Photo of five different people each wearing a facemask

Public health agencies are urging people to wear face masks to help curb the spread of COVID-19. What to do if face masks cause or worsen eczema on your face?

Wearing a mask is our new normal and it’s the right thing to do during the COVID-19 pandemic. However, it can be a source of anxiety for people who suffer from facial eczema.

Facial eczema is very common, especially in young children. Symptoms are often uncomfortable, painful and itchy. It can occur anywhere on the face, but it’s most often found on the chin and cheeks. Some adults also develop eczema around the lips.

How can face masks cause or worsen eczema?

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, we live in a uniquely stressful time due to the pandemic. Stress is a known eczema trigger. If you are feeling anxious or stressed, develop some stress-coping activities. Talk with a mental health specialist.

What are symptoms of facial eczema?

  • Red or blotchy skin
  • 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?

  • Cleanse your face with a gentle wash, pat dry the skin and then add moisturizer before and after putting on a mask.

Moisturizers add a protective layer that can reduce the dryness that comes from wearing a face mask. Use a gentle, fragrance-free moisturizer that is best for your skin type.

Don’t use makeup in areas covered by the mask. Makeup on skin covered by a mask can clog your pores and cause flare-ups, according to the American Academy of Dermatology (AAD).

  • Wear a cloth mask made of two layers of fabric.

CDC recommends using 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 irritate your skin.

  • Make sure it’s 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.

  • Avoid N95 masks unless you’re a frontline healthcare professional.

N95 masks are made from synthetic plastic fibers, usually polypropylene (PP). They fit tightly. More than one-third of healthcare workers reported facial itch, rash or acne after wearing N95 masks daily for several months, according to AAD.

  • Wash your cloth mask often.

CDC recommends you wash it after 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.

Many face mask companies are responding to the need for washable, skin-safe face masks using soft fabrics.

  • Take a break from wearing a mask when you can so you can let your skin breathe.

Remove your mask outdoors or in a place where you can maintain 6 feet separation from others. Healthcare workers 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 corticosteroid, topical calcineurin inhibitor and topical PDE4 inhibitor medications. Topical calcineurin inhibitors are commonly prescribed to treat facial eczema.

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

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