Why protective face masks can affect the skin (and how you can prevent it)

While many frontline workers already wear protective masks every day, wearing a face mask out in public has suddenly become a part of daily life for the rest of us as well. Face masks may be necessary for now, but wearing them regularly or for prolonged periods can be hard on the skin.

A lot of factors come into play- the attributes of the skin (sensitivity & underlying pre-existing skin conditions) and attributes of the mask (material of the mask, itā€™s fitting and duration of wearing).

Keep reading to understand the negative effects of wearing a face mask on the skin and how to prevent them.

Background on how Protective Masks affect the Skin

Click each drop down menu to learn more!

Why address mask related skin issues?

Besides getting rid of the skin concern itself, mask related skin concerns have a link with COVID 19 transmission!

  • Damaged skin exposes the basal layer of the skin which have found to contain the receptor for Severe acute respiratory distress-related Coronavirus-2 (SARS-CoV-2)
  • Irritated skin can be itchy which may promote frequent touching of the face as hence entry of the COVID-19 virus!
  • Irritation may also induce the wearer to remove the mask, at a time or place where it should not be removed.
Why would wearing a mask affect your skin?
  • Prolonged occlusion leads to a damp and warm micro-environment. There can also be increased sweating under the mask. This can exacerbate underlying skin conditions. It encourages the multiplication of germs like Pityrosporum yeast that act in seborrheic dermatitis and rosacea, bacteria that promote acne etc.
  • If something rubs against your skin all day, it disrupts the protective skin barrier, allowing moisture to escape and irritants to enter.
  • Medical masks may contain preservatives or disinfectants that may cause an irritant or allergic reaction.
  • In situations where it isn’t possible to remove your mask for prolonged periods, restricted fluid intake may lead to a feeling of intense thirst and constant lip licking, causing dry lips.
How do mask related skin concerns present?

Sites like nasal bridge, cheeks & chin, where the mask remains in contact, are more likely to be affected.

One could experience redness, itching, irritation, pus-filled bumps etc. These features could represent a wide spectrum of skin concerns:

  • Flare up of pre-existing conditions like seborrheic dermatitis, rosacea
  • Acne/breakouts
  • Irritant contact dermatitis or allergic contact dermatitis- eczematous lesions on the face corresponding to areas that are in contact with the mask. This would improve during holidays and time off from work.
  • Friction dermatitis
  • Pressure urticaria
  • Sores behind the ears or allergic dermatitis to the elastic ear strap
  • Lip lick dermatitis

Ways to protect the skin if you wear a face mask!

If you know you are going to be wearing your face mask for more than a few hours follow these steps to help prevent your skin from becoming irritated from your protective face mask. Click each factor to learn more >

Follow a gentle skin care routine

Gentle skin care can prevent skin problems and play a vital role in healing your skin.

  • Gentle cleansing – Prior to putting on a mask, use a gentle (mild, fragrance-free) cleanser to remove oil and dead skin cells to avoid clogged pores.
  • Daily Moisturizing ā€“ Moisturisers act as a protective layer that keep the skin barrier intact and therefore reducing the risk of irritation!
    • Apply a moisturizer immediately after washing your face and at least 30 min before a wearing mask.
    • If your skin is oily, or if you live in hot & humid weather, you can use a gel moisturiser!
  • Gentle cleansing & moisturising should be done not only before wearing a mask but also after coming home and taking your mask off as well!
  • Avoid harsh/irritating skin care products that you may be using otherwise like salicylic acid, retinoids, scrubs or aftershave.
Skip wearing makeup

Beneath a mask, makeup is more likely to clog pores and lead to breakouts or worsen mask-induced skin problems. If you have to wear makeup look for products labelled ā€œoil-freeā€, ā€œmineral-basedā€ or ā€œnon-comedogenicā€ (non-pore blocking)

Wear the right mask
  • A snug, comfortable fit prevents coronavirus transmission. It also reduces skin problems. If the mask feels too tight or slides around your face, the friction irritates your skin. Youā€™re also more likely to touch your face to adjust a poorly fitting mask which should be avoided in Covid times!
  • The fabric is also important. Invest in cloth masks (Of course, medical professionals may have to follow stricter guidelines!) But soft, natural, and breathable fabric, such as cotton is best for sensitive skin. Or at least ensure a lining of such fabric on the inside to be in contact with the skin. These materials would be gentler on your skin as opposed to disposable ones. Avoid synthetic fabrics, such as nylon, polyester, and rayon as these are more likely to irritate your skin.  Remember that while lighter fabrics are easier to breathe through, they may not filter the virus very well if loosely woven or in a single layer! Look for masks that are multi-layered or made of tight weave fabrics.
Wash your cloth face masks

Many health care organizations now recommend washing cloth mask after each use to prevent the spread of germs. But this is good for the skin too since washing removes oils, dead skin cells & particle build-up that collect inside the mask.

  1. Wash the masks in hot water, unless the instructions say otherwise.
  2. Use a fragrance-free, hypoallergenic detergent.
Taking a few minutes mask break every few hours

This tip helps health-care workers on the frontline to save their skin. Of course, only remove your mask when itā€™s safe to do so (like inside your car, at home or away from crowds) and after washing your hands. This gives the skin an intermittent ā€˜breatherā€™ break and an opportunity to wipe off the sweat.

Stop behind-the-ear soreness

Ensure your mask fits well. Find masks with different types of ties and ear loops and wear a different type each day.

Protect your lips

If you develop dry skin and chapped lips prevent this by applying petroleum jelly to your lips after washing your face. To prevent breakouts, take care to apply the petroleum jelly only to your lips and avoid lip licking.

Continue the treatment plan your dermatologist designed for you 

If already you have an underlying skin condition, such as acne or rosacea, itā€™s especially important to follow your treatment plan. This can help keep the condition under control.

These basic measures should help prevent (and to an extent improve) most mask-related skin issues. In case a concern persists or worsens, itā€™s time to approach your dermatologist!

To conclude, while wearing a protective face mask can seem inconvenient, it can be the simplest and easiest way to protect you and your loved ones in these times.

Published by Dr. Kanya Rani Vashisht

Dermatologist by day. Dreamer by dusk.

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