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Personal Protective Masks Increase Severity of Rosacea, Acne

Though essential in preventing the spread of COVID-19, a recent study published in Dermatologic Therapy found masks trigger flares in patients with acne or rosacea.

To evaluate the incidence and severity of mask-related rosacea and acne (also known colloquially as maskne), Damiani et al conducted a multicenter, observational, prospective study of untreated patients who wore masks during lockdown. Inclusion criteria stipulated that patients had a previous diagnosis of acne or rosacea, were not currently using a topical or systemic therapy for their disease, and wore a mask for at least 6 hours per day.

The group evaluated patients at baseline and again after 6 weeks and recorded clinical, pharmacological, and psychological data based on the two teledermatology appointments. Acne was assessed by Global Acne Grading Scale (GAGS) and Dermatology Life Quality Index (DLQI), and rosacea by Clinician’s Erythema Assessment, Global Flushing Severity Score, Investigator Global Assessment, Patient Self-Assessment, and DLQI. Data were analyzed by t test, Mann-Whitney test, or Wilcoxon test to compare the change from baseline to 6 weeks post quarantine.

In total, 66 patients were enrolled: 30 with acne and 36 with rosacea. Following 6 weeks of mask use and quarantine, patients with acne saw a significant increase in GAGS in mask-related areas (P<.0001). Similarly, patients with rosacea experienced worsening of severity as measured in both physician- and patient-reported outcomes (P<.0001). Patients in both groups reported a statistically significant decrease in quality of life as well (P<.0001).

“Masks appear to trigger both acne and rosacea flares. Additional studies are needed to generate evidence and inform clinical decision‐making,” concluded the study authors.—Lauren Mateja

Reference:
Damiani G, Gironi LC, Grada A, et al. COVID-19 related masks increase severity of both acne (maskne) and rosacea (mask rosacea): Multi-center, real-life, telemedical, and observational prospective study. Dermatol Ther. 2021;34(2):e14848. doi:10.1111/dth.14848