Best Maskne Prevention Tips from a Dermatologist

In this article, we share an excerpt from Masking Up: A Dermatologist’s Guide to Maskne by Dr. Teo Wan Lin, Dermatologist at TWL Specialist Skin & Laser Centre, to give you tips on maskne prevention and the ideal face mask you should be looking for.

The tendency of the fabric mask to alleviate or trigger the dermatological disease

Acne, perioral dermatitis, seborrheic dermatitis, eczema, and rosacea are some of the common skin conditions that will be worsened by the wearing of a face mask. The reason is due to the occlusive microenvironment increasing the growth of bacteria and yeast, as well as the friction causing skin discomfort which can trigger off inflammation in individuals with pre-existing dermatological conditions. All fabrics will reduce the ventilation around the area of the skin covered by the mask, and this will increase heat and moisture, factors that promote microorganism growth. When it comes to maskne prevention, these are important factors to consider.

How functional textiles can help balance the “germs” required in maintaining skin health

What is the skin microbiome?

The term microbiome refers to the balance of germs-bacteria, viruses, fungi, mites, that work with our body to keep it healthy. These germs have to be present for our immune system to work and self-regulate. It is formed at birth, changes as one age, varying in terms of each location i.e. the germs on our scalp are vastly different from that in our oral cavity, our nose, and the rest of the skin. Various dermatological conditions have now been shown to be linked to microbiome dysbiosis, which relates to an imbalance in the skin flora.

Acne patients, for example, are colonized with propionibacterium acnes, and the latest research shows the link between a new type of bacteria known as C.acnes, on the skin of sufferers. Seborrheic dermatitis, a flaky condition that can affect the eyebrows, the nasolabial folds, around the nose area, and the scalp, is linked to an overgrowth of a yeast organism known as Malassezia furfur, which favors oily, moist and humid environments. Eczema is linked to staphylococcus aureus colonization, which drives a superantigen effect that causes inflammation in eczema patients. 

Functional biotextiles in dermatology, such as those impregnated with silver, zinc, or copper ions, have been proven to have biocidal effects i.e. inhibiting or killing off microorganisms upon skin contact. These have been used to treat fungal and bacterial infections, as well as an adjunct therapy in the treatment of eczema.  Such textiles hold potential for the treatment of maskne, and help in maskne prevention because of its effects on the microbiome and may reduce the risk of antibiotic resistance in individuals being treated for maskne.

The CUIONS™ Copper Silk Face Mask has been laboratory tested to kill Staphylococcus Aureus, a common bacteria that can cause secondary skin infections in acne and worsening of facial eczema. Bacterial/Fungal infections can cause maskne, making the mask ideal for maskne prevention. The surface is also water/splash resistant with adjustable ear loops.

The copper nanoparticle mask is clinically proven to be more hygienic than the standard fabric mask. It has anti-odor properties with the copper ions killing bacteria/fungi/microbes that come into contact with the mask. This is particularly suited for comfortable wear against your skin over prolonged periods. Copper impregnation is also backed by clinical studies to have active skincare properties such as anti-wrinkle and anti-ageing, due to stimulation of collagen growth through contact with copper ions actively released on contact with skin. Data from randomised controlled trials demonstrate statistically significant reduction in facial wrinkles after 2 weeks of exposure to copper infused textile.

How the material of fabric masks affect the skin – poor ventilation as a contributing factor

Many would have heard the term “breathable” fabrics being used when discussing the material of face masks and it is appropriate for me to delve further on this topic here for maskne prevention.

Our skin maintains a healthy microenvironment via self-regulation through transepidermal water loss, ceramide skin barrier, and natural moisturizing factors. Most of us are born with healthy skin barriers and the topmost layer also known as stratum corneum where most of the action happens. The health of the stratum corneum is crucial because we are able to produce sufficient amounts of lipids and natural moisturizing factors at the surface of our skin. Our stratum corneum adjusts according to our environment.

Transepidermal water loss increases in dry temperate climates and reduces in humid climates like Singapore. However, there is always a problem that arises when you have a dysregulation of the skin microenvironment. Poor ventilation is a very simplistic way to think about it in terms of what’s going on at the skin barrier but it reduces the evaporation of fluids from the surface of your skin. The fluids refer to your saliva, your nasal secretions, sweat which otherwise will not get in contact with skin. All that creates a new environment that does not allow your skin to breathe. The key concept here is that it is important to maintain a healthy skin microenvironment

Maintaining a healthy skin microenvironment for maskne prevention

Firstly, to counteract the negative environment that the facial covering is creating — essentially the increased moisture and heat retention.  How do we do that? The type of material matters of your mask. We know that there are breathable fabrics and there are non-breathable fabrics. Breathable fabrics would typically be made up of natural plant-derived origins such as silk, cotton, linen. However, these do not wear well and are less durable. They can have the added function of wicking moisture away from your skin which results in increased breathability, but also can retain the moisture within the fabric itself due to low evaporation rates and result in increased discomfort from the weight and stickiness of the fabric.

Synthetic fabrics – polyester, polyurethane derivatives are commonly used as part of surgical masks as well as N95 masks. The reason is that the tight weave of these synthetic fabrics can effectively prevent the transmission of respiratory particles and droplets. However, these are not kind to the skin at all. In fact, polyester creates an even “stuffier” environment and this can increase your chance of getting acne mechanica also known as occlusion acne, and does not help with maskne prevention.

That’s when the concept of breathability becomes important in maskne precention. What exactly is this breathability about? It is the material’s ability to wick moisture away from your skin and to keep it dry. You are constantly breathing in and out and this moisture will accumulate regardless especially when you talk while the fabric is in direct contact with your skin. Our saliva also contains enzymes. In individuals who have prolonged contact with this saliva on their skin, some may develop eczema or dermatitis in addition to mask acne bumps.

Natural Materials

The Lyosilk Mask is synthesised to be anti-microbial due to its quick drying and moisture wicking properties. It provides a cooling, sweat-wicking, breathable layer against skin to prevent skin irritation due to prolonged surgical mask wear.

The benefit of natural materials is that it is breathable. Though these are not waterproof, the density of these fibers is often much less than synthetic ones hence reducing the protection to the environment. This reduces the efficacy of the product. Natural fibers would include silk, cotton, linen. In my practice, we have been recommending individuals who have to wear a surgical mask in restaurants and medical settings to use a mask slip.

An example would be the Lyosilk mask slip to use with the surgical mask (derived from 100% plant cellulose fibers). It is very smooth and soft on the skin while wicking away moisture, which leads to increased breathability on your skin.  This, however, would mean there is an added layer to the surgical mask, which would increase the heat retentive properties of the mask. For usage in non-healthcare (lower-risk) settings, a reusable fabric mask made of a treated synthetic fabric with increased evaporation coefficient, cooling properties would be ideal for maximum comfort without compromising on the effectiveness of controlling the environmental spread of respiratory droplets.