After nearly a year of wearing face masks, the writers and editors at the Strategist have learned a thing or two. We’ve tracked down the best ones for working out, the best ones for kids, and even the best ones for doubling up. Last July, we even wrote about how to prevent and treat “maskne” which is actually the “result of the mechanical friction of fabric against the skin,” board-certified dermatologist Carlos Charles, founder of Derma di Colore, explained to us. “That friction can lead to inflammation and irritation of the skin that impacts the pores, contributing to acne.” The dermatologists we spoke to suggested switching to cotton or silk masks, sticking to gentle skin care, and treating with topicals in order to keep maskne at bay. But the main maskne culprit, the mask, isn’t going anywhere anytime soon — and neither, it seems, are the breakouts.
Even though I swap out my masks daily, wash them weekly, and have a dermatologist-approved skin-care routine in place, I too was developing breakouts around my mouth and cheeks from daily mask-wearing. In pursuit of lesser-known maskne hacks, I turned to r/SkincareAddiction (SCA), Reddit’s dedicated skin-care sub (which boasts 1.3 million members, including writer Rio Viera-Newton). It’s worth noting that while some SCA members are real dermatologists and estheticians, most are just skin-care obsessives offering anecdotal, and often unfounded, skin-care advice. So when I found a post that suggested reducing maskne could be as simple as rinsing with an antiseptic mouthwash, I called up both a dermatologist and a dentist to investigate.
“When you breathe out, whatever is in your mouth gets aerosolized — which is the whole issue you have with COVID. It’s going to get on your mask, and then it’s going to rub on your face,” explains dentist Dr. Elisa Mello of NYC Smile Design. “You’re creating a little incubator [on your face] because it’s covered. It’s keeping everything in” — bacteria included. With that in mind, board-certified dermatologist Dr. Hope Mitchell agrees that swishing with an antiseptic mouthwash before wearing your mask could potentially minimize any skin-irritating bacteria around the mouth. “Although we don’t have any data to prove a direct relationship of oral bacteria and skin acne with regards to maskne, there may be consideration for an indirect relationship of oral bacteria disrupting the skin pH or microbiome, possibly contributing to disruption of the skin’s barrier,” says Dr. Mitchell. “If this occurs, one may experience irritation, sensitivity, or perhaps even acne.” (Dr. Mitchell notes that no scientific studies have been conducted to test its efficacy.)
If you are interested in adding an antiseptic mouthwash to your beauty routine, not all mouthwashes are created equal, Dr. Mello warns. “Mouthwashes with alcohol and fluoride have been associated with perioral dermatitis, which can mimic acne or maskne,” she explains. “If you are rinsing with a fluoride or alcohol rinse, and then you put your mask on, it’s going to rub onto your face. It will kill some bacteria, but it might actually cause dermatitis.” The mouthwashes that are safest for skin, she says, are those without alcohol or fluoride and ones that aren’t formulated for tartar control, which tend to be harsh on skin. “Ingredients like peppermint, thyme, echinacea, eucalyptus, even lavender, those are all antibacterial and anti-inflammatory, without the drying effect of alcohol,” she says. “If you breathe those out onto your mask, and then it gets onto your face, it’s not going to cause too many problems.”
In short: The science is tentative, so proceed with caution — and with the right mouthwash.
Below you’ll find Dr. Mello’s and Dr. Mitchell’s favorite skin-safe antiseptic mouthwashes — along with the one I’ve been using. (I have seen considerable improvement!) And if you still aren’t quite convinced, Dr. Mello explains that simply keeping up with your oral health can help reduce facial bacteria, and therefore acne, too. “Even brushing [before putting on your mask] is a good idea,” she says. “One hundred percent.”
Mouthwashes to Try
Dr. Mitchell recommends starting with this gentle mouthwash from CloSYS, which is alcohol-free, dye-free, sulphate-free, and pH balanced. “Activated by your saliva, it kills bad bacteria in ten seconds,” she says. “I would recommend using after brushing your teeth and prior to applying your mask.” And for an unflavored mouthwash, the taste isn’t too bad either, she adds.
“I use this mouthwash in the office, and it’s really good,” says Dr. Mello of this all-natural mouthwash, which contains eucalyptus, thyme, peppermint, lavender. “It’s really quite helpful for healing, and it’s all natural. It’s a win-win.” For those who are particularly susceptible to perioral dermatitis, this one is also sodium-laureth-sulfate-free, which can be another hidden trigger.
[Editor’s note: This item is scheduled to restock on February 7, 2021.]
RiseWell’s alkalizing mouthwash claims to inhibit the growth of bad bacteria and biofilm with the help of essential oils and sodium bicarbonate. It’s free of alcohol, fluoride, and sodium laureth sulfate, and is nice-looking enough to leave out on the countertop.
Another fluoride- and alcohol-free option, mouthwashes from Colgate’s Swish line kill up to 99 percent of germs and come in recyclable aluminum bottles.
To be clear: This mouthwash is not alcohol-free, but it’s the one I’ve been using (I picked up a bottle before I spoke to Dr. Mello). It is fluoride-free, and doesn’t seem to irritate my skin. If I know I’m going to be wearing my mask for several hours straight, I’ll swish with this — up to two times per day — and avoid eating or drinking until I’m able to remove my mask. I used to get those pesky whiteheads around my lips almost every time I wore a mask, but now they’re much, much less frequent.
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