Face Masks and Facial Eczema: What You Can Do

Face masks have become commonplace in the U.S. since the COVID-19 pandemic. But what to do if the masks cause or worsen eczema on your face?

Facial eczema is very common, especially in young children. It could be the result of atopic dermatitis or contact dermatitis. Seborrheic dermatitis is a form of eczema on the scalp.

Eczema symptoms are often uncomfortable, painful and itchy. They can be a source of anxiety and depression for many people living with eczema.

Facial eczema can occur anywhere on the face, but it’s most often found on the chin and cheeks. Some adults develop eczema around the lips.

How can face masks cause or worsen eczema?

Your face tends to have sensitive skin. Face masks that are too tight or made of fabric that is scratchy or uncomfortable can rub against the face, causing irritation. Some masks may absorb the natural moisture on your face, drying out your skin.

When you’re breathing out into a face mask, you redirect your own airflow back on to your face. This traps your breath inside your mask. It can cause dry, red and itchy skin.

Prolonged face mask use can also cause facial acne (called “maskne”) and rosacea.

In addition, anxiety and stress are eczema triggers. If you are feeling anxious or stressed, consider stress-coping activities. Talk with a mental health specialist.

What are symptoms of facial eczema?

• Red or blotchy skin for people with light skin tones
• Purplish, brown or ashen gray skin for people of color
• Rough, bumpy or scaly skin
• Itchiness
• Dry skin with flaking
• A stinging or burning sensation
• Open, oozing crusty sores

What are some ways to prevent facial eczema due to wearing a face mask?

Keep your skin hydrated.

Cleanse your face with a gentle wash. Pat dry the skin. Then add a sensitive skin moisturizer before and after putting on a mask.

Moisturizers add a protective layer. They can reduce the dryness that comes from wearing a face mask. Use a gentle, fragrance-free moisturizer.

Don’t use makeup in areas covered by the mask. Makeup on skin covered by a mask can clog your pores and cause an eczema flare.

Wear a cloth mask made of two layers of fabric.

Use a mask made of cotton, or with cotton as the inside layer. The mask should be easy to wash and breathable. If cotton is not available, any soft, lightweight fabric should do. Synthetic fabrics such as nylon, polyester or rayon are more likely to cause irritated or inflamed skin.

Wear a well-fitting mask.

The mask should not be so tight that it presses against your skin. It should not be so loose that it moves around and rubs against your skin. Try out different masks to find one that is best for you.

Wash your cloth mask often.

Wash a cloth mask after every time you wear it. Washing it will remove sweat, oils, skin cells and germs. You can wash it in the washing machine or by hand. It should be washed in hot water. It’s best to use a fragrance-free, hypoallergenic laundry detergent. Make sure your mask is completely dry before wearing it again.

Take a break from wearing your mask when you can.

Let your skin breathe. Healthcare workers, many of whom wear masks for their jobs, have found that a 15-minute mask break every four hours helps their facial skin.

What is the treatment for facial eczema?

Moisturizers are the first-line treatment for all eczema. Doctors recommend you apply it twice per day, including after a bath or shower. Increase moisturizer use on your face after wearing a mask most of the day.

The American Academy of Dermatology (AAD) recommends you use a moisturizer with one of the following ingredients:

• Ceramides
• Hyaluronic acid
• Dimethicone

When moisturizers are ineffective, doctors turn to topical corticosteroids, topical calcineurin inhibitors and topical PDE4 inhibitors to treat eczema. Topical calcineurin inhibitors are commonly prescribed to treat facial eczema. Keep a watch for side effects of topical steroids, including skin thinning on the face.

Learn more about eczema medications and treatment options. If you experience a severe flare-up of eczema on the face, schedule an appointment with your doctor and/or a specialist such as an allergist or dermatologist.

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Reviewed by:
Purvi Parikh, MD, FACAAI is an adult and pediatric allergist and immunologist at Allergy and Asthma Associates of Murray Hill in New York City. She is on faculty as Clinical Assistant Professor in both departments of Medicine and Pediatrics at New York University School of Medicine.