L&rsquo;Officiel speaks to two expert dermatologists to find out.&nbsp;

Mask-wearing should be easy for most of us, especially when it means keeping ourselves and others safe. Frequent use though results in an issue that can get a bit heavy on our confidence in a webcam-dependent world: maskne. What triggers it? How to prevent it? And when breakouts die down, how do we heal the scars? Board-certified dermatologists Dr. Michael Chua of Imperial Dermatology and Dr. Windie Hayano of Skin, INC. weigh in.&nbsp;
<h6 style="text-align: left;">What really causes maskne?&nbsp;</h6>
<h6 style="text-align: left;">Dr. Michael Chua: </h6>
Maskne is a phenomenon that results from two things: friction caused by the mask to the skin and the unnecessary &lsquo;steam&rsquo; formation between the mask and mouth, making it a suitable environment for the proliferation of the normal flora&nbsp; (bacteria, fungi, and Demodex, a kind of mite) of the skin.
<h6 style="text-align: left;">Dr. Windie Hayano: </h6>
Mask acne is a particularly new condition a lot of people are experiencing due to the increased and mandatory wearing of a face mask or covering due to COVID.&nbsp; Acne is an inflammatory condition of the sebaceous glands and it has been plaguing people since, well, forever. Normally, the four pillars of acne are due to hormone changes, bacterial colonization, and abnormal skin exfoliation.&nbsp; However, there are conditions that worsen it like increased humidity with increases in temperature, occupational conditions, stress, sugar and dairy-rich diet, and of course genetic preponderance.&nbsp; Health care workers are used to mask-wearing but we are also not used to donning it for extended hours especially very tight N95 masks.&nbsp;&nbsp;
As you know, we are in a particular period in history, and mask-wearing is probably the most important thing we can do to protect ourselves and others from contracting COVID and other airborne diseases.&nbsp; It does however cause certain issues like mask acne.&nbsp; The tightness of the mask is necessary to provide protection but that can cause, friction and pressure on areas like the nose, cheeks, jawline, and behind the ears.&nbsp; The rubbing and friction can irritate these areas and cause inflammation on top of pigmentation and thickening of affected areas.&nbsp; Being in an already humid and hot country&ndash;it can promote bacterial overgrowth and cause our sebaceous glands to produce more sebum so you get this breeding ground for acne to just worsen. Some people may also be experiencing not just acne but also irritation from the mask and its components itself so there have been reports of contact dermatitis as well. It's important to distinguish between the two.&nbsp;&nbsp;
We must also consider the stress that the pandemic is causing to people. If we are to talk about acne specifically, the stress can cause levels of cortisol to rise, and hence, there can be a cascade of not just testosterone but also prostaglandins that promote inflammation.&nbsp;&nbsp;
<h6 style="text-align: left;">Knowing the answer to the first question, what would be the best ways to avoid maskne since wearing masks now is unavoidable?&nbsp;</h6>

WH: Well, I'm happy that you do point this out because mask-wearing is a must. But it does not mean that all is lost. First, consult your dermatologist. This can make all the difference, honestly. Your dermatologist can give you an accurate diagnosis and offer treatments like laser, light, chemical peels, and procedures that can quickly alleviate your condition. Low-level light therapy like the Healite can give you medical-grade anti-bacterial and anti-inflammatory doses of specific wavelengths of light that will alleviate pain, edema, and redness. Chemical peels like salicylic acid and glycolic acid at higher concentrations can effectively exfoliate and dry up lesions faster in between skincare while lasers can prevent and heal scarring and prolonged erythema or pigmentation. Other treatments that can help would be Botox injections that can prevent oiliness, excessive sweating, and even redness.&nbsp; This type of approach must be done by an expert doctor otherwise you can have unwanted side effects.&nbsp; In particularly severe conditions, our doctor may also prescribe oral medication like antibiotics or retinoids but this really has to be done under medical supervision. A conscious effort to improve and fortify skin quality can be done with injectables for hydration.&nbsp; We now have on hand hydrating fillers like Volite, Redensity, Skin booster, Rejuran. There is a whole range of cross-linked and non-cross-linked fillers for this purpose.&nbsp; I personally like Platelet-rich plasma combined with micro-needling or through lasers.&nbsp; These can really help keep skin looking supple and healthy.&nbsp;&nbsp;
MC: Unfortunately, with the pandemic, we need to prioritize wearing really protective masks. We shouldn't compromise that. The tighter, the better. That said, we need to always ensure that we change masks regularly for hygienic reasons. A good antiacne regimen also works in preventing pimples as well as doing damage control.
<h6 style="text-align: left;">What kind of products should we include in our skincare regimen that will strengthen our skin against maskne breakouts?&nbsp;</h6>
MC: Maskne is also treated like regular acne, thus antibacterial toners and creams are a staple. If the type of acne is comedonal (blackheads/whiteheads), products containing retinol/tretinoin might be warranted. Over-the-counter products containing benzoyl peroxide and azelaic acid work best for inflamed pimples. In severe cases, oral antibiotics are a must. Please avoid self-medication though and see your board-certified dermatologist.
WH: That said, an acne regimen is quite useful. Start your day with a mild cleanser, depending on how oily your skin is, you can actually skip the toner and just move into a really good sunblock. If your doctor deems it necessary, a salicylic acid toner or glycolic acid toner can be added. During the day, you may opt to cool and hydrate the skin with a mist. Personally, I like to use antioxidant serums containing niacinamide, hyaluronic acid or a yeast extract like the ones found in Shiseido&rsquo;s Ultimune prior to sun protection. I like hydrating mist in between especially when you can&rsquo;t really take a long break.&nbsp; I love the Ginza mist by Shiseido but it does have menthol which may not be tolerated by all skin types so you can opt for Avene or Evian thermal water. Local brands like Happy Skin even have mists with SPF.&nbsp; I liked that too. At night, I definitely recommend a gentle but thorough cleanse.&nbsp; I don&rsquo;t advocate mechanical scrubbing with a handheld device because that can just irritate the skin more.&nbsp; Constant rubbing is just a big no.&nbsp; Again, a serum rich in antioxidants and other actives are great followed by a retinol-based gel like Adapalene.&nbsp; Only then do I apply a rich hydrating cream that has calming properties. For oily skin, you can use something with hyaluronic acid formula. Ingredients like Centella asiatica and madecosside can be used due to their anti-inflammatory properties. There is more specific skincare for those rosacea types like Ruboril, or metronidazole topical gels. This is where your dermatologist can really guide you.&nbsp;&nbsp;
Shift to a low-sugar, high-antioxidant diet.&nbsp; Supplements that have B complexes are great for your skin.&nbsp; I personally like Heliocare but there are many of these skin supplements in the market.&nbsp; All things considered, compliance and consistency are key.&nbsp; You can&rsquo;t expect miraculous changes if you don&rsquo;t even take these supplements and skincare for at least three months to give you their benefit.
<h6 style="text-align: left;">After maskne, we need to focus on healing irritation and dark spots. What are the easiest ways to address this?&nbsp;</h6>
MC: There are many remedies that address discoloration as a result of pimple bouts. Products that contain alpha arbutin and kojic acid are good examples of over-the-counter ingredients. For stubborn cases, please see your board-certified dermatologist for stronger lightening agents or perhaps procedures like chemical peels or laser treatments. Deep scars though are harder to treat, thus it requires invasive procedures that should be done by professionals only.
WH: The most common long-term effect of any inflammatory reaction on the skin is either prolonged erythema and hyperpigmentation. This is especially true for Asian skin.&nbsp; I find such cases to use specific skincare that contains tyrosinase inhibitors.&nbsp; But the idea is to continuously use your acne regimen.&nbsp; For specific whitening, ingredients like niacinamide, cysteamine, kojic acid, and hydroquinone can be used.&nbsp; But again, do it under the care of a doctor. The non-negotiable will still be your sun protection.&nbsp; You can&rsquo;t expect sustainable results without it. Lasers like the Spectra XT are pigment-specific and you can do it in combination with other brightening lasers like LASEMD 1927nm Thulium laser.&nbsp; I personally take healing seriously so I like to mix my treatments (yes, even for acne) with PRP or platelet-rich plasma and growth factors that are great for skin. Prolonged redness can be a long-term concern as well so I target abnormal vasculature with lasers like a 595 nm laser or using the Clarity laser which is an Alexandrite (755 nm) and Long Pulsed 1064 Nd Yag combination platform.&nbsp; So the answer is, there really isn&rsquo;t an easy way to treat because these approaches have to be customized and we treat in layers and as we do so, we can remodel collagen and prevent and treat scarring at the same time.&nbsp;&nbsp;
Find Imperial Dermatology at Unit 907, Prestige Tower, F. Ortigas Jr. Road, Pasig City. Strictly by appointment only at (02) 8637 4097
Find The Skin INC at Room 303-304 Tritan Plaza Building, San Gregorio St., Paseo de Magallanes, Magallanes Village 1232 Makati, Strictly by appointment only. 028-8533024 or +63-917841501
Image by Patrick Bertrand from the L'Officiel Archives 1972 Issue 642

Image by Patrick Bertrand from the L'Officiel Archives 1972 Issue No. 642

How To Prevent and Treat Maskne 

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How To Prevent and Treat Maskne

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