KUALA LUMPUR: Face masks have become an essential part of everyday life with the government mandating its use in public areas to fight the spread of Covid-19.
Individuals, particularly ones with sensitive skin, however, have been seeking ways to fight what has been brewing under the mask — acne and skin irritation.
The term "maskne", short for mask-induced acne, has been cropping up on social media as more Malaysians attest to this pesky skin problem.
Doctors have also taken to social media to speak on maskne after seeing an increasing number of people with the condition, which is not necessarily caused by the unhygienic practise of mask-wearing.
"I do not have the exact figure on the number of cases, but there is a surge in people being treated for skin irritation and acne breakouts due to continuous mask-wearing," Dr Azura Mohd Affandi, a consultant dermatologist at Hospital Kuala Lumpur told the New Straits Times.
Maskne, she said, was a type of acne mechanica caused by skin friction, heat, pressure on the skin, or when the skin is not exposed to the air.
"Prolonged wearing of face mask causes an occlusive effect, which results in high temperature and humidity around the mask area.
"It causes increased sebum (oil) production and pore occlusion, which causes bacteria proliferation and leads to acne formation. The usual location of maskne is over the chin, bridge of the nose and cheeks."
Dr Azura said prolonged mask-wearing could also cause folliculitis (an infection of the hair follicles), while others had developed eczema due to irritation and allergy to the mask, where symptoms include itchiness and red patches.
She said healthcare and other frontline workers were most at risk due to prolonged use of masks and tighter fit.
However, doctors have reported an increase in acne flare-ups in people outside of health care, especially in those prone to get acne, like teenagers and people who often put on heavy make-up.
She said while a three-ply disposable medical mask is best for the protective effect, a washable cotton mask would be a better option.
Using a face cover made of 100 per cent cotton would be a good compromise because it allows the skin to breathe, Dr Azura said.
"As the temperature rises and you sweat more, you will need to keep the mask clean. Reusable face mask must be washed daily and allow it to dry thoroughly.
"Remove the mask to allow the skin to breathe when you are alone or not in a crowded place. Wipe the excess oil and sweat on the face with a clean tissue or towel."
Dr Azura advised people to practise simple skincare routines to prevent maskne and skin irritation, such as by washing face two to three times daily with a gentle soap-free cleanser.
"It is not advisable to use exfoliating masks as it will strip the skin barrier, leading to breakouts. When your skin barrier is disrupted, more bacteria can get in and cause increased water loss.
"When the skin is dehydrated, it tells the sebaceous glands to produce more oil and skin cells not to shed, which causes clogged pores and leads to acne.
"Apply a mild, fragrance-free moisturiser that will improve the skin barrier and reduce water loss. Avoid using make-up or putting too much face products on the skin."
She said the treatment for maskne would generally be the same as for regular acne, but it could be irritating to the skin and people would still need to contend with the continued irritation of the mask.
"One can try an over-the-counter benzoyl peroxide cream, starting with a 2.5 or 5 per cent concentration. Apply the cream after cleansing the face and before putting on the face mask.
"Retinoid containing cream can be added at night. In severe cases, consult a dermatologist, as you may need systemic treatment like oral antibiotics or isotretinoin.
"Wearing a face mask is extremely important in our fight against Covid-19, and it should not be compromised.
"However, the public should be aware of the skin problems that can arise from prolonged wearing of face mask and practise proper and rational face mask usage."