How Face Masks Could Be Triggering Your Rosacea

Once stay-at-home orders went into place in New York City in March, I had the privilege of adjusting to a new kind of workday that involved little-to-no pants-wearing, zero makeup, and much more time spent on the couch. Given how easily triggered my rosacea is, I assumed that a low-activity, makeup-free way of life would put me on the path to clear, calm skin — but that was not the case. As the days, then weeks, then months passed in quarantine, my rosacea flared up like never before.

Left wondering why — while my rosacea carried on basking in its angry redness — I turned to a professional to get some answers. I didn't expect to learn that there was a handful of ways in which my skin condition could be impacted by the global pandemic.

The first culprit is the one thing I thought would be helpful: my lifestyle switch. "For rosacea patients, stress and anxiety are prevalent triggers — and any sudden change in routine, like the pandemic, can give someone severe anxiety," says Annie Gonzalez, MD, a Miami-based, board-certified dermatologist at Riverchase Dermatology. "Whenever the body is under any stress, certain chemicals like adrenaline and cortisol are released and prompt an inflammatory response in some rosacea patients."

Perhaps the most unsurprising offender is the face mask, a necessary — yet not necessarily pleasant — accessory as COVID-19 continues to spread throughout the United States. "Because [rosacea] is a result of skin barrier dysfunction and hypersensitivity around the blood vessels in the face, wearing a mask can exacerbate the disease," Dr. Gonzalez says. That combination of friction, heat, and a moist environment created underneath the mask makes you not just more susceptible to acne, but rosacea flare-ups, too. Dr. Gonzalez stresses that this should not discourage mask-wearing, as it's essential to protect yourself and those around you. Opt for breathable (yet effective) masks, choose lightweight fabrics, and carry around an extra mask when out and about in case yours starts to feel a little too humid.

You'll also want to pay attention to your environment at home, especially with all the extra time many of us are spending indoors. Not only does air conditioning rack up your utility bill, but you'll want to be mindful of your proximity to the cold ventilation and the temperatures in your home for the sake of your skin, too. "Extreme cold can dry you out and irritate the already susceptible blood vessels near the surface of the skin," Dr. Gonzalez explains.

Similarly, it's important to be conscious of protecting yourself from the sun with a minimum of SPF 30 — not just during your daily walks or socially-distant beach trips but also when you're working by a window. Heat and humidity are the most common triggers for flare-ups, so you'll want to stay protected. "The summertime can be a very infuriating time for rosacea patients," Dr. Gonzalez says. "Heat and UV rays dilate the blood vessels, causing redness and flushing." Your best bet is to avoid extreme temperatures and ensure the air around you is comfortable — not too warm or too cold.

If you, unlike me, have actually found your rosacea improving over the past few months, Dr. Gonzalez says that this is still a possible outcome. Between spending more time at home and doubling down on routines from mindful eating and mental-health maintenance to skin care, there are some who might find the changes beneficial. There's also the fact that many people are wearing less makeup, which means less tugging and potentially aggravating ingredients on the skin. 

Also important is the distinction between different types of rosacea, as neurovascular rosacea (facial redness) and inflammatory rosacea (bumps and pimples) — the most common types — are the most likely to flare up during stressful situations. Ocular rosacea, which affects only the eyes, can also be aggravated by stress and anxiety. 

So, what can you do to treat your rosacea when avoiding potential triggers seems impossible? Start by booking a telemedicine appointment with a licensed dermatologist so you can evaluate your options, which could be oral or topical prescriptions. Additionally, Dr. Gonzalez urges rosacea patients to focus on stress management and recognizing trigger patterns. "Try to find the root cause, whether acute or chronic, and write it down in a journal," she advises. "Trying to control skin conditions is stressful in itself and sometimes impossible. However, patients must remember that we are always in control of and can improve our health habits, which can influence how our bodies function, including our skin." 

That said, it's totally normal to have moments when you feel like everything is spiraling out of control these days. But with daily mask-wearing and a baseline level of stress being our "new normal," committing to healthy habits — from journaling to reapplying sunscreen — can make all the difference.