Diagnostic and management considerations for “maskne” in the era of COVID-19

Teo, Wan-Lin

doi:10.1016/j.jaad.2020.09.063

Cited by 64 publications

(122 citation statements)

References 5 publications

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“…In our real‐world study, acne vulgaris and rosacea appeared to worsen in untreated patients wearing masks. Maskne is a recognized subtype of acne mechanica, 5 and mask rosacea is a potential new entity triggered by mask‐wearing during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…Focusing on facial dermatoses, Hua et al 3 evaluated the short‐term cutaneous impact of wearing surgical masks (SM) and PPE on the skin finding a relevant modification in the level of hydration, trans‐epidermal water loss, pH, erythema, and sebum production. Masks are usually coupled with dressing and moisturizers to prevent both dehydration and pressure ulcers, 4 but topical agents may be comedogenic and detrimental for preexisting facial inflammatory dermatoses, especially for acne 5 . In fact, maskne or mask‐related acne is a well‐recognized comorbidity due to PPE during COVID‐19 pandemic both in healthcare workers 6 and less in the general population 7 .…”

Section: Introductionmentioning

confidence: 99%

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COVID‐19 related masks increase severity of both acne (maskne) and rosacea (mask rosacea): Multi‐center, real‐life, telemedical, and observational prospective study

Damiani

Gironi

Grada

et al. 2021

Dermatologic Therapy

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Masks are essential for COVID-19 prevention, but recently they were suggested to modify cutaneous facial microenvironment and trigger facial dermatoses. To evaluate mask-related rosacea and acne (maskne) in untreated patients during lockdown. In this multi-center, real-life, observational prospective study, we enrolled stable, untreated acne and rosacea patients that wore masks during lockdown at least 6 h/ day. They underwent two teledermatological consultations, at the baseline and after 6 weeks. Clinical, pharmacological, and psychological data were recorded. A total 66 patients, 30 (median age: 34.0 [30.25-29.75] yoa) with acne and 36 patients (median age: 48 [43-54] years) with rosacea, were enrolled in this study. After 6 weeks of mask and quarantine, patients with acne displayed an increased Global Acne Grading Scale (GAGS) score in mask-related areas (P < .0001). Likewise, after 6 weeks of mask and quarantine, patients with rosacea displayed a worsen in both physican (P < .0001) and patient (P < .0001) reported outcomes. Remarkably, patients reported also a statistically significant decrease in their quality of life (P < .0001).Masks appear to trigger both acne and rosacea flares. Additional studies are needed to generate evidence and inform clinical decision-making.acne due to masks, COVID-19, mask rosacea, maskne, pandemics, rosacea due to masks | INTRODUCTIONDuring COVID-19 pandemics, the introduction of personal protective equipments (PPE), such as masks and gloves, drastically changed facial and hand dermatoses dermatoepidemiology. 1,2 Focusing on facial dermatoses, Hua et al 3 evaluated the short-term cutaneous impact of Giovanni Damiani and Laura C. Gironi have contributed equally to this study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

COVID‐19 related masks increase severity of both acne (maskne) and rosacea (mask rosacea): Multi‐center, real‐life, telemedical, and observational prospective study

Damiani

Gironi

Grada

et al. 2021

Dermatologic Therapy

View full text Add to dashboard Cite

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“…Maskne (acne due to mask) and mask rosacea are classified as “true Koebner” since our current understanding is that the inflamed pilosebaceous units are further influenced by mask‐related microenvironment and mask‐related mechanic traumas, as hypothesized for vitiligo KB mask‐related 16 …”

Section: Discussionmentioning

confidence: 99%

“…Coherently with the nosologic definition, we defined maskne/mask rosacea as koebnerized dermatoses only if the acne/rosacea worsened in areas mask‐covered after regular mask wearing 16 . Patients with rosacea underwent patch tests 17 to rule out a possible concurrent allergic contact dermatitis due to mask release of formaldehyde 18 …”

Section: Methodsmentioning

confidence: 99%

Mask‐induced Koebner phenomenon and its clinical phenotypes: A multicenter, real‐life study focusing on 873 dermatological consultations during COVID‐19 pandemics

Damiani

Gironi

Kridin

et al. 2021

Dermatologic Therapy

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During COVID-19 pandemic, wearing masks for prevention became mandatory but evidence suggest that is also detrimental for skin. Although facial dermatoses due to masks increase in both healthcare workers and general population, a pathogenetic hypothesis remains still elusive. We aimed to evaluate the prevalence of dermatological consultations due to Koebner triggered dermatoses In this prospective, multicenter, real life study carried out in Italy from March 11th to December 11th 2020 during COVID-19 pandemics, dermatological consultations (in-person and telemedicine) to study the prevalence of Koebner (KB) phenomenon due to masks were evaluated. Boyd and Nelder classification was adopted for Koebner phenomenon and Bizzozero's for KB intensity. A total of 229/873 (26.2%) dermatological consultations were KB triggered dermatoses and lesions were located in mask-covered ear area (76 [33.2%]), malar area (73 [31.8%]), perioral area (53 [23.1%]), and nose (27 [11.8%]). The first KB category grouped 142 patients (psoriasis, vitiligo, maskne, and mask rosacea), the second one 24 (warts, molluscum contagiosum, and impetigo), the third one 46 (atopic dermatitis), and the fourth one 17 (eczema). Among previously KB negative psoriatic patients that became KB positive, 9/13 (69.2%) had discontinued or modified the prescribed antipsoriatic treatment. Mask-related Koebner phenomenon is an important clinical sign to orient clinician's therapeutic protocols during COVID-19 pandemic, especially in patients with psoriasis.

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“…Han et al reported 24 patients with acne flares associated with “maskne” after these patients had worn a mask for more than 4 hours/day over 2 months (although the duration of wearing a mask was found to be unrelated to acne severity) 8 . The authors suggested that their patients should place two layers of gauze in their masks to reduce the amount of exhaled water vapor and sweat 7 . General advice on skin hygiene is needed as well as the use of beta hydroxy acids (such as salicylic acid) washes or lotions to decrease hyperkeratosis and oil concentration in the skin 9 .…”

mentioning

confidence: 99%