Illustration by Marcelina Jagielka
Long gone are the heady days of Spring 2020, when face coverings were like gold dust. We’ve spent the last two years acclimatising to fabric over our faces, and – love them or loath them – nobody can deny that masks have been an essential part of getting us out of our houses and back out into the world. Unfortunately, that means we’ve also spent two years with our skin stifled by sweaty masks and recirculated breath, leading to the phenomenon known as ‘maskne’: the painful pimples that erupt under your facemask.
In 2020, the skincare industry was worth £2.2bn in the UK alone (CTPA Annual Report 2020, p. 49.) – that’s big, big business. Mainstream women’s magazines – your Cosmopolitans, Glamours, Vogues and their ilk – have hundreds of articles dedicated to acne, and dozens just for maskne alone. If you look for acne treatments online, especially on social media, you’ll be greeted with just as many of these articles as medical sources like the NHS website. Using women’s mags as their mouthpiece, the beauty industry puts out a coordinated message: if you can find the right cleanser, toner, serum, exfoliator, spot patch, SPF, peel, polish, and moisturiser, you can get your acne under control. No pressure, right? The introduction of masks to the equation compounds the problem. There are dozens of listicles by beauty blogs and online magazines recommending the best masks for sufferers of maskne, some of them reaching the £50 price mark. It’s another element of skincare that can be pushed onto the consumer for profit.
This might all sound a bit conspiratorial. I’m not trying to suggest that the beauty industry is pure evil – no doubt, a lot of companies spend huge amounts of time and effort on developing skincare formulae that will work for many acne sufferers. Unfortunately, the scientific literature on the topic suggests that maskne is a particularly thorny issue which beauty editors, for all their knowledge and good-will, may not be equipped to deal with.
We tend to think about acne as a teenage problem and, in many cases, that’s accurate. Unfortunately, acne among adults – especially adult women – is on the rise (Skroza et al, p. 21). Adult acne usually presents as deep-set inflammatory lesions (what you might think of as a pustule or pimple, with white gunk inside) rather than comedones (also known as blackheads). It usually concentrates around the lower half of the face, between the corners of the lips and the chin (Dréno, p. 15). Because the spots originate deeper in the skin, they’re much harder to treat with commercially available skin products. This adult female pattern of acne is often swept under the label of maskne, and understandably so – it occurs exactly where the facemask covers. The media, whether it be beauty influencers, magazines, or television adverts, claims that finding the right facemask, along with a whole host of other pricey skincare products, can solve the issue of adult acne.
This persistent framing of acne as a beauty issue encourages people, especially women, to spend huge amounts of money and time on commercial products, rather than seeking medical treatment. Not only is this frustrating for the individual, but it’s potentially dangerous. 40% of adult acne sufferers have a psychiatric co-morbidity; in layman’s terms, acne correlates with mental health issues, commonly anxiety and depression (Sood, Jafferany, and Vinaya Kumar, p. 3177). The longer both the acne and the associated mental health issues go untreated, the worse they can become. On top of that, acne is physically uncomfortable, itchy, and painful.
By any reasonable assessment, then, acne is clearly a medical issue, not a beauty one. Nonetheless, there’s shame around seeking medical treatment for it. It feels like admitting that you don’t fit into the beauty standard, and therefore aren’t beautiful. We need to medicalise maskne to reduce the stigma around heading to the doctor’s office rather than Sephora. By re-framing the rhetoric around skincare to reflect its medical aspects, rather than insisting that it can be solved with commercial beauty products, we might be able to reduce the discomfort – both physical and emotional – of acne sufferers. Sometimes, it’s no Accutane, no gain.
CTPA, Annual Report 2020, https://www.ctpa.org.uk/storage/annualreports/2020/#page=1 [16/03/2022]
Skroza, Nevena, Tolino, Ersilia, Mambrin, Alessandra, Zuber, Sara, Balduzzi, Veronica, Marchesiello, Anna, Bernardini, Nicoletta, Proietti, Ilaria, and Potenza, Concetta, ‘Adult Acne Versus Adolescent Acne: A Retrospective Study of 1,167 Patients’, The Journal of Clinical and Aesthetic Dermatology, 11/1 (2018), pp. 21-25
Dréno, Brigitte, ‘Treatment of Adult Female Acne: A New Challenge’, Journal of the European Academy of Dermatology and Venereology, 29/5 (2015), pp. 14-19
Sood, Sneha, Jafferany, Mohammad, and Vinaya Kumar, Sushruth, ‘Depression, Psychiatric Comorbidities, and Psychosocial Implications Associated with Acne Vulgaris’, Journal of Cosmetic Dermatology, 19/12 (2020), pp. 3177-182