experts have seen a surge in skin complaints linked to our new hygiene measures. Here’s how to tackle them

The warm, damp environment behind a mask can cause an accumulation of sweat and humidity — an environment ripe for breakouts, itching and dryness.

One of the unexpected hangovers of lockdown living is the effect it’s having on our skin. From acne — “maskne” — associated with mask-wearing, to dry, chapped hands, our skin is facing a fight of its own to stay healthy. Some are experiencing allergic reactions to the chemicals in detergents used to wash masks or in antibacterial soaps and sanitisers.

A recent survey by dermatologists from the British Skin Foundation hints at the scale of skin problems, revealing that 56 per cent of children are experiencing some type of skin complaint associated with their hands. These include irritant dermatitis, which causes inflammation of the skin, and eczema, rates of which have increased to affect one in four children — up from one in five before the pandemic. There are likely to be similar problems among adults.

“Hygiene has been essential in reducing transmission of the coronavirus, but the flip side is that the frequent use of alcohol gels, water and soap have stripped away the natural oils in our skin,” says dermatologist Zainab Laftah.

“This compromises the skin’s barrier function and has resulted in increased rates of eczema requiring medicated creams in all age groups.”

Dr Adil Sheraz, a consultant dermatologist at the Royal Free Hospital in London, says the spike in eczema has been so significant that many hospitals have set up clinics to deal with it. “There has been a sharp rise in people experiencing real problems with the skin on their hands,” he says.

A Miss Venezuela beauty pageant contestant wears a mask in Caracas before going on stage. Picture: AFP

Sheraz says that masks can worsen existing skin issues or cause new ones. The warm, damp environment behind a mask can cause an accumulation of sweat and humidity that, combined with friction and pressure, creates an environment ripe for breakouts, itching and dryness.

Keeping a mask scrupulously clean — or replacing a disposable mask immediately after use — is essential.

“Masks soak up oil, sweat, dirt and pollution, creating a platform for bacteria and yeasts to multiply over time,” Laftah says.

“Putting a dirty mask on your face can lead to acne breakouts, skin infections and inflammation caused by these bacterial and yeast infections.”

A fabric mask that is not dirty or wet should be stored in a clean, resealable plastic bag before it is reused the same day, according to the World Health Organisation.

But how and how often to wash it? The WHO advises washing fabric masks in soap or detergent “at least once a day”. Soap powder and a standard laundry cycle is considered enough to wash coronavirus off.

Dry your fabric mask in a tumble dryer if you have one, but otherwise lay the mask flat to air-dry it.

Here’s the experts’ guide to preparing and protecting your skin.

Maskne

Mask acne, or maskne, is caused by a combination of hormonal changes in our bodies because of stress and the humidity beneath a mask. The result is a build-up of oil and dirt on the skin, creating an ideal environment for bacteria to grow.

What to do: The American Academy of Dermatology advises going make-up free beneath your mask to avoid clogging pores. “If you are very concerned about an acne outbreak, consult a pharmacist about what to use as some over-the-counter acne products, such as those containing salicylic acid, are harsh and might make matters worse,” Sheraz says.

Use a gentle, non-comedogenic cleanser and don’t overwash skin because it triggers the skin to produce more oil, potentially worsening the outbreak.

Actor Johnny Depp takes his mask off at the San Sebastian Film Festival in Spain last weekend. Picture: AFP

Itchy, dry skin

Even if you have never had eczema or the related irritant dermatitis before, there’s a greater chance you may be suffering now. Dry, red and itchy patches on your face, beneath a ring or between your fingers are classic signs. If you don’t rinse off soap thoroughly with water or dry your hands properly, Laftah says, “it enables chemical irritants to penetrate the skin deeper, resulting in inflammation”.

What to do: Wash hands with fragrance-free soap — even soaps and shower gels labelled “for sensitive skin” often contain parabens that will strip the skin of oils — and again with a rinse-off emollient product. “Don’t use hot water because it will irritate the skin further; cool or lukewarm is best,” Sheraz says.

“But do rinse thoroughly and pat dry, as rubbing hot, damp skin with a towel can make it feel more itchy and will break down the skin barrier even more, causing more dryness.”

A masked commuter at Sydney’s Town Hall Station. Picture: James Gourley

Hair loss

Laftah says she is not seeing more cases of hair loss owing to a stress-induced condition called telogen effluvium, most often seen after a serious illness, traumatic event or sometimes after childbirth.

“The sudden shock to the body causes a temporary disruption of the normal hair cycle, shifting healthy growing hair to the ‘hair-shedding phase’ known as telogen, which results in hair loss,” she says.

What to do: Although it can be distressing, telogen effluvium is temporary. “It’s a non-scarring condition, which means your hair will grow back within six to nine months of a complete hair cycle,” Sheraz says. “In the meantime, use gentle hair products and consume enough protein in your diet to aid regrowth.”

Low ferritin (stored iron) levels can exacerbate hair loss, so be sure to consume iron from red meat, chicken, fish liver, eggs, bread, beans, pulses and green, leafy vegetables.

Tennis star Novak Djokovic after winning his men's final match at the Internazionali BNL d'Italia at Foro Italico in Rome on Tuesday. Picture: Getty Images

Cosmetic sensitivity

“Wearing a mask for even a short time can make the skin on your face become more sensitive,” Laftah says.

Sensitivities can arise in reaction not only to the mask itself, but to cosmetics, cleansers and skin products that they were previously using with no problems. There are also cases of people being allergic to adhesives and dyes in masks, or even the detergent they use to wash their face covering.

What to do: Try to eliminate what’s causing the sensitivity. Cut down on products that can potentially irritate your skin, including aftershave, products containing retinol and leave-on salicylic acid, and change your washing powder. Also, consider what mask you wear — 100 per cent cotton allows the skin to breathe, although you’ll need to keep it spotlessly clean.

Some lip balms can irritate our skin.

Chapped lips

Dry skin and chapped lips are a common mask-related skin problem. “Our lips lack the natural oil glands present in the rest of our skin, so they are particularly prone to becoming dehydrated behind a mask,” Laftah says.

The use of some fragranced lip balms and those containing ingredients such as camphor, menthol or salicylic acid can be irritants to the sensitive and thin skin on the lips so are best avoided.

What to do: Try a simple lip barrier containing petroleum jelly (such as Vaseline).

Redness around the mouth and nose

If the corners of your mouth and the skin around your lips and up to your nose are red with a rash and cracked, causing itchiness or inflammation, it could be a specific form of another mask-related problem called perioral dermatitis. Perioral dermatitis can also be a reaction to harsh cosmetics or toothpaste.

What to do: Products containing the detergent sodium laureth sulphate, including some toothpastes, can contribute to dryness of skin around the mouth. “Switch to mild, fragrance-free cleansers and be careful when you wash your face,” Laftah says. The rash tends to clear slowly, but can take a few weeks or even months. If it isn’t improving, consult a pharmacist or see a dermatologist.

Iran's Supreme Leader. Ayatollah Ali Khamenei, wears a mask over his beard in Tehran. Picture: AFP

Beard rash

Skin flaking, not too dissimilar to dandruff, is common when men are growing a beard. “Combine that with the hot and moist environment created by wearing masks, and skin infections are common. Particularly beard folliculitis — inflammation of hair follicles in the beard area caused by infection with the bacterium Staphylococcus aureus — and seborrheic dermatitis, a form of beard eczema caused by the yeast Malassezia globosa,” Laftah says.

What to do: Brush your beard before washing to exfoliate, and keep it clean by washing with warm water and a gentle soap or shampoo every day. “If you get an acute breakout, try using an antifungal cream and medicated shampoo to treat the inflammation and reduce the amount of yeast colonising the skin,” Laftah says.

The Times