The Center for Disease Control and Prevention (CDC)’s latest guidance advises Americans to wear a protective face-covering in public areas where social distancing is difficult, to reduce the risk of transmitting a COVID-19 infection.
The new norm is wearing a cloth face covering at all times outside, and PPE when we’re at work. But what is happening to our skin under the mask?

In a recent study published in JAAD, 70 percent of healthcare workers interviewed cited dry skin, 56.8 percent face tenderness, especially on the bridge of the nose, 52.5 percent itchy skin. Over 60 percent noted peeling skin, 49.4 percent experienced erythema due to burst blood vessels, and 32.9 percent had acne-like pimples. The nasal bridge, where a mask rests, was the most common area of irritation. N95 masks, due to their tight fit required to properly work, were the worst. We are already starting to hear concerns form our patients regarding acne like lesions and rosacea flares with mask wearing.
So what should we do, and what should we tell our patients? It is important to understand why we see irritation under these masks to be able to address it properly. Reasons for irritation: One, the direct pressure from the mask, two, the accumulation of moisture on the skin, and three, due to the direct friction from the material of the masks.
We need to treat skin very gently at this time, and increase and support its protective barrier.
My recommendations:
- Start with a gentle, pH-balanced face wash such as SkinCeuticals Gentle Cleanser or Revision’s Papaya Enzyme Cleanser. Follow with a non-oil containing and non-comedogenic moisturizer such as Metacell B3, which contains anti-inflammatory niacinamide, Hydrating B5 Gel if you have oilier skin (you can re-apply multiple times during the day), or La Roche-Posay Cicaplast Baume B5, which contains cica for sensitive skin.
- Don’t forget your lips underneath the mask. Use YouthFull Lip Replenisher from Revision to keep them hydrated.
- GO MAKEUP FREE, to decrease further hair follicle occlusion and irritation that can lead to more acne breakouts.
- After the mask comes off, it’s very important to make sure to wash your face. Again, use only gentle face wash as skin under the mask has already been irritated. Don’t rub to dry, just gently blot and pat.
- If the skin is already inflamed, use prescription Cleocin T with Hytone Toner to calm it down. Otherwise apply Azelaic acid (either prescription Finacea, or non-prescription The Ordinary Azelaic Acid Suspension 10%) followed by a good barrier restoring cream such as Revision’s DEJ Face Cream, or SkinCeuticals Triple Lipid Restore.
- You all know my love for SkinCeuticals Phyto-Corrective Masque, use it a couple of times each week as an overnight sleep mask, and use a SkinCeuticals Biocellulose mask over the weekend.
But most important, don’t stress, because you don’t want to add to aggravation. We are all in it together, and we’ve got it!