Plastic surgeon James Beckman, MD, shares 6 tips for clear skin during the pandemic.

By Tonya Johnson

As many plastic surgeons and team members are now wearing face masks daily while treating patients, Plastic Surgery Practice caught up with board certified plastic surgeon and Theraderm Clinical Skin Care founder James Beckman, MD, about to learn more about “maskne.”

June is Acne Awareness Month, and “maskne”—face mask-related acne—is on the minds of plastic surgeons and patients alike.

The interview with Beckman, who is also an adjunct  associate clinical professor in the Dermatology Department at the University of Arkansas Medical School, has been lightly edited for length and clarity.

PSP: How does wearing a mask all day affect skin?

JB: The skin surface of the face and scalp plays a great part (up to 80%) in regulating our body temperature. Air flow across skin picks up moisture from the perspiring head and face when our body temperature increases. The evaporation of water (sweat) requires heat. The heat then leaves the body with the evaporated sweat and thus the skin is cooled.

With a mask covering part of the face, the evaporative cooling effect is decreased. Surgeons wear masks during surgery procedures to prevent breathing germs out into open surgical wounds. The masks worn during surgery have two pairs of strings for a reason. The lower pair of strings go behind neck to tie the lower mask edge below the chin. The upper pair of strings pass above ears to tie behind the head. This effectively covers nose and mouth to filter all breathing.

As surgeons usually have multiple surgeries in one day of operating, the upper pair of strings can be released to let the mask drop down off of the surgeon’s face to allow drying of skin, easier breathing and talking, etc.

PSP: What do you suggest for making mask wearing more comfortable, as well as to keep skin supple and healthy?

JB: Surgical masks do not filter particles as small as the COVID virus. No masks are effective in keeping a virus from having access into your body—as viruses can enter the eye conjunctiva and enter the body just as effectively as breathing them in.

But masks DO help in preventing possible spread of virus from an asymptomatic carrier breathed out to another person. Rules are made to have people wear COVID-filtering masks in public as a precautionary step in controlling viral spread as a public health measure.

The masks worn now in public could easily have two sets of strings as in surgical masks. Then every hour or so the mask could be easily let down for a few minutes to allow air-drying of face skin. This allows comfort and prevents long periods of wetness from warm, damp breath.

PSP: How can wearing a mask all day cause more breakouts?

JB: Masks prevent airflow to the face, facilitating a damp, warm environment that fosters bacterial growth. Breakouts are what we see with acne. Bacteria are always on the skin’s surface and easily get trapped in hair follicles. Acne breakouts are always enhanced in skin that isn’t kept clean.

There is a form of acne in football players called acne mechanica. These acne breakouts are a result of wearing shoulder pads and/or chin straps that rub directly on skin and grind in bacteria and grime.

Masks that don’t fit well can rub on facial areas in a similar fashion. Each day should begin with wearing a clean mask. Using the same mask every day that has not been cleaned or sterilized is asking for trouble!

6 Additional Ways to Achieve Clearer Skin

  1. Keep skin clean by washing it in the morning and evening with a gentle surfactant cleanser.
  2. Restore natural skin moisturizer barrier elements that are removed by washing, such as via moisturizer.
  3. Drink 6 to 8 glasses of water daily.
  4. Maintain a good sleep patterns and a healthy diet.
  5. Remove a face mask for 5 minutes every hour to give skin a “rest” and prevent bacterial invasion and skin maceration or irritation.
  6. Add more omega-3 fatty acids to your diet. They are a natural anti-inflammatory. They also lower insulin-like growth factor 1 and may reverse some of the effects of snacking on sugary, fatty foods—something many people are ingesting during quarantine. Foods that are high in omega-3s include fish (salmon, sardines, and anchovies are best), tofu, soybeans, broccoli, flaxseed, mustard seeds, walnuts, and almonds. Need a vegan option? Try organic flaxseed oil.

[RELATED: Theraderm Skin Institute, Zimmer MedizinSystems Kick Off Nationwide Training for New Anti-Aging Technology]

Beckman also recommends the Theraderm Reversion Clear Skin System that he invented to help reduce maskne. The 3-step system includes a clarifying cleanser, which is designed to deep clean, calm, and soothe inflamed, acne-prone skin; a purifying toner, which treats existing breakouts by exfoliating dead skin cells and prevent clogged pores; and a spot treatment, which visibly reduces pimples overnight. “The Reversion Clear Skin System is antimicrobial and eradicates 99.9% of surface bacteria for up to 12 hours,” Beckman says. “Other products use benzoyl peroxide (BP), which is not as effective in eliminating bacteria and can be irritating at high concentrations. Not to mention—BP bleaches your clothes and pillowcases!” 

Tonya Johnson is associate editor of Plastic Surgery Practice.