Skin care and the season of COVID

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Dr. Alyssa Searles Daniel, a board-certified dermatologist with Novant Health Dermatology – SouthPark offers suggestions on preventing and treating maskne — facial breakouts caused by masking — along with tips for skin care during a long, hot summer.

Is there specific medical advice when it comes to masking and skin care – especially in the remaining days of summer?

Everyone needs to wear sunscreen. And it’s counterintuitive, but it is imperative for people with skin of color to wear sunscreen every day, too. It’s a huge teaching point for me, and a lot of my patients of color are hearing that message for the first time.

If you have acne or are acne-prone and go out in the sun, the sun may make those areas of acne darker on people with already-dark skin tones. It’s called post-inflammatory hyperpigmentation. You want to prevent it if you can, and you can help prevent it by wearing sunscreen.

What sunscreens should people of color look for?

I usually suggest sunscreen with mineral blockers – zinc or titanium – for acne-prone skin, but those aren’t the easiest form of sunscreen for darker skin types to comply with. Zinc can leave a lighter film on the skin. You can mix in some of your foundation to help with that. Or you can use a product that already has tint in it.

What are some examples?

I like La Roche-Posay’s tinted sunscreen for face. It’s widely accessible – Target carries it – and at a good price point. There’s another brand – Beautycounter – that’s gone the extra mile to be inclusive. Their Dew Skin tinted moisturizer has an SPF 20 mineral sunscreen in it, and it comes in several shades to match a variety of skin tones.

Are you getting a lot of questions from patients now about maskne?

Yes – and those questions aren’t just coming from patients. Our fellow physicians who must wear masks eight to 12 hours a day are calling our office to find out how to combat maskne. The advice is the same for all skin types: Cleanse daily, moisturize daily and wear sunscreen. Change and wash your mask often. Because I work in health care, I change my mask two or three times a day.

Anything else we can do to protect against maskne?

Don’t overdo it on makeup. The more you have on under that mask, the more likely your pores are to get clogged. If you have moisturizer, sunscreen and makeup, that’s a lot of layers trapped under a mask. And then you have your breath trapped in there and the humidity in the air, and all of that is making breakouts more likely, especially for people with sensitive skin.

Does a mask block UV rays?

Intuitively we know that a mask guards against the sun in the same way a T-shirt does. Your exposed skin might get sunburned, but the skin under your shirt doesn’t. A mask probably offers some sun protection, but you still need to wear sunscreen.

Do you put sunscreen on underneath your mask?

If you’re going to be outside, it’s a good idea to put sunscreen over your whole face. You’re going to take your mask off at some point, and you want that skin to be protected.

If you’re going to be inside for most of the day, there’s no need to put sunscreen on the part of your face your mask covers. You still need to wear sunscreen every day, though.

Is there any type of mask people that’s less likely to produce skin irritation?

Cotton is probably the best fabric to look for, and a pleated cotton mask has been proven to offer the most protection from COVID-19. There’s a study at Duke University that showed that neck gaiters made of “performance-enhancing” material may not be effective in stopping the spread of the coronavirus. It’s just one study, so it’s not the final word. But I’d be leery.

There’s a brand called Coolibar that makes clothing, hats and swimwear that offers sun protection. They’re now making masks and bandanas that protect against COVID and sun damage.

Let’s go back to the issue you mentioned earlier – post-inflammatory hyperpigmentation. I understand preventing it is preferable to treating it. But is it something that can be treated with over-the-counter products?

Vitamin C serum can be effective. There’s a reliable brand called The Ordinary. Look for their product that contains azelaic acid. It can improve uneven skin texture. But if those darker spots turn into keloid scarring – something that’s more common in skin of color – you probably need to see a physician for treatment.

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