A Dermatologist’s Guide To Skincare During Circuit Breaker

The coronavirus pandemic has made wearing facial masks a new norm: while it is vital in preventing the spread of the virus, the problem is that most of us aren’t quite sure how to deal with the pesky side effects of wearing a mask for prolonged periods.

“Maskne” is a term that has recently surfaced, whereby wearing surgical masks has contributed to the rise in acne breakouts. A recent study also showed a striking 97% of skin damage including dry and itchy skin, redness, and pimples from wearing an N95 mask amongst front-line medical workers in Hubei¹.

Medical workers aren’t the only ones susceptible to the itchy spots, red marks, and bruising – anyone who wears a mask can be affected – demanding a radical change in the way we take care of our skin.

The most common problems that have emerged as a result of prolonged usage of a mask and excessive personal hygiene include contact and irritant dermatitis caused by materials in the masks, pressure ulcers, and the exacerbation of pre-existing disorders like acne².

While many of us are choosing to #StayHome during this circuit breaker period, this is no excuse to let your skincare routine take a backseat – here is our guide to keeping your skin at its best wherever you are!

For those with Acne

Wearing a mask all day is the easiest way to clog up your pores and hair follicles with oil, sweat, dirt, and bacteria – all of which play a key role in acne flareups.

Especially in the hot and humid weather in Singapore – sweat and moisture can quickly get trapped underneath our masks and create the perfect breeding ground for acne-causing bacteria to thrive.

While products containing benzoyl peroxide, salicylic acid, and retinoids like vitamin A are effective medications for acne – it is important to be more careful when using these ingredients during this time, as they can potentially contribute to irritation and cause more harm than good while wearing a mask. Instead, double cleanse whenever you can, and avoid scratching and picking at your face.

Use a gentle and pH-balanced cleanser to wash your face, exfoliate twice a week to get rid of dirt and dead skin cells, and apply a hydrating serum at night. You can also try chilling your facial masks in the fridge to help with any swelling and inflammation.

For those with Rosacea

Rosacea is a condition that is often mistaken for acne due to the redness and inflammation that comes with it. Common symptoms include flushing, patchy dryness, and acne-like bumps on the skin.

Since people with rosacea often have sensitive skin, this also makes them far more prone to irritation while wearing facial masks. Just like with acne, heat and humidity can also cause rosacea symptoms to worsen.

In order to prevent a flareup – avoid any vigorous scrubbing using harsh substances such as products containing benzoyl peroxide, AHA, and BHA, especially since they are likely to cause irritation to the skin.

Instead, apply a light moisturizing cream to calm and soothe the skin, while also acting as an additional barrier to minimize friction while wearing a mask.

For those with Eczema

Wearing masks for long periods of time can also trigger eczema symptoms to appear and cause a true allergic reaction due to specific materials found in masks such as formaldehyde, glue, or rubber components.

It can be a difficult time for those facing eczema as washing our hands and faces more frequently can cause it to dry out – causing patients to itch and scratch – resulting in open and wet wounds that are susceptible to infection.

To prevent the vicious cycle of itching and scratching, try using topical steroids, a gentle cleanser, and moisturizer to ease the itch and inflammation, and pick out products containing ingredients such as ceramides, hyaluronic acid (HA), and vitamin B3 (niacinamide) to reduce the redness and “lock-in” moisture.

As eczema involves the compromise of your skin barrier – the use of moisturizers is the best way to repair and heal your skin, while providing an additional layer of support and comfort while wearing a mask.

For those with Pressure Ulcers

Pressure ulcers have become a growing concern, especially amongst healthcare workers who are required to wear face masks for long periods of time.

An important factor in ensuring an N95 mask is effective is making sure there are no open gaps around the edges of the mask. However, wearing it too tightly causes the skin and underlying tissues to break down, resulting in pressure ulcers that can be painful and open to infection.

Often occurring on the nose or behind the ears – the best way to protect your skin is to apply a silicone-based barrier cream containing zinc oxide 30 minutes before putting on your mask – these creams are exceptionally useful in reducing friction and preventing excessive moisture loss.

Should You Still Wear Makeup?

Given that majority of us are now working from home, there is no better time to let your skin breathe and take a break from makeup.

If you must – apply a barrier cream before using a light foundation (preferably mineral-based) for coverage – ensuring that it is fully absorbed into the skin before putting on your mask.

Remember: cosmetics such as lipsticks and heavy foundations can contaminate your mask and cause damage to the fabric; resulting in a compromised barrier and decreased air filtration to protect your from droplets. Whenever you can, skip the makeup entirely and instead go straight for your sunscreen and moisturizer.

Recommended At-Home Treatments: LED Therapy

Due to the closure of most beauty salons and aesthetic clinics – the best way to keep your skin clear and healthy during this period is to simply maintain a tried-and-tested skincare routine that works for you.

From DIY facials, aromatherapy, to jade rollers – consumers are now looking for alternative ways to relax and rejuvenate their skin while at home. Today, there are also a wide range of innovative products that range from cleansing, microdermabrasion, and laser and radiofrequency devices that can temporarily replace in-office treatments in the comfort of your own home.

A wonderful example is at-home LED (light-emitting diode) devices – a great option during this circuit breaker period since professional treatments that address a variety of conditions such as acne, aging, and pigmentation cannot be carried out.

Using different coloured wavelengths of visible light to penetrate the skin, LED therapy helps to trigger natural intracellular reactions to tackle a multitude of skin concerns. In a dermatology clinic, doctors often use them for the treatment of acne by regulating the production of sebum production, stimulating collagen and elastin to minimize wrinkles, and accelerating the wound healing process in patients.

The two most common colours used are:

Red light: primarily deals with relieving redness and inflammation, and promoting cell repair and blood circulation. They are great for wound healing and gives you a smoother, more supple, and glowy complexion. It is also a medically-approved treatment for rosacea.

Blue light: primarily used to kill off bacteria and is best suited for those with acne-prone skin. The blue rays help to regulate oil glands and block the excess production of sebum. Ideal for those with acne, eczema, or psoriasis.

A 2009 study demonstrated at-home LED treatments as a safe and effective treatment, where patients with mild-to-moderate inflammatory acne saw a significant reduction in the number of acne lesions³.

In fact, a 2015 study conducted by researchers at the University of Chicago found that combining both red and blue light produced the most successful outcomes in treating acne and inflammation as compared to using them in isolation⁴!

Key Takeaways

At the end of the day, the pandemic has not only taught us to be more aware of our physical and mental health, but our skin health as well. Ultimately, it is the harmony of all 3 elements that will keep us feeling and looking our best during this difficult time.

Applying moisturizers is especially important as it works as an additional barrier between you, the mask, and the external environment. Chinese experts have also reported the use of emollients, barrier creams, and moisturizers as essential in preventing skin complications aggravated by the use of facial masks and personal hygiene measures⁵.

In essence, stick to a routine that consists of a cleanser, serum, and moisturizer. Don’t forget to also exfoliate twice a week as it aids the absorption of your moisturizers and regularly wash your masks if they are reusable ones.

Dr. Angeline Yong is an experienced dermatologist that has been raising awareness of skin health since the very start of her practice, and prides her work in providing a whole range of comprehensive, all-rounded services to patients.

We hope this guide can help you to build a strong foundation for your skin during this unsettling period. Even if you have fallen off your game recently, know that you can always get back on track and it is never too late!

Should you wish to tackle aging, skin cancer, hair loss, or severe acne and allergic reactions after the circuit breaker – you can count on us to provide the best quality care possible, where only the most progressive and innovative solutions are customized to meet your goals. From pigmentation treatment using her signature blend of picoway and picosure laser, FUT and FUE hair transplant, skin cancer screening, and MOHS micrographic surgery – contact us to learn more about our treatments today!

Note: Our clinic will be focusing only on essential medical and surgical treatments during the circuit breaker period. In the meantime, stay safe and we hope to see you very soon!

References:
1. Lan, J., Song, Z., Miao, X., Li, H., Li, Y., Dong, L., Yang, J., An, X., Zhang, Y., Yang, L., Zhou, N., Yang, L., Li, J., Cao, J., Wang, J., & Tao, J. (2020). Skin damage among health care workers managing coronavirus disease-2019. Journal of the American Academy of Dermatology, 82(5), 1215–1216. https://doi.org/10.1016/j.jaad.2020.03.014
2. Darlenski, R., & Tsankov, N. (2020). Covid-19 pandemic and the skin – What should dermatologists know?^☆☆☆. Clinics in Dermatology, Advance online publication. https://doi.org/10.1016/j.clindermatol.2020.03.012
3. Gold, M. H., Andriessen, A., Biron, J., & Andriessen, H. (2009). Clinical Efficacy of Self-applied Blue Light Therapy for Mild-to-Moderate Facial Acne. The Journal of clinical and aesthetic dermatology, 2(3), 44–50.
4. Pei, S., Inamadar, A. C., Adya, K. A., & Tsoukas, M. M. (2015). Light-based therapies in acne treatment. Indian dermatology online journal, 6(3), 145–157. https://doi.org/10.4103/2229-5178.156379
5. Yan Y, Chen H, Chen L, Cheng B, Diao P, Dong L, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for healthcare workers fighting against coronavirus disease 2019. Dermatol Ther. 2020:e13310.

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A Dermatologist’s Guide To Skincare During Circuit Breaker