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ABy Margaret Mielczarek. ccording to Brisbane-based dermatologist Dr Leona Yip, mask acne – or ‘maskne’ as it’s come to be known – “is a term that was created to explain the phenomenon of acne formation and clogged pores with long hours of mask wearing during the pandemic”. According to PCCA Australia Education and Training Manager, and RP contributor, Marina Holt, maskne is a new Covid-related term, “because it’s not like healthcare workers never wore masks before”. “It really refers to what’s better known as mask acne, or really pimples \\\\\\\\\\\\\\\[that result\\\\\\\\\\\\\\\] from irritation from the mask,” she said. “Basically, it’s just being seen more because frontline healthcare workers are needing to wear their masks all the time, much more purposefully. “And it’s increasingly seen in the normal population, particularly as mask wearing is becoming mandatory in areas such as Victoria, where you really couldn’t go out without a mask.” Such areas now also include greater Sydney, the Central Coast, the Blue Mountains and Wollongong in NSW, as well as greater Brisbane. Causes of maskne Ms Holt says dermatologists have a medical term for maskne: ‘acne mechanica’. “It’s the type of acne that’s caused by repetitive physical trauma to the skin, usually by rubbing or scratching,” she said. “So, when you wear a mask, it really forms the perfect storm of oil secretions from the skin, sweat – because you’re talking through your mask and increasing that moisture, heat and bacteria – and also friction in all the areas where the mask is in \\\\\\\\\\\\\\\[contact\\\\\\\\\\\\\\\] with the skin.” These contributing factors and the increased use of masks among the general population, secondary to Covid-19 mandates, mean maskne is now “being seen in patients who have never had skin issues before”, Ms Holt says. Dr Yip cites “various factors” as causes of acne and other skin conditions that may arise from prolonged and consistent wearing of face masks. The three main factors that contribute to maskne, she says, are humidity and heat, cosmetics and friction. “The trapping of humidity and heat under the mask from long hours of wearing it ... can cause irritation to the skin,” she said. Such heat and humidity can also be caused by breathing, Dr Yip adds. “Breathing out ... air from the nose and mouth, \\\\\\\\\\\\\\\[can release\\\\\\\\\\\\\\\] bacteria, and that bacteria contributes to the acne formation process, too,” she said. “The second factor is occlusion or clogged skin pores from cosmetics. Makeup and skin care use under the mask ... can cause acne breakouts.” Elaborating on the third factor, friction, that contributes to maskne, Dr Yip said: “Friction from components of the mask, like wires that shape the nose ... can cause problems.” Irritation from the edges of the mask can also cause different skin problems, in addition to acne, she adds. Considering mask type and fit Although, as Dr Yip points out, “healthcare professionals and those on the frontline ... need to use properly fitted masks – the N95”, such masks, “because they need to be tightly fitted ... can cause more problems” associated with maskne. “Because they \\\\\\\\\\\\\\\[the N95 masks\\\\\\\\\\\\\\\] need to be tightly fitted, there’s a lot more trapping of humidity and heat, and \\\\\\\\\\\\\\\[this\\\\\\\\\\\\\\\] can therefore cause more problems with maskne,” she said. Dr Yip advises that for non-healthcare professionals who may be prone to maskne, “when possible and safe to do so ... cotton masks are better because they’re more breathable on the skin”. “If possible, take breaks as well \\\\\\\\\\\\\\\[from wearing a mask\\\\\\\\\\\\\\\] because that will help to reduce the chance of these tightly fitted masks causing maskne problems,” she said. The fit of a mask is important to consider, Ms Holt says, because ill- fitting masks will raise the potential for increased face touching. “It’s really important to make sure that the mask is fitted as comfortably as possible, because we often see people touching their faces constantly as the mask is not flush with the face – is too big, too small – and every time the mask shifts it causes unnecessary friction,” she said. Ms Holt points out that in an industry where masks are used regularly, checks are made to ensure they are being worn correctly. HEALTH SKIN MATTERS 35 “There are mask procedures for people who have to wear them in labs,” she said. “But, of course, it’s a very different thing when you’re just going out to do your shopping and you need to put your mask on.” Ms Holt advises that for those prone to maskne, cotton masks are recommended. She suggests using a 100 per cent cotton mask rather than a disposable mask “if you’re prone to maskne or if you have very sensitive skin”. “But it does need to be 100 per cent cotton, not polycotton, because the polyester will just increase the likelihood of sweating,” Ms Holt said. She adds that cotton masks should be washed regularly, while disposable ones should not be reused. “With a cotton mask, it’s really imperative that it’s washed daily, after use, to minimise bacterial contamination,” she said. “On the other hand, if you’re using a disposable mask, it’s really important not to reuse them, and of course, to dispose of them appropriately.” Wearing the same mask Another important consideration when wearing masks is frequency or duration of their use. “If you’ve got a mask on all day, you’re breathing into it \\\\\\\\\\\\\\\[and\\\\\\\\\\\\\\\] that sweat is getting captured,” she said. “That breath is going to increase the likelihood of bacteria being trapped in those masks. So, you want to be making sure that you’re changing those frequently – a couple of times a day. “Or if you like, if you’re on public transport you’d want to be using one mask outbound, as it were, and a different mask inbound. You wouldn’t want to be putting that same mask on for long periods.” The importance of hygiene According to Ms Holt, one of the best ways to prevent or minimise the chances of developing maskne is through ensuring “a quite simple, daily hygiene routine” that will help to “minimise discomfort”. “You want to make sure that you’re washing your face,” she said. “Not scrubbing it like crazy but just washing your face with a gentle cleanser ... \\\\\\\\\\\\\\\[or one of the other\\\\\\\\\\\\\\\] really good TO PAGE 36 RETAIL PHARMACY • JAN/FEB 2021