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Beneath the Mask: Treating “Maskne”

Julie C. Harper, MD, discusses some of the latest trends in social media for the prevention of maskne as well as reviews treatment options for patients with acne.

Dr Harper is a clinical associate professor of dermatology at the University of Alabama, Birmingham and consultant for Galderma.


Dr Julie Harper: Absolutely. Overall, just treating acne in general, we have always. We’ve got good guidelines that are published by the American Academy of Dermatology on managing acne. We know there are four targets when we’re treating acne.

We’re trying to hit the plugging of the follicle. We’re trying to hit C acnes, which is a bacteria. We’re trying to target inflammation, and when we can, we want to target the excess oil in the skin. We can’t always hit all of those, but our goal as acne doctors and acne prescribers is to try to hit as many of those as we can.

Again, a real cornerstone for treating acne for many years has been the topical retinoids. We have tretinoin. We have adapalene. We have tazarotene. Then again, we have this newcomer, the first new one in 20 years, which is trifarotene cream. Whether you have mild disease or pretty severe disease, those are considered first‑line treatments.

Of course, we also have topical benzoyl peroxide. We have topical antibiotics. We have systemic antibiotics. We have oral isotretinoin. In women, we have hormonal therapies. There are lots of different things available that we can use either by themselves or in combination when we need to in order to make acne better.

What I would tell people who are already on treatment for acne, and now maybe they feel like they’re flaring up because of their mask wearing or having to do, it’s really just please stay consistent. Don’t give up. I would say with your topical medications, if possible, put them on at least a good hour before you have to wear the mask. If possible, move their application to bedtime.

In dermatology, if we want to drive a medication into the skin, if we want to push, if you’ve got a bad hand rash, and we give you a topical steroid to put on it, we can cover that with a glove and then make it work better. We can push it into the skin, and you get more absorption, more penetration of the drug.

That would be what the mask would be doing potentially right now, although that may sound good to you, in the acne world, that might be irritating. When possible, I would use the medication and not immediately cover it with the mask. I would try to use it at a separate time of day.

Really, the main take home is, be consistent. This is not the time to make a big change to your treatment plan. You need to stay consistent. Do try to take that mask off when it is safe, and you can do it. Wash your face. Use a clean mask when that’s possible. All of those things together should help us to really control acne even in this era of maskne.

Of course, acne and maskne is important. It’s going to now be a big market. There’s a lot of things I’ve read about and heard about out there that are trying. Might, they’re trying to help lessen this maskne that’s out there. I’m not convinced that any of them make a big difference.

For example, something that helps to keep the mask from touching your face, there’s usually still a component of that that does touch the face. Again, I don’t think it’s about the mask touching as much as it is that warm, moist environment. As long as we are breathing underneath that mask, unfortunately, it’s going to be a warm, moist environment.

I’ve also seen where there are certain masks as they themselves are anti‑microbial, but I don’t know that that translates to the skin being anti‑microbial. It would be of course that the mask maybe is not able to harbor organisms. The C acnes that’s involved in acne is on the skin anyway, so I’m just not convinced that they do a lot.

You’re better off just washing that mask, doing great skincare, and staying very, very diligent with the treatment that you’re already on. If you’re not on treatment, we do have things that can help.

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