COVID‐19 related masks increase severity of both acne (Maskne) and rosacea (Mask rosacea): Multi‐center, real‐life, telemedical, observational prospective study

Background
Masks are essential for COVID‐19 prevention, but recently they were suggested to modify cutaneous facial microenvironment and trigger facial dermatoses.

Objective
To evaluate mask‐ related rosacea and acne (maskne) in untreated patients during lockdown

Methods
In this multi‐center, real‐life, observational prospective study, we enrolled stable, untreated acne and rosacea patients that wore masks during lockdown at least 6h/day. They underwent two teledermatological consultations, at the baseline and after 6 weeks. Clinical, pharmacological and psychological data were recorded.

Results
A total 66 patients, 30 (median age: 34.0 [30.25‐29.75] yoa) with acne and 36 patients (median age: 48 [43‐54] years) with rosacea, were enrolled in this study. After 6 weeks of mask and quarantine, patients with acne displayed an increased Global Acne Grading Scale (GAGS) score in mask‐related areas (P<0.0001). Likewise, after 6 weeks of mask and quarantine, patients with rosacea displayed a worsen in both physican (P<0.0001) and patient (P<0.0001) reported outcomes. Remarkably, patients reported also a statistically significant decrease in their quality of life (P<0.0001).

Conclusions
Masks appear to trigger both acne and rosacea flares. Additional studies are needed to generate evidence and inform clinical decision‐making.