Compromised skin barrier induced by prolonged face mask usage during the COVID-19 pandemic and its remedy with proper moisturization

Skin Res Technol. 2023 Jan;29(1):e13214. doi: 10.1111/srt.13214. Epub 2022 Nov 25.

Abstract

Background: Prolonged face mask usage, a daily practice for the public due to the COVID-19 pandemic, creates high levels of humidity underneath the mask, which may cause unexpected skin concerns.

Objective: To investigate the impact of repeated mask usage on the face by comparing skin properties inside and outside of the mask-covered areas.

Methods: A double-blinded, randomized, split-face clinical study was conducted with 21 healthy female participants who wore face masks at least 6 h every day for 1 week, with one side of their face treated with a moisturizer three times daily. On day 8, after 5 h of wearing the mask, skin properties (sebum, hydration, and trans-epidermal water loss [TEWL]) were evaluated at 15, 60, and 120 min post-mask removal, followed by barrier disruption and recovery assessment.

Results: Mask usage weakened stratum corneum (SC) on facial skin compared to uncovered areas, including reduced SC hydration (p < 0.02 at 15 min) and increased TEWL in response to tape stripping challenge (p < 0.03 after stripping). In addition, sebum production also increased after mask removal (p < 0.01 at 15 min). Notably, a daily moisturizer mitigated these effects by increasing SC hydration (p < 0.001) and improving SC resilience against barrier disruption.

Conclusion: Daily prolonged usage of a facial mask, essential due to the COVID-19 situation, generated a high-humidity microenvironment and led to compromised SC, which was revealed by a barrier challenge technique. Moreover, proper facial moisturization may help to maintain skin homeostasis and prevent the barrier impairment caused by repeated mask usage.

Keywords: face mask; moisturizer; skin hydration; skin occlusion; stratum corneum barrier.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • COVID-19*
  • Epidermis / physiology
  • Female
  • Humans
  • Masks / adverse effects
  • Pandemics / prevention & control
  • Skin
  • Water

Substances

  • Water

Grants and funding