Maskne Treatment & Prevention: Dermatologist Best Tips

In August 2020, Dr. Teo Wan Lin, author of Skincare Bible – Dermatologist’s Tips on Cosmeceutical Skincare, was invited as a guest dermatologist for Clozette’s Instagram live session on the topic of maskne. A prominent researcher in the area of cosmeceutical skincare, Dr. Teo answered questions about acne care, hydrocolloid patches, maskne, and imparted useful tips for skincare routines. Read on to find out more about what Dr. Teo shared with editor Becks Ko and beauty KOL Khaw Xin Lin. 

Watch the full IG live stream here.

When it comes to choosing skin care products to tackle maskne, should we choose natural ingredients or “chemical” ingredients? 

Dr. Teo emphasized that one should focus on whether the ingredient itself is evidence-based. “Some examples of naturally-derived ingredients that are beneficial come in the form of potent plant-based antioxidants, while chemical ingredients that are beneficial include salicylic acid, benzoyl peroxide, retinol, and retinoids. While these are synthetic structures, they have also been proven in our studies to have specific benefits for the skin.” 

Botanical ingredients are anti-inflammatory 

Dr. Teo highlighted a few specific botanical ingredients that can address inflammation. “Centella Asiatica (CICA), also known as the Indian pennywort, has been well-established to be a potent antioxidant. Centella Asiatica reduces inflammation and promotes good healing of scars. Ingredients like those derived from avocado oil are rich in polyphenols and fatty acids. Oleic acid – can also help in inflammation as well as the healing of acne scars. Salicylic acid which was first derived from the bark of willow trees,  is a chemical compound that can have good effects in terms of reducing oiliness of skin.”

What is the ideal cleanser?

On the topic of cleansers, Dr. Teo pointed out that the ideal cleanser is one that can effectively remove the oil, dirt, and grime, while at the same time, functions as a humectant. This means that it preserves a layer of moisture on the surface of your skin to minimize water loss to the environment — a phenomenon known as transepidermal water loss. “In individuals who have skin conditions such as acne, eczema, there is an imbalance in this bacterial count, and cleansing then particularly becomes an important part of the skincare routine. If the cleanser is too harsh on the skin, you’re going to aggravate these conditions because it dries the skin barrier out.

On the other hand, it has to effectively remove all these particles that are a breeding ground for bacteria.” She further elaborates, “If you find that your cleanser is making you feel that your skin is squeaky clean and a little bit tight after rinsing it off, this is a sign that it is far too drying and it may not even address your concern of having greasy skin. Such a phenomenon will actually lead to excess oil production as a compensatory response.”

Sulfate-based vs amino acid surfactants

“The science behind a cleanser is really that of surfactants, which are basically the key ingredients involved in the cleansing work.” In traditional sulfate-based cleansing surfactant systems, there is a very high pH environment. Over time, it increases the abrasiveness and dehydration of the skin’s barrier. All of which increase the skin’s susceptibility to infections and dryness. 

How to use an acne spot cream?

If you are wondering what skincare routine one should adopt for acne-prone skin, Dr. Teo underlined the steps to take. “First, cleanse with a good cleanser that doesn’t dehydrate the skin. Now, the second part, moisturizing. If you suffer from acne or maskne, it’s good to have on hand an acne spot cream that works for you. If you tend to be acne-prone over the entire chin or the cheek area, on regular days, I would apply a thin layer of the acne cream over the entire acne-prone part of your face.

And when you have a pimple, depending on the recommended dosage of the product, to apply it at the earliest sign of the pimple developing. Finally, use sunscreen. Whenever you heal from a pimple, post-inflammation hyperpigmentation (PIH) is a concern, and wearing sunscreen can help to inhibit excess melanin production caused by inflammation, reducing scarring.” 

Should people with acne-prone or oily skin type skip moisturizers? What type of moisturizers to use for oily skin? 

On the importance of moisturizing, Dr. Teo brought attention to how skipping moisturizers even if you have oily skin is a myth. “The reason is that even when your skin is greasy, it may lack the lipid barrier that protects your skin from the environment. This is a common phenomenon in individuals who find that they have both oily and dehydrated skin.

If you have oily skin and you decide to skip a moisturizer and use a very harsh, astringent cleanser and toner, you may actually have you have a paradoxical phenomenon called reactive seborrhea. That’s when overproduction of oil occurs because the oil glands attempt to compensate. This is definitely not ideal when you are trying to control oily skin.” If you tend to have oily skin, avoid heavy cream formulas and opt for serums and emulsions in the daytime, especially in a humid climate like Singapore. 

A dermatologist’s approach to treating acne or maskne – separating myths from facts

Preventing acne from reappearing on the same spot

“If you have acne that keeps appearing over a certain spot, you could actually have something a little deeper known as an acne cyst.” An acne cyst is essentially a collection of pus, dead skin material that is segregated by a cyst wall. While it may reduce when it’s less inflamed, the cyst wall persists.

If you’re having a recurrent, painful,  deep acne bump that lasts for anything longer than 2 weeks, then the suspicion of having an acne cyst is more likely. On another note, Dr. Teo elaborates, “if you tend to get acne over a certain area such as your chin or your cheeks, then using the right products can help prevent the formation of microcomedones, to prevent appearance of acne.” 

Letting our acne “breathe”

“This is quite a paradox because, on one hand, we know that occlusion acne can occur with comedogenic substances and more recently, maskne, which is acne mechanica due to occlusion of the face mask on skin. On the other hand, a moist environment is optimal for the healing of inflammation.” 

“If you do not have inflamed acne, then it is important for your skin to have some breathability in terms of moisture-wicking because this breeds bacteria and can cause flare-ups in acne. However, if you do have inflamed acne, then using the right acne care product can help the acne to heal faster. The effects of such products can be enhanced by creating a moist, wound-healing environment such as using a hydrocolloid acne patch.

Should we pop our acne?

“Popping a pimple is always a bad idea because it can get more inflamed and you may introduce more bacteria. If you notice your acne is coming to a head and there’s pus at the surface, after a warm shower, you can use a damp cotton pad to gently compress the area and the pus should come out naturally. However, if you’re not able to do so, definitely don’t proceed to squeeze it.” 

Best fabric to prevent maskne?

On the point of choosing the best fabric to prevent maskne, Dr. Teo suggested opting for functional textiles. “None of the natural materials are waterproof. However, if you’re talking about skincare, typically natural fibers tend to allow more breathability in layman’s terms.

What I am recommending my patients right now is the concept of functional textiles. So the usage of synthetic fibers, in this case, would be ideal because it’s waterproof, but it has to be treated so that it’s skin-friendly. There are several physical factors that can alter the breathability of synthetic textiles, such as incorporating certain metallic ions like silver, copper, and zinc which can confer antibacterial properties that can reduce the occurrence of maskne.” 

More tips on combating maskne and functional textiles can be found in Dr. Teo’s latest book Masking Up – A Dermatologist’s Guide to Maskne released in September 2020. The book launches in bookstores islandwide in October 2020.