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Face covers are fast becoming a wardrobe staple as we try to get back to normal. Or the new normal, in any case. 

As of June 15, people in England will have to wear face covers while travelling on public transport and visiting hospitals, the government has said.

And, as people head back to work and find themselves in situations where social distancing isn’t possible, face covers may provide a way to protect themselves and those around them – so could be in greater demand.

One consequence of wearing a face cover, especially in the warmer weather, is that they can irritate the skin. So how can you avoid that?

What you can do depends on the type of mask you’re wearing. Most people will be wearing cloth face covers rather than the PPE (personal protective equipment) used by healthcare workers. “Cloth-based masks should not have much impact on the skin,” says Dr Adil Sheraz, a consultant dermatologist and British Skin Foundation spokesperson.

However if more heavy-duty masks are used – such as N95 or FFP3 – then this has been linked to different issues such as acne, rosacea flare-ups, allergic dermatitis, itchiness, ulceration and pigmentation of the skin, he adds.

The risk of what some have dubbed ‘maskne’ (mask-induced acne) is greater because such masks are tight-fitting and can, in turn, lead to blocked follicular openings and outbreaks of spots and acne. “The increased sweating doesn’t help either,” says Dr Sheraz.

Rosacea flare-ups can be triggered from the heat of wearing a mask, as it increases blood circulation in the surrounding skin. And the constant friction of the mask against the face can result in itching and redness. 

Those wearing PPE for extended periods of time might also experience skin chaffing, redness and even ulcers. Professor Karen Ousey, director of the Institute of Skin Integrity at the University of Huddersfield, said mask wearing among health workers can cause tears to the skin, which can lead to infection.

A study of medical staff treating Covid-19-infected patients found 42.8% experienced serious skin injury related to the use of PPE.

What can you do about it?

For those wearing heavy-duty masks, it’s best to only wear them for two hours at a time, allowing the skin to rest in between. For healthcare workers, ideally this would mean coming away from a patient, relieving the pressure from the mask in a safe place and cleaning the skin again.

“Make sure the skin is well hydrated,” adds Dr Sheraz. “Drink lots of water throughout the day and apply a layer of moisturiser, ideally water-based, at least 30 minutes before putting the mask on.”

Even for those wearing cloth or disposable surgical masks, the key is to wear them when you need to – in circumstances where it’s hard to properly socially distance – and then give your skin a break. 

Dressings under the mask, such as plasters, should ideally be avoided, he adds, as they may affect the seal between the mask and face. This is crucial as studies have shown properly fitted masks are key to keeping safe. If a dressing needs to be used, it should be as thin as possible and ideally silicone based. 

If your mask is causing pigmentation – where the skin darkens in areas where the mask rubs – Dr Sheraz says it will generally settle itself after a few months.

“Keeping the mask on for as short a period as possible with regular breaks and making sure it fits correctly so there isn’t much friction will reduce the risk of developing post inflammatory pigmentation,” he says. “Regular emollient use will help clear pigmentation quicker if it does develop. There are also pigment-reducing creams available, however they can be an irritant so should be used under guidance.”

What about wearing makeup under masks? A thin layer shouldn’t make much of a difference, says Dr Sheraz, although a thick layer of foundation may result in increased acne breakouts when wearing a tight-fitting mask.

It’s important to wash your mask after every use (or dispose of it, if it’s a surgical mask). Not only for safety reasons, but also to keep your skin healthy and clean.

If you find your mask is causing you to break out, there are some treatments you can use. With acne, for example, salicylic acid or benzoyl peroxide is fine, says Dr Sheraz. However, it’s worth noting that overuse will irritate the skin and the masks may, then, cause more issues on the now sensitive skin, he adds.

If your skin is dry as a result of mask-wearing, apply a thin, water-based moisturiser to the area. 

Professor Ousey advises people wearing masks to keep their skin clean, dry and free of sweat. “And if they do feel their masks rubbing, take them off as soon as they safely can,” she adds.