One side effect of the COVID-19 outbreak is an acne outbreak. Our clinic observes that there is an increase in patients who have gotten acne from the mandatory mask measures. We see as much as an increase in 20% of acne sufferers. We have been seeing patients of all ages and gender suffering from this.
Acne is a chronic inflammatory skin condition that forms when hair follicles are clogged with oil (sebum) and dead skin cells. Acne can come in several forms consisting of:
The cause of acne is multifactorial (Hormonal, genetic, medications etc). Acne occurs when the pores of your skin become blocked with oil and dead skin and this is the perfect breeding ground for bacteria to flourish. Each pore of your skin is the opening to a follicle. The follicle is made up of a hair and a sebaceous (oil) gland. The oil gland releases sebum (oil), which travels up the hair, out of the pore, and onto your skin. The sebum keeps your skin lubricated and soft.
One or more problems in this lubrication process can cause acne. It can occur when:
These problems contribute to the development of pimples. A pimple appears when bacteria grows in a clogged pore and the oil is unable to escape.
Due to the COVID-19 pandemic, we have been seeing many iatrogenic cases of acne due to prolonged mask usage.
There is a term for this – Maskne, which is known as acne mechanica medically. Acne mechanica is a form of acne that can affect anybody. It is triggered by excess heat, pressure, or friction (1). And in this case due to the friction on the face due to prolonged mask usage.
Masks help to keep saliva and any other droplets –emitted from breathing, talking, coughing or sneezing from getting into the air and potentially transmitting Covid-19 virus. Which also means these masks trap moisture and heat and is a perfect breeding ground for acne-causing bacteria to grow and worsen acne outbreak. Anything that traps heat or causes friction on the skin can cause acne mechanica. It doesn’t help that the 3-ply surgical mask is also splash-proof which means it is impermeable, so droplets cannot pass in and out.
In patients especially women, who are prone to perioral acne (acne around the mouth), mask wearing can worsen acne outbreak. As for men, mask wearing may also cause beard acne due to the friction and the trapped moisture, heat and dirt under the mask. When shaving, take note to shave in the direction of hair growth to prevent irritation of the hair follicles that can worsen acne. In addition, some people may be sensitive or allergic to the materials used in the manufacture of the masks and develop irritant or allergic contact dermatitis which present as a rash, redness, swelling and itchiness, and all these may also further worsen the acne.
Research has been done to show that acne has a psychological impact affecting self-confidence and productivity of sufferers. “Acne was perceived as troublesome and impacted self-confidence. Makeup was frequently used to conceal acne. Facial acne negatively affected health-related quality of life, was associated with mild/moderate symptoms of depression and/or anxiety, and impacted ability to concentrate on work or school.”
Even if your acne outbreak burn out or resolve, many acne sufferers are left with acne scars which they have to battle with. Research show that acne scars can also affect the sufferers both physically and psychologically.
A study was conducted by the National Skin Centre to understand the Impact of Post-Acne Scars on the Quality of Life Among Young Adults in Singapore. The study found that patients with acne scarring “were self-conscious of their acne scars and felt that their acne scars was affecting their social activities.” It also concluded that, “post-acne scars have a significant negative effect on the Quality Of Life of young adults. It highlights the need to increase public awareness of acne vulgaris and its sequelae through education programs and advocating early treatment to reduce the risk of scarring.”(3)
It is therefore imperative that we do our best to treat acne or maskne to prevent acne scarring.
The best way to avoid getting Maskne is to prevent it.
During this pandemic, mask wearing is mandatory. The golden rule in preventing maskne:
Additionally, streamlining your existing skincare routine is best when dealing with maskne or active acne in general. Proper cleansing with a gentle cleanser is a great way to cleanse any dirt trapped by the mask. Followed by a light moisturizer that is not too rich.
For women, wear minimal or no make-up beneath the mask.
For men, it might not be a good idea to keep a beard now as it causes more sweat and dirt being trapped around the area especially with a mask on. Remember to shave in the direction of the hair growth.
For acne sufferers, you will need to consult your doctor who will assess your acne condition and may prescribe:
Another way to treat acne scars is with Profhilo, newly launched in Singapore in Sep 2019.
It contains one of the highest concentration of HA in the market at 64mg per 2 ml of product. It is also called an injectable skincare used for improving skin quality, delivering deep skin hydration and treating skin laxity. As it can stimulate the production of collagen and elastin, Profhilo can be used to treat acne scars with fairly good results.
Over a period of 3 – 4 weeks, Profhilo kick starts the production of elastin, re-modeling the skin tissue and giving it a plumper and tighter look radiating a natural glow. Profhilo can be used as a standalone treatment or in conjunction with other fillers to replace volume loss, hydrate and tighten skin.
Maskne and acne when left untreated can lead to the formation of acne scars which can be difficult to treat. The Covid-19 pandemic may be here to stay at least till the end of the year and mask-wearing measures will be needed to help flatten the curve. It is therefore important for all of us to develop good mask-wearing habits, including frequent change of surgical masks and daily washing of our reusable masks with a gentle and mild detergent. Visit a doctor if you develop maskne who will then assess your skin condition, prescribe you with the appropriate treatments to help bring your maskne under control.
To find out more about acne and treatments, please contact the doctor or therapist at Ageless Medical.