Is Your Face Mask Making Your Skin Condition Worse?

Little things can set off major skin flares. So what to do when your face is swathed in itchy fabric? We asked the experts.

by Erin L. Boyle Health Writer

You might have heard of “maskne”—acne on your face caused by wearing a mask—but what if you already had a chronic skin condition, like rosacea or facial eczema, before masks became vital during the pandemic? It’s quite possible that wearing masks has caused your chronic issues to worsen, thanks to their hot, restricting fit. So how do you prevent flares and continue to treat your skin condition, all while wearing a face mask? We asked top dermatologists for smart ideas to survive these unusual times.

Triggering Mask-Induced Flares

Masks can spell trouble for facial skin for two main reasons—they promote irritation due to moisture trapped under the mask, and increase sensitivity because of the friction from rubbing against the skin, says Julie Harper, M.D., a dermatologist and clinical associate professor of dermatology at the University of Alabama in Birmingham.

Add to this irritation the facial breakouts or flares common with chronic conditions like rosacea and eczema, and you have a recipe for itching disaster. “It’s an ideal environment for the development of acne, rosacea, and perioral dermatitis symptoms, to name a few,” Dr. Harper says.

So now you’re caught between protecting yourself from COVID and protecting your skin from painful flares. Not a fun spot to be. The good news (and there is a sliver, we promise) is that certain steps can help reduce your odds of a mask-induced flare. Start with these tips.

Choose the Right Fabric

If you prefer wearing a reusable mask, choose one made of cotton fabric, preferably organic, says Debra Jaliman, M.D., a dermatologist in private practice and assistant clinical professor of dermatology at Mount Sinai School of Medicine in New York City. This breathable fabric is less likely to irritate your face than synthetic fabrics like polyester, which can cause overheating, worsening conditions like rosacea and eczema. Cotton is also great at absorbing sweat. Bamboo is another good fabric option—a soft, breathable material with antibacterial properties. Just make sure that these fabrics line the side of the mask you’ll wear closest to your face.

Wash with Care

“Reusable masks need to be washed often, and the detergents used to wash these masks can irritate someone with sensitive skin and even contribute to maskne,” Dr. Jaliman explains. Look for detergents that are fragrance-free and hypoallergenic.

In addition, “some masks are not washed properly,” Dr. Jaliman says, which can allow bacteria to fester. The Centers for Disease Control and Prevention recommends that you wash reusable masks after each use at the hottest water setting allowed (you can wash with other clothes if you wish)—then use the highest heat setting in the dryer. (You can also air-dry it flat, preferably in the sun, which can help kill viruses.) If you prefer, wash masks by hand using a bleach solution (5 tablespoons of 5.25% to 8.25% bleach per gallon of room temperature water or 4 teaspoons per quart), as long as the fabric won’t discolor.

Change Masks Frequently

If you’ve been opting for disposable masks over cloth ones, that’s probably preferable for your skin, says Dr. Jaliman, as it ensures the covering will be germ-free. Of course, that’s only assuming you throw the mask away after each use and grab a fresh one. If it’s a reusable covering, wash after every wear to help prevent flares. In addition, follow this good rule of thumb: Change your mask when it gets dirty, wet, or damaged—even if you’ve only had it on for a few hours.

Keep Skincare Simple

“Many of us have multistep regimens that we do each morning, but I suggest only putting on the essentials,” says Dr. Harper. Since people can’t see makeup beneath a mask anyway, why not forgo the foundation to help your skin breathe better? If you can’t give it up, choose a non-comedogenic product that won’t clog your pores. Do continue your usual chronic skin treatments as directed by your doctor, but if your skin breaks out beneath your mask, hold off on medications until it heals: Certain treatments that contain salicylic acid, as well as certain peels or scrubs, can make your skin worse if it is raw from a flare, according to the American Academy of Dermatology Association (AAD).

Adjust Your Treatment Schedule

One important note for acne retinoid treatment: Do not treat, mask, and go. “I would avoid applying the medication and immediately covering your face with a mask,” says Dr. Harper. “This could drive too much of the medicine into your skin too quickly, causing irritation.” It might also cause the inside of your mask to become moist, thus losing its breathability and unwittingly trapping more bacteria against your skin. She has her patients put acne medicine on before bed, so this shouldn’t be an issue.

Remove Mask, Wash Face

By now, you’re trained to wash your hands after you get home from being out, but it’s important to wash your face after removing your mask, too. This will remove any oils, sweat, snot, and saliva the mask might’ve trapped on your skin. Be sure to use a gentle cleanser to prevent flares—the AAD has a Face Washing 101 video video to help guide people with sensitive skin—and then apply your typical treatment for your chronic condition, as needed. Also, don’t forget to moisturize with a lotion that contains ceramides, hyaluronic acid, and/or dimethicone after washing to add a protective layer against facial dryness.

Focus on Fit

For people with chronic skin issue such as rosacea, the fit of your mask matters. It should cover both your nose and mouth, and shouldn’t gape, because it can chafe your skin, potentially causing irritation. (The AAD calls this ideal experience a “snug, but comfortable fit.”) “Finding the right mask that fits well and doesn’t cause the skin to overheat is important to consider for rosacea sufferers,” says Dr. Harper, because heat is a common trigger for rosacea flare ups.

If long-term mask wear is causing rosacea bumps or blemishes despite your best attempts to prevent them, talk with your derm. Soolantra Cream or Oracea capsules (both prescription-only) might be options. One more rosacea tip from Dr. Harper: “Creating a barrier between the skin and mask is also important, so I would recommend a fragrance-free moisturizer for sensitive skin to help prevent irritation from the mask.”

Softness Is Everything

If you’re dealing with eczema, make sure to pick the gentlest, softest fabric you can find (some companies that make eczema friendly-clothing are branching out into masks—check your favorite labels to see if they’re getting involved). Thinking of making your own? Cotton t-shirts, when layered, make for eczema-friendly mask fabric. To reduce flare symptoms, your doctor might recommend elidel cream (prescription only), which you can apply to your skin before donning a mask.

Acne Isn’t Inevitable

Despite what you may have read (or experienced firsthand) about masks causing acne, it doesn’t have to be the case. Using lotion with aloe vera can calm your skin beneath the mask, and cold compresses (leave a wet washcloth in the freeze until you’re ready to use) can reduce irritation once the mask is removed. If you are prone to acne and your meds aren’t keeping up with the task at hand, talk with your doctor about trying a new treatment. “If you’ve tried one acne medication and weren’t happy with the results while wearing a mask, there are other prescription products out there that could result in clearer skin,” says Dr. Harper. “Just ask your dermatologist.”

Erin L. Boyle
Meet Our Writer
Erin L. Boyle

Erin L. Boyle, the senior editor at HealthCentral from 2016-2018, is an award-winning freelance medical writer and editor with more than 15 years’ experience. She’s traveled the world for a decade to bring the latest in medical research to doctors. Health writing is also personal for her: she has several autoimmune diseases and migraines with aura, which she writes about for HealthCentral. Learn more about her at erinlynnboyle.com. Follow her on Twitter @ErinLBoyle.