Reader question: I have to wear a cloth mask every day, all day when I work, and my face is not doing well with this. I don’t know whether to try and dry out these superficial blemishes or keep it moisturized. Any suggestions would be much appreciated! —Nelson Gibson When you’re faced (pun intended) with a bad bout of acne, the natural urge is to smother it with exfoliants and spot treatments. But PSA: Dehydration alone is not the answer to acne! Drying out your skin can trigger your sebaceous glands to produce even more oil to make up for the lack of moisture. That means more congestion and potentially more breakouts on the rest of your face (hard pass, thanks). Before we dive into the right treatment, it’s important to understand what causes maskne in the first place. More professionally speaking, it’s called acne mechanica, which includes any skin issues due to pressure, friction, rubbing, squeezing, or stretching. Friction causes the top layer of your skin to release water, and as a result, your skin loses its natural moisture. “The constant chafing of the mask in contact with skin can cause the skin barrier to break down and hair follicles to break open, which then allows acne-causing bacteria into the skin,” says Hadley King, MD, board-certified dermatologist in New York City. Second, you have all that excess oil and sweat buildup. You already have oil, bacteria, and dead skin cells on your skin, but when you wear a mask, these things can build up and block your pores. “The occlusive nature of a protective mask creates a humid and warm environment under the mask, which can lead to increased sebum and sweat. In turn, this leads to irritation, inflammation, and breakouts,” says Dr. King. In short, maskne is a contradicting matter of skin being dry and oily, which complicates things. However, the approach to getting rid of it is the same as other types of acne. To answer your question, that means drying out the pimples and keeping them moisturized. First, you want to support the skin barrier with a non-comedogenic moisturizer, ideally a soothing one that contains all three key components: humectants, emollients, and occlusives. “It’s important to look for products that contain all three because they work together to moisturize the skin, seal hydration, and reduce mask friction,” says Dr. King. Even though it might feel flat-out wrong to moisturize pimples, the main issue with acne is inflammation—so remember that it responds better and improves when you calm it down. Another thing to note: Most pimple treatments do their job by decreasing oil production, so it’s important that a moisturizer be there as a buffer so your skin can tolerate the acne regimen. Once you have your hydrating base, it’s time to get specific. When it comes to maskne, the focus should be on spot treating—the goal is to dry out the pimples, not your whole face. According to Dr. King, salicylic acid is an excellent pore-clearing ingredient because it exfoliates the stratum corneum (the surface of the skin) and penetrates deep into pores to remove sebum. Another star ingredient is benzoyl peroxide because of its antibacterial properties (read: reduces acne-causing bacteria on the skin). “It not only kills P. acnes and Staph. Aureus bacteria that contributes to acne, it also helps to prevent and clear clogged pores,” says Dr. King. She adds that micronized formulations are better because they cause less irritation to the skin and stabilize the molecule so the shelf life is longer. In addition to spot treatments, try incorporating a topical retinoid into your routine at least two to three times a week (or every day if your skin is already well adjusted). This has a comedolytic effect, meaning it helps clear gunk from pores, leaving them less distended. By increasing cell turnover, the skin is continually sloughing off damaged cells and healthy skin is always what you see on top. Long story short, yes, you should moisturize maskne since maskne is inflammation—and inflammation needs hydration. But you also can—and should—layer it with targeted treatments, such as salicylic acid, benzoyl peroxide, and retinoids, to unclog pores and boost skin cell turnover. If these methods don’t work, speak with your dermatologist about starting a stronger prescription medication.
