Impact of mask wear on the skin of clinical year medical students during the COVID-19 pandemic: A cross-sectional study

Abstract

Objectives: Use of facial masks since the onset of the COVID-19 pandemic has led to a new type of mechanical acne termed Maskne. Long-term wear of masks can increase skin damage leading to de novo onset of, or worsening of pre-existing facial dermatoses such as acne, rosacea, and dermatitis. We have encountered numerous studies on the effects of mask wear on skin of health-care professionals, mainly COVID-19 first responders, but there seems to be scarce literature on the effects of mask wear in medical students. The objective of the study was to investigate how mask wear during the COVID-19 pandemic has influenced the skin condition of clinical year medical students from Georgian Medical Universities. Materials and Methods: A cross-sectional study was conducted online through a survey among 152 clinical year medical students (4th, 5th, and 6th years) of Georgian Medical Universities, from February 27, 2022, to April 18, 2022. Participants’ were asked a series of questions focusing on their mask habits such as type of mask worn, duration of wear, frequency of changing the mask, and about their skin condition before and after mask usage. Results: From a total of 151 respondents, of which 69.5% (n = 105) were female and 30.5% (n = 46) were male, with majority of participants from the 5th year 48.1% (n = 62), followed by 4th year 30.5% (n = 46) and 6th year 28.5% (n = 43), 51.4% (n = 76) of students experienced acne/rosacea or had their pre-existing acne/rosacea worsen since they started wearing masks. The top three common manifestations are closed comedones 65.8% (n = 52), pustules 43% (n = 34), and papules 26.6% (n = 21). However, there was no statistically significant relationship between the type of mask used and the daily duration of wear on facial dermatoses. Conclusion: Widespread use of masks may flare up acne in some medical students causing a negative impact on their self-confidence. One of the limitation of our study is the small sample size. Furthermore, information from the participants related to hereditary and acne exposome factors that may contribute to the development of, or worsening of acne was not carried out, and no follow-up was performed. The data were collected through an online survey only, without a physical examination in person of the participants’ skin. Therefore, the details reported are up to the participants’ discretion. Further research in this area needs to be carried out with a bigger sample size and with the diagnosis of mask acne confirmed by a medical professional. It is important to diagnose and treat this new age dermatological condition in a timely manner to prevent lasting adverse effects on skin condition.