One year after the start of the Pandemic from Covid-19, among the measures adopted to decrease the risk of contracting the Sars CoV-2 virus in addition to social distancing even the daily use of the the face mask, worn both outdoors and indoors, frequent hand washing and the use of sanitizing gels.

These new habits could cause adverse effects on the skin. It is therefore important to pay more attention to the care of the skin of the face and hands, but how?

What are the actions to follow to prevent the onset of skin diseases?
We asked Dr. Stefano Vegliospecialist in dermatology in Aosta and Dubai.

Dr. Stefano Veglio

What are the main problems it can cause the face mask to the skin of the face? 

Rosacea, an inflammatory skin disease, is one of the problems associated with prolonged mask wear. The cause of the onset of the skin disease is a dilation of the blood vessels increased by the heat generated by the mask. Also acne can occur and worsen, where it is already present, due to friction with the mask and occlusion of the skin, which suffers changes in humidity and microcirculation with accumulation of sebum. All these skin reactions are the result of alterations in the skin's microenvironment. 

Let's speak about acne. We hear more and more about Maskne, a neologism derived from the fusion of "mask" and "acne". What is it? How to treat it and who are the people most affected?

It is not a new pathology but today with the obligation to wear a mask its incidence has increased and we hear more about it. It is an acne caused by the rubbing of the mask and by the factors of heat and humidity of the same that go to occlude the hair follicles creating an inflammation of the sebaceous gland.

The most affected are those who tend to have seborrheic skin or who have suffered from acne in the past. However, the disease can also arise in people who do not have a great tendency to acne. The recommended therapy is to apply retinoid-based products, topical antibiotics and perform a thorough and regular cleansing of the face.

Are there some masks that cause skin reactions more than others? 

The more effective a mask is in terms of protection against the risk of infection with the virus, the greater the development of this type of acne because the device occludes, being very tight, the part of the face.  

Women and make-up: does make-up contribute to worsening the health of facial skin? 

The make-up in combination with the use of masks can aggravate the situation because there is a double occlusion of the follicles. 

What about those can't do without make-up?

Make-up products suitable for seborrhoeic and acne-prone skin types are available on the market and give good results and limit the problem. It is important to remove make-up as soon as possible and to avoid applying make-up to areas covered by the mask to prevent double occlusion of the face. 

Have you had an increase in patients with facial skin problems in the last year? 

In 30 years of practice I have never seen such a massive increase in conditions such as acne and rosacea as in the last year.  

What are your tips? 

The mask should be worn to prevent the spread of infection, but as soon as possible it should be removed. It is essential to recognise the first symptoms and to consult a specialist who will be able to advise on targeted treatment and prevent the dermatological disease from progressing.  

Wash hands frequently with soap and water is a simple rule for proper personal hygiene and is one of the actions to counteract the spread of the Sars CoV-2 virus. These days, however, an increase in irritative dermatitis is being reported. 

Dr Veglio, is the problem the frequency with which we repeat this gesture and the products we use?

Irritative dermatitis is unfortunately very common. Washing hands frequently with water causes the skin to dry out and diminishes our defences. In addition, using soaps weakens the hydrolipidic mantle, creating more irritation and the appearance of itching.

The hydroalcoholic gel, essential to ensure effective hand sanitation, creates further problems for the epidermis. According to theHigher Institute of Health "the use of alcohol-based detergents is sufficient to kill the virus and proper hand hygiene is one of the keys to preventing infection". While the excessive use of hydro-alcoholic gels limits infection with the virus, it can also cause problems for the skin of the hands. 

What can be done to overcome these problems? What are your advices for a conscious use...

The secret is to use emollient creams several times a day that are free of perfumes, dyes and preservatives and can also be used on damaged skin. 

What are the most common contact dermatitis?

Dermatitis caused by interaction with metals such as nickel and those allergic to soaps, creams containing perfumes and preservatives or even the use of rubber gloves. Latex is often the source of allergic dermatitis, so vinyl or nitrile gloves are preferable, as they are less likely to cause allergic problems. 

What is the difference between irritative contact dermatitis and allergic contact dermatitis?

Allergic contact dermatitis is an acute inflammation of the skin due to contact with substances, called allergens contained in the product, capable of stimulating an immunological response. In this case, the immune system reacts by creating eczema or dermatitis specifically triggered by contact with the substance. The problem is solved with the removal of allergological noxa and the application of cortisone-based creams or emollients.

Irritative contact dermatitisby far the most frequent, is an inflammatory reaction of the skin caused by different factors that contribute, each in its own way, to decrease and eliminate the protective epidermal layer called the hydrolipidic mantle. The skin begins to dry out with the presence of even painful cracks. In this case, on the one hand it is easier to act because it is enough to protect the skin, but on the other hand it is more difficult because the elements that can generate this dermatitis are numerous, such as: the use of foaming soaps, sanitizing gels, contact with dust and also environmental dryness (the marine one is more protective than the mountain one).

The therapy to follow is to apply emollient and protective creams free of perfumes and preservatives to be applied at least 4-5 times a day and a few minutes after washing the hands. Also, I recommend using soaps that don't contain too many surfactants (soaps not soaps, ed.) in order to eliminate the irritating action often generated by the use of detergents themselves'. 

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