Maskne: A New Acne Variant in Covid-19 Era

Abstract

"Maskne" has been one of the negative spinoffs of the universally acceptable and effective role of face mask in containing the ongoing pandemic of SARS-CoV-2 virus or COVID 19. Several factors contribute to its aetiopathogenesis including heat, humidity, mechanical friction and microbiome dysbiosis in a complex interplay under the occlusive area of the mask. Clinically, the morphology is not very different from acne vulgaris with comedones and inflammatory acne, but in a characteristic distribution over a roughly circular area of face covered by mask. Since the use of face masks is likely to continue in the near future, measures like wearing a comfortably fitting mask of appropriate fabric, using disposable masks, increasing mask-free period when at safer places, avoiding unnecessary use of personal care products over the occluded skin, proper and gentle cleaning of the affected areas, intermittent mopping off of the excessive sebum and sweat and use of specific, topical and systemic therapy could help in its resolution.

Keywords: Acne mechanica; COVID pandemic; acne variants; adverse effects; face mask; maskne; personal protective equipment.

Figure 1

De novo acne with inflammatory papules, comedones and pigmentation on mask covered areas (cheek, nose)

Figure 2

Inflammatory acne lesions with post-inflammatory hyperpigmentation in mask covered area with scars of previous acne over left cheek in acne predisposed person. (Image courtesy: Priyanka Hemrajani, Senior Resident Dermatology, ESIPGIMSR, New Delhi.)

Figure 3

Line sketch image showing common 'O area of distribution' of acne lesions due to mask wearing. (Line sketch courtesy Kanika Fernandes, Udaipur.)