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A recent analysis on COVID-19’s impact on skincare habits led to several significant findings, including the following: Surgical and sponge masks are linked to increased odds of facial skin problems compared to cotton, but using moisturizing products, especially creams, led to beneficial effects on skin health.¹

These findings and others on skincare and pandemic-related habits’ effects on skin health were assessed in this recent study, during which investigators examined the notion of damage to the skin in relation with wearing masks causing what they referred to as a “pandemic within a pandemic.”²

The team’s analysis—carried out in 34 provinces in China—was authored by Bin Yang MD, PhD, from the Dermatology Hospital at Southern Medical University, Guangzhou, China.

“The China Dermatologist Association has initiated a ‘national residents' scientific skincare habits survey…(1) to investigate the impact of lifestyle changes caused by the pandemic in terms of facial skin problems, that is, cutaneous signs and symptoms, due to mask wearing for a long time, and (2) to analyze Chinese residents' facial cleansing and moisturizing habits,” Yang and colleagues wrote.

Background and Findings

The study’s investigators—from the China Dermatologist Association—began a comprehensive survey through the Internet to examine the results of changes in lifestyle due to the COVID-19 pandemic on facial skin struggles, specifically those resulting from prolonged mask usage, and to assess the habits of skincare used by Chinese residents.

The team’s research took place throughout 34 provinces around China and utilized an online questionnaire and 28 total inquiries relating to study participants' skin health, effects of mask usage, behavior related to mask-wearing, and facial cleansing/moisturizing habits. The investigators collected a total of 9258 responses from participants, with 6641 validated respondents who were 82.8% within the 18 - 40 age group and 82% women.

The investigators found that 92.3% of the survey’s respondents were shown to have reported that they regularly-used surgical masks at the time, and they noted varied durations-per-day of wearing masks and frequency of mask replacement. Additionally, the team’s survey disclosed pre-epidemic skin conditions related to acne, skin sensitivity, seborrheic dermatitis, and allergy.

Around 26.6% of participants reported having had a decline in their skin health versus their skin conditions in the pre-epidemic period, showing signs such as itching, erythema, and acne exacerbation. The team explored the connection between types of masks as well as facial skin concerns and noted that surgical and sponge masks were found to have been linked to greater odds of issues when contrasted with use of cotton masks.

Additionally, the research team found that longer durations of wearing masks was correlated with more occurrences of conditions such as redness, acne, and itching.

Notably, the investigators’ analysis of practices during the pandemic indicated that excessive cleansing and fairly-consistent moisturizer application, particularly creams, were linked with a beneficial effect on skin health.

In addition to these findings, the research team noted that the term "MASKNE" has begun to emerge as a description of mechanical acne due to continuous textile-skin friction, an occurrence which affects both the skin’s microbiota and production of sebum.

“Both hospital surveys and literature reviews confirm that duration of protective equipment wearing is the most common risk factor,” they wrote. “The present survey also shows that mask wearing duration is positively correlated with skin, ocular and respiratory problems.”

References

1. ^{Wang, X., Liu, L., Yang, H., Kerob, D., Zhang, X., Zhang, Z., Liu, Z. and Yang, B. (2023), A survey of the impact of the COVID-19 epidemic on the skin condition and skin care habits of Chinese residents. J Cosmet Dermatol. https://doi.org/10.1111/jocd.15807.}
2. ^{Bhathia R, Sindhuja T, Bathia S, et al. Iatrogenic dermatitis in times of COVID-19: a pandemic within a pandemic. J Eur Acad Dermatol Venereol. 2020; 34(10): e563-e566. doi:10.1111/jdv.16710.}