“Virtually all skin types will see some form of irritation from wearing a face mask if they are wearing them for extended amounts of time each day,” said Dendy Engelman, a dermatologic surgeon in New York. “Many people will see irritation from the physical friction and/or pressure of the material on their skin, while others will see acne pop up.”
Why masks cause irritation
Masks trap moisture, sweat, oil and dirt close to our skin. The resulting blemishes can include acne, small bumps, inflamed hair follicles, irritation, pressure sores, broken blood vessels, contact dermatitis and rosacea, said Jacob Steiger, a facial plastic surgeon in South Florida.
Habits we engage in while wearing masks can exacerbate the problem. Because the masks tend to move (there are very few custom-fitting masks on the market), we’re continually touching our faces to adjust them, leaving behind dirt or other irritants on our skin. We also move the mask around to eat or to take a sip of coffee — and any friction causes irritation.
Even the simple act of breathing is a complication. “When we breathe or talk into the masks, we increase moisture, which ends up changing our skin’s natural PH,” Steiger said. “This can result in an overgrowth of bacteria, which can create acne, inflamed hair follicles and a flare-up of rosacea.”
To avoid blemishes, you need to alter your skin-care routine and consider what kind of mask you are wearing.
Changing your skin-care routine
Keeping clean is the most important thing you can do to prevent breakouts, Engelman said.
So, before you pop that mask onto your face, wash with a gentle cleanser such as those from Alastin or Cetaphil. Add soothing products like Avene’s Cicalfate Restorative Skin Cream and SkinCeuticals Triple Lipid Restore, which will hydrate, repair and support your skin’s barrier function, Engelman said. Avoid wearing makeup, which can soil the mask and further clog your skin.
Next, tackle the irritation that the mask may be causing from friction. For this, she suggests a barrier cream such as Vanicream Moisturizing Ointment. “I’d suggest you use it sparingly along the edges where the mask is most tightly fitted,” Engelman said.
The goal is to seal in moisture to protect the skin, said LeighAnne McGill, a physician assistant with the Dermatology and Laser Center of Chapel Hill. She recommends applying a moisturizer containing anti-inflammatory ingredients such as niacinamide. Niacinamide is a B vitamin that supports the skin barrier by helping with ceramide production — proteins that retain water inside the skin. It also helps regulate the amount of oil produced by the acne-forming unit within the skin, she said.
To treat acne and blemishes caused by the masks, try cleansers containing salicylic acid, benzoyl peroxide or elemental sulfur, McGill said. Salicylic acid is a beta-hydroxy acid, which helps keep your pores clean, while benzoyl peroxide is a topical antibiotic that decreases levels of the bacteria that worsen inflammation on your skin. For those with sensitive or rosacea-prone skin, elemental sulfur is a gentle option that decreases skin redness and inflammation, McGill said.
Consider the type of mask
The type of face mask you’re wearing is also key, especially if you’re prone to acne. But in some cases — if you’re a health-care worker, for example — you might not be able to do much about it.
N95 masks, which can filter out more than 95 percent of small particles that could contain viruses, are considered essential protection for health-care workers performing procedures such as intubations. When fitted correctly, they create a tight seal around the nose and mouth, so health-care workers who wear these masks for long hours often experience pressure ulcers and irritant rashes in addition to breakouts, McGill said. Surgical masks don’t form the same kind of tightfitting seal, so they don’t do as much damage to your face, McGill said. They protect from droplets, but not small particles.
The effectiveness of cloth masks depends on the material, the fit and the number and kind of layers. When it comes to your face, cloth masks can absorb natural oils, which may trigger your skin to compensate and overproduce oil, leading to more acne, McGill said. The best cloth option for your skin is a mask made from silk or silk-lined materials, said Adam Mamelak, an Austin-based dermatologist, because silk has antimicrobial properties and has been shown to be better for people with sensitive skin. The downside to those? They aren’t as effective at preventing the spread of the novel coronavirus because they tend to gap around the cheeks, mouth and nose. Plus, the fabric is porous, so smaller droplets may be able to get through. Mamelak suggests looking for silk masks that include multiple layers with filters in between.
If you can’t snag a silk mask, try to find one with layers of breathable material such as cotton, which would be less irritating than heavier, more airtight fabrics that can increase facial sweating, said Dana Marshall, dermatologist with Klinger & Marshall Dermatology in Gretna, La. Avoid masks that have adhesives or glue that touch your skin directly.
Washing your mask
Regardless of the material, the mask needs to be cleaned often — both to protect yourself from the virus and from exacerbating skin irritations. (Oils and any dirt on the mask will affect your skin). If possible, wash it after every time you wear it. “The buildup of germs, makeup, lip balm, oils and even detergent residue on your mask can worsen acne and skin irritation when pressed against your skin,” said Gwen Whiting, co-founder of The Laundress, which sells eco-friendly laundry and home cleaning products. She recommends using a gentle detergent free from unnecessary additives such as dyes.
Put the mask in a mesh washing bag to protect the elastic from snagging, and use the hottest water possible, Whiting said. It can be washed along with your regular laundry. Adding a capful of bleach alternative to the hot water will offer an extra boost of clean. Use the highest heat setting to dry, and leave it in the dryer until the mask is completely dry.
If you’re washing your mask by hand, the Centers for Disease Control and Prevention recommends using 5 tablespoons of bleach per gallon of room-temperature water. Soak the mask in the solution for five minutes before rinsing with cool or room-temperature water and drying, in direct sunlight, if possible.
Braff is a freelancer based in Chicago. Follow her on Twitter at @daniellebraff.