Maskne: a narrative review of mask-related acne in healthcare workers during the Covid-19 pandemic

Authors

  • Débora da Silva Mendonça Centro Universitário ABC, Faculdade de Medicina do ABC, Departamento de Medicina da Coletividade, Santo André, SP, Brasil https://orcid.org/0009-0005-0831-6143
  • Claudia Esteban Centro Universitário ABC, Faculdade de Medicina do ABC, Departamento de Medicina da Coletividade, Santo André, SP, Brasil https://orcid.org/0000-0003-1225-7500
  • Maria José Fernandes Gimenes Centro Universitário ABC, Faculdade de Medicina do ABC, Departamento de Medicina da Coletividade, Santo André, SP, Brasil https://orcid.org/0009-0002-3656-8418
  • Eduardo Costa Sá Centro Universitário ABC, Faculdade de Medicina do ABC, Departamento de Medicina da Coletividade, Santo André, SP, Brasil e Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Patologia, Unidade Curricular de Medicina Legal, São Paulo, SP, Brasil https://orcid.org/0000-0001-6431-5421

DOI:

https://doi.org/10.11606/issn.2317-2770.v28i1e-212490

Keywords:

Masks, Acne, Maskne, Mask related acne

Abstract

Introduction: "Maskne", a term used to describe acne related to prolonged use of protective masks, is a type of acne caused by mechanical injury (pressure, friction) and occlusion. Objectives: This review aims to gather information on the prevalence of maskne, as well as to explore its risk factors, clinical characteristics, therapeutic measures, and preventive strategies. Methods: We conducted a narrative review of 19 articles published between 2020 and 2022, sourced from the PubMed, LILACS and SciELO databases. Results: The highest prevalence of maskne was identified in the United States (68.7%). Risk factors for developing maskne include prolonged mask use (>4-6 hours/day) and a history of pre-existing acne. Maskne is characterized by the presence of papules, pustules and comedones in areas covered by the mask, which appear after 6 weeks of mask usage. It may worsen pre-existing acne and improves after extended mask-free periods. Treatment is based on proper skin cleansing, moisturization, and the use of topical medications such as retinoids, benzoyl peroxide and salicylic acid. Preventive strategies include avoiding prolonged mask use, taking 15-minute breaks every 2 hours, not reusing the same mask for many days, and maintaining good hand hygiene. Conclusion: Despite being a recent phenomenon, maskne is already prevalent and has the potential to increase in the occupational context.

Downloads

Download data is not yet available.

Author Biographies

  • Débora da Silva Mendonça, Centro Universitário ABC, Faculdade de Medicina do ABC, Departamento de Medicina da Coletividade, Santo André, SP, Brasil

    Disciplina de Saúde Ocupacional, do Departamento de Medicina da Coletividade, da Faculdade de Medicina do ABC 

  • Claudia Esteban, Centro Universitário ABC, Faculdade de Medicina do ABC, Departamento de Medicina da Coletividade, Santo André, SP, Brasil

    Disciplina de Saúde Ocupacional, do Departamento de Medicina da Coletividade, da Faculdade de Medicina do ABC 

  • Maria José Fernandes Gimenes, Centro Universitário ABC, Faculdade de Medicina do ABC, Departamento de Medicina da Coletividade, Santo André, SP, Brasil

    Disciplina de Saúde Ocupacional, do Departamento de Medicina da Coletividade, da Faculdade de Medicina do ABC 

References

Centers for Disease Control and Prevention. How to Protect Yourself and Others [Internet]. [Acesso em 2023 jan. 19]. Disponível em: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

Drozdowski R, Gronbeck C, Feng H. Mask-related acne in the COVID-19 pandemic: an analysis of Twitter posts and influencers. Clin Exp Dermatol. 2021;46(5):943-5. DOI: https://doi.org/10.1111/ced.14608

Teo WL. Diagnostic and management considerations for "maskne" in the era of COVID-19. J Am Acad Dermatol. 2021;84(2):520-1. DOI: https://doi.org/10.1016/j.jaad.2020.09.063

Hadžavdić A, Bukvić Mokos Z. Maskne: A new entity in the COVID-19 pandemic. Acta Dermatovenerol croata. 2021;29(3):148-53.

Teo WL. The "Maskne" microbiome - pathophysiology and therapeutics. Int J Dermatol. 2021;60(7):799-809. DOI: https://doi.org/10.1111/ijd.15425

Foo CC, Goon AT, Leow YH, Goh CL. Adverse skin reactions to personal protective equipment against severe acute respiratory syndrome--a descriptive study in Singapore. Contact Dermatitis. 2006;55(5):291-4. DOI: https://doi.org/10.1111/j.1600-0536.2006.00953.x

Xerfan EMS, Facina AS, Andersen ML, Tufik S, Tomimori J. Acne flare-up due to mask wearing: A current pandemic scenario and its relationship with sleep. Skin Res Technol. 2021;27:1002–3. DOI: https://doi.org/10.1111/srt.13048

Kantor J. Behavioral considerations and impact on personal protective equipment use: Early lessons from the coronavirus (COVID-19) pandemic. J Am Acad Dermatol. 2020;82(5):1087-8. DOI: https://doi.org/10.1016/j.jaad.2020.03.013

Özkesici Kurt B. The course of acne in healthcare workers during the COVID‐19 pandemic and evaluation of possible risk factors. J Cosmet Dermatol. 2021;20(12):3730-8. DOI: https://doi.org/10.1111/jocd.14530

Dani A, Eseonu A, Bibee K. Risk factors for the development of acne in healthcare workers during the COVID-19 pandemic. Arch Dermatol Res. 2023;315(4):1067–70. DOI: https://doi.org/10.1007/s00403-022-02434-z

Darnall AR, Sall D, Bay C. Types and prevalence of adverse skin reactions associated with prolonged N95 and simple mask usage during the COVID-19 pandemic. J Eur Acad Dermatol Venereol. 2022;36:e1805-e1810. DOI: https://doi.org/10.1111/jdv.18365

Purushothaman PK, Priyangha E, Vaidhyswaran R. Effects of prolonged use of facemask on healthcare workers in tertiary care hospital during COVID-19 pandemic. Indian J Otolaryngol Head Neck Surg. 2021;73(1):59-65. DOI: https://doi.org/10.1007/s12070-020-02124-0

Altun E, Topaloglu Demir F. Occupational facial dermatoses related to mask use in healthcare professionals. J Cosmet Dermatol. 2022;21(6):2535-41. DOI: https://doi.org/10.1111/jocd.14415

Kiely LF, O'Connor C, O'Briain G, O'Briain C, Gallagher J, Bourke JF. Maskne prevalence and associated factors in Irish healthcare workers during the COVID-19 pandemic. J Eur Acad Dermatol Venereol. 2022;36(7):e506-e508. DOI: https://doi.org/10.1111/jdv.18054

Yaqoob S, Saleem A, Jarullah FA, Asif A, Essar MY, Emad S. Association of acne with face mask in healthcare workers amidst the COVID-19 outbreak in Karachi, Pakistan. Clin Cosmet Investig Dermatol. 2021;14:1427-33. DOI: https://doi.org/10.2147/CCID.S333221

LeBlanc K, Woo K, Wiesenfeld L, Bresnai-Harris J, Heerschap C, Butt B, Chaplain V, Wiesenfeld S. Impact of prolonged PPE use on Canadian health professionals. Br J Nurs. 2022;31(15):S30-S36. DOI: https://doi.org/10.12968/bjon.2022.31.15.S30

Cretu S, Dascalu M, Salavastru CM. Acne care in health care providers during the COVID‐19 pandemic: A national survey. Dermatol Ther. 2022;35(10):e15753. DOI: https://doi.org/10.1111/dth.15753

Zuo Y, Hua W, Luo Y, Li L. Skin reactions of N95 masks and medial masks among health-care personnel: A self-report questionnaire survey in China. Contact Dermatitis. 2020;83(2):145-7. DOI: https://doi.org/10.1111/cod.13555

Aloweni F, Bouchoucha SL, Hutchinson A, Ang SY, Toh HX, Bte Suhari NA, Bte Sunari RN, Lim SH. Health care workers' experience of personal protective equipment use and associated adverse effects during the COVID-19 pandemic response in Singapore. J Adv Nurs. 2022;78(8):2383-96. DOI: https://doi.org/10.1111/jan.15164

Dash G, Patro N, Dwari BC, Abhisekh K. Mask-induced skin changes during COVID pandemic: A cross-sectional web-based survey among physicians in a tertiary care teaching hospital. J Cosmet Dermatol. 2022;21(5):1804-8. DOI: https://doi.org/10.1111/jocd.14881

Althobaiti HM, Althobaiti H, Khan M, Alsatti H, Samarkandy SJ. The association between facial dermatosis and face-mask wearing during COVID-19 in Saudi Arabia. Cureiro. 2022;14(2):e22265. DOI: https://doi.org/10.7759/cureus.22265

Proietti I, Borrelli I, Skroza N, Santoro PE, Gualano MR, Bernardini N, et al. Adverse skin reactions to personal protective equipment during COVID-19 pandemic in Italian health care workers. Dermatol Ther. 2022;35(6):e15460. DOI: https://doi.org/10.1111/dth.15460

Spigariolo CB, Giacalone S, Nazzaro G. Maskne: the epidemic within the pandemic: from diagnosis to therapy. J Clin Med. 2022;11(3):618. DOI: https://doi.org/10.3390/jcm11030618

Raju SP, Sachdev M, Khunger N, Madnani N. Mask acne in skin of color: a significant dermatological condition amidst the COVID-19 pandemic. J Clin Aesthet Dermatol. 2022;15(4):44-8.

Cuddigan J, Black J, Deppisch M, Pittman J, Sonenblum S, Tescher A. NPIAP position statements on the prevention of lesions with N95 masks [Internet]. Westford, MA: NPIAP; 2020. [Acesso em 2023 jan. 13]. Disponível em: https://cdn.ymaws.com/npiap.com/resource/resmgr/position_statements/Mask_Position_Paper_FINAL_fo.pdf

Centers for Disease Control and Prevention. Implementation of filter facial respirator (FFR) reuse, including reuse after decontamination, when there is a known shortage of N95 respirators [Internet]. [Acesso em 2023 jan. 13]. Disponível em: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuse-respirators.html

Das A, Kumar S, Sil A, Jafferany M. Skin changes attributed to protective measures against COVID-19: A compilation. Dermatol Ther. 2020;33(4):e13796. DOI: https://doi.org/10.1111/dth.13796

Dréno B, Dagnelie MA, Khammari A, Corvec S. The skin microbiome: a new actor in inflammatory acne. Am J Clin Dermatol. 2020;21(Suppl 1):18-24. DOI: https://doi.org/10.1007/s40257-020-00531-1

Tsai TF, Rajagopalan M, Chu CY, Encarnacion L, Gerber RA, Santos-Estrella P, Llamado LJQ, Tallman AM. Burden of atopic dermatitis in Asia. J Dermatol. 2019;46(10):825-34. DOI: https://doi.org/10.1111/1346-8138.15048

Xu H, Li H. Acne, the skin microbiome, and antibiotic treatment. Am J Clin Dermatol. 2019;20(3):335-44. DOI: https://doi.org/10.1007/s40257-018-00417-3

Techasatian L, Lebsing S, Uppala R, Thaowandee W, Chaiyarit J, Supakunpinyo C, et al. The effects of the face mask on the skin underneath: a prospective survey during the COVID-19 pandemic. J Prim Care Community Health. 2020;11:2150132720966167. DOI: https://doi.org/10.1177/2150132720966167

Gupta MK, Lipner SR. Personal protective equipment recommendations based on COVID-19 route of transmission. J Am Acad Dermatol. 2020;83(1):e45-e46. DOI: https://doi.org/10.1016/j.jaad.2020.04.068

Reszke R, Matusiak Ł, Krajewski PK, Szepietowska M, Białynicki-Birula R, Szepietowski JC. The utilization of protective face masks among Polish healthcare workers during COVID-19 pandemic: do we pass the exam? Int J Environ Res Public Health. 2021;18(2):841. DOI: https://doi.org/10.3390/ijerph18020841

Rudd E, Walsh S. Mask related acne ("maskne") and other facial dermatoses. BMJ. 2021;373:n1304. DOI: https://doi.org/10.1136/bmj.n1304

Choi JM, Lew VK, Kimball AB. A single-blinded, randomized, controlled clinical trial evaluating the effect of face washing on acne vulgaris. Pediatr Dermatol. 2006;23(5):421-7. DOI: https://doi.org/10.1111/j.1525-1470.2006.00276.x

Araviiskaia E, Dréno B. The role of topical dermocosmetics in acne vulgaris. J Eur Acad Dermatol Venereol. 2016;30(6):926-35. DOI: https://doi.org/10.1111/jdv.13579

Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-73. DOI: https://doi.org/10.1016/j.jaad.2015.12.03. Erratum in: J Am Acad Dermatol. 2020 Jun;82(6):1576

Zagórska-Dziok M, Sobczak M. Hydrogel-based active substance release systems for cosmetology and dermatology application: a review. Pharmaceutics. 2020;12(5):396. DOI: https://doi.org/10.3390/pharmaceutics12050396

Patel AB, O'Donnell A, Bonebrake A, McHugh M, Espiritu K, Steele M, et al. Stewardship of personal protective equipment (PPE): an important pandemic resource for PPE preservation and education. Infection Control and Hospital Epidemiology. 2021;42(5):636–7. DOI: https://doi.org/10.1017/ice.2020.311

Published

2023-06-20

Issue

Section

Articles

How to Cite

1.
Mendonça D da S, Esteban C, Gimenes MJF, Sá EC. Maskne: a narrative review of mask-related acne in healthcare workers during the Covid-19 pandemic. Saúde ética justiça [Internet]. 2023 Jun. 20 [cited 2026 Jan. 18];28(1):1-9. Available from: https://revistas.usp.br/sej/article/view/212490