Face masks have become a necessary safety precaution during the COVID-19 pandemic. And even though many states have lifted mask mandates, not everyone feels comfortable shedding these protective coverings just yet.
Research shows that masks can reduce transmission of the virus by 70 percent or more when people consistently wear them over their nose and mouth.
Yet mask-wearing can be irritating — literally. In one survey conducted in Thailand in 2020, nearly two-thirds of healthcare workers surveyed reported skin problems like acne, rash, and oily skin from wearing face masks.
Masks can cause skin trouble, even in people who don’t have to wear them all day long. When you have psoriasis on your face, fabric rubbing against your sensitive skin for even a short amount of time can lead to a flare-up.
Managing psoriasis in the time of COVID-19 requires striking a balance between protecting yourself from infection and preventing flares.
A few simple tips can make wearing face masks less likely to irritate your skin.
Many masks are made from rough fabrics that can irritate your skin.
For some people living with psoriasis, the friction from the mask or its ear loops rubbing against your skin can trigger the Koebner phenomenon. This is when psoriasis lesions form on areas of your body that didn’t have lesions before, often due to skin irritation or injury.
Doctors don’t know exactly what causes the Koebner phenomenon. One possible explanation is that the skin irritation or injury triggers your immune system, resulting in new psoriasis lesions.
Following a few simple tips can help keep you protected against COVID-19 without triggering a psoriasis flare on your face.
Don’t go too tight
Choose a mask that’s snug but comfortable.
N95 masks have the tightest fit. They offer excellent protection against COVID-19, but they can irritate your skin in the process. If that happens, consider switching to a KN95 or a three-ply surgical mask, which don’t fit as tightly.
Find the right fabric
A scratchy mask can make you itch. Scratching breaks the thin outer layer of skin, called the epidermis, causing an injury that can set off the Koebner phenomenon.
If you wear a cloth mask, look for one made from soft, natural, breathable fabrics such as cotton. That will be gentler on your skin than human-made fabrics like nylon and polyester.
Tie it in the back
Ear loops create friction that can sometimes trigger psoriasis flares behind your ears. Try to find a mask with ties or an elastic band that goes behind your head instead of one with ear loops.
Apply a gentle, fragrance-free powder in the areas where your mask might rub against your skin. Ask your dermatologist to recommend a powder that’s safe for people with psoriasis.
Keep your mask clean
Wash cloth masks in the washing machine or by hand every day, following the instructions on the label. Use the same fragrance-free, gentle detergent or soap that you use to wash your clothes. Rinse the soap out well. Make sure the mask is completely dry before you wear it again.
If you use disposable masks, throw them out after each use.
Wash your hands
Proper handwashing can reduce the spread of infection. Having clean hands is also important when you touch your face or put on your mask.
As you may remember from the early days of the pandemic, to fully clean your hands, you need to wash them with soap and water for at least 20 seconds — enough time for you to sing “Happy Birthday” twice.
Be gentle with your skin
When cleansing your skin, avoid harsh soap in favor of a gentle cleanser. Try not to scrub your skin when you wash your face. Pat dry with a cotton towel. Moisturize immediately after washing to trap moisture in.
Wearing a mask all day can really dry out your skin. Apply a moisturizing cream before putting on your mask to form a barrier between your skin and the mask. If your lips are dry, also apply a lip balm.
At the end of the day when you take off your mask, reapply moisturizer to help soothe irritated skin.
Using topical over-the-counter cortisone cream along with the moisturizer can also help relieve and limit skin irritation.
Look for a cream that contains ingredients such as ceramides, hyaluronic acid, and dimethicone.
Take (safe) mask breaks
If you wear your mask for long periods of time, try to take a 15-minute mask break every 4 hours. Go outside or to a place where you can be alone for a few minutes and remove your mask.
Adjust your treatment
If you’ve tried everything and your mask is still irritating your face, check with your dermatologist. You may need to change your treatment to help manage mask-related flares.
It might take a few tries to find a mask that protects you without irritating psoriasis flares. Play around with different brands. Ask your dermatologist for advice if you’re having trouble finding something that’s easy on your skin.