What’s Really Causing Your Maskne? (It Might Not Be Your Mask)

a medical mask on a counter

A few months into the pandemic, I heard another freshly-minted word for the first time: maskne. With it, came the claim that the hot, stifled breath trapped inside our protective masks was turning the lower halves of our faces into a bacterial breeding swamp fit for Shrek himself, and causing breakouts of teenage-level acne en masse.

While the concept wasn’t new — the technical term is “acne mechanica” and athletes who wear helmets and chin guards have been experiencing it way before COVID-19 ever passed our clammy lips — the added element of stress is a compounding factor. In short, the pandemic is stressing us TF out. In fact, twice as many Canadians reported they’d been feeling “consistent or constant stress” during the COVID-19 pandemic as before it, according to a survey from Nanos Research.

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Acne and stress are no stranger to me. About five years ago, angry, cystic breakouts plagued my jawline and neck (the same places maskne shows up) and I did everything to rid myself of it: changed my pillowcases often, edited my skincare routine, tried antibiotics, and cut out dairy. None of it worked, and what eventually did, was heavy-duty medication, and its accompanying slew of side effects. The one thing I didn’t consider on my pre-meds journey was my stress levels, and looking back I believe it was what triggered the acne. But I still wonder: Exactly how does a stressful year translate into a breakout? And, could I actually have been capable of making a dent in my stress levels — or would managing them just be another thing to stress out about?

So, if your skin is getting angrier by the day, don’t let your mask take all the blame — it’s worth examining whether stress is the culprit or a contributing factor. We talked to a nutritionist specializing in hormones, digestion and mental health to get some answers.

How exactly do you go from feeling stressed to seeing that manifest as acne?

Unsurprisingly, the answer is complicated and begins with understanding your body’s stress response. “Let’s say you’re in an accident, all that your body needs to do is to protect itself — you need to think quickly, heal quickly, and that’s what your body is working on,” explains Rhiannon Lytle, a registered holistic nutritionist at the Vancouver-based Integrative Naturopathic Clinic and co-host of Organika’s wellness podcast, The Enhanced Life. “So, your digestion gets shut down and your reproduction gets shut down, too.”

While that may be an ideal response in a time of crisis, it gets complicated in our modern predicament. “Now that we’re in this chronically stressed state, our digestive systems and hormones are dysregulated,” says Lytle. “So, this hormone cascade happens that can then impact our skin.” She explains that the hormones that are normally regulated can go off-kilter because of that spiked cortisol (the stress hormone). “Especially the sex hormones that can impact acne a lot, like progesterone, estrogen and testosterone.”

That’s also compounded by our degraded digestion (stress, you’ve seriously outdone yourself, good job, 11/10). “When our digestion is affected, we’re not pulling in the nutrients that we need for better skin health,” says Lytle. This can show up as acne, but also as more tired-looking skin, dry skin, and a noticed increase in wrinkles. It’s common knowledge that stress can lead to eating poorly (anyone who’s hit up McDonald’s on a bad day knows that), but even if you’re eating clean, stress still trips you up. “Even if you are eating properly, the stress is causing you not to absorb those nutrients well.”

So what can we do to manage stress, and in turn, have healthy, clear skin again? Lytle offers a number of strategies she uses in her practice, none of which include stressing about the stress itself, which was my personal plan.

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Regulate your blood sugar

“When you get super hungry, your blood sugar is really low,” says Lytle. “And when your blood sugar is really low, your cortisol spikes up really high.” She explains that if you’re going on this blood sugar roller coaster every day, you’re also going on a stress roller coaster. “Just think about how many people get ‘hangry’ all the time.”

So how do you maintain an even-keeled blood sugar level? Besides eating less refined sugar and carbs (duh), she tells her clients to eat smarter, too. “If you’re having something with sugar or a refined carbohydrate, make sure you’re pairing it with fat, fibre and protein.”  For example, she says that if you’re having your coffee with sweetener first thing in the morning, adding some kind of collagen powder for protein (like this one, which has 9 grams per serving) or a source of fat like MCT oil. Or, if you’re having an apple, pair it with nut butter. This is because protein and fat are both digested more slowly than carbohydrates (translation: no spike). Bonus: you’ll stay fuller longer.

She also advises clients to keep carbs to a minimum in the morning, and add protein and fat to your breakfast, to avoid stepping on that roller coaster to begin with.

Add ashwaganda

You may or may not have heard of this Goop-y sounding herb native to Asia and Africa, but Lytle recommends adding this functional food to your diet. “Ashwaganda has been shown in studies to reduce your body’s response to stress,” says Lytle. “It’s not going to work overnight, it takes a few weeks for people to start seeing the effects.”

It can also help to regulate your blood sugar: “It’s used by a lot of diabetics and is shown to have a lot of benefits for people who are diabetic,” says Lytle. “It’s not just people who are diabetic who need to think about their blood sugar, anyone with hormonal imbalances needs to work on their blood sugar, too.”

Track your bowel movements

So, remember how we said that when you’re stressed your digestive system shuts down? Here’s why that’s extra brutal for your stress levels: “We excrete excess estrogen with our digestive system, especially by having good bowel movements,” says Lytle. “Good bowel movements, daily, are key for good skin health and good hormone regulation.” She suggests adding a digestive enzyme into your day if you’re finding that you’re not meeting that standard. Upping your fibre intake can also help get things moving again, too. Reminder: Women should aim for 25 grams of fibre a day, men should aim for 38.

Gut healthy

Like we said, when you’re stressed, your digestion stops, and this also impacts your gut microbiome. Lytle explains that can further affect mood because that’s where your neurotransmitters, which control whether you feel happy, sad or anxious, live. “Serotonin is a big one and a lot of it is produced in your gut,” says Lytle. The effect is cyclical: “Our stress levels impact our digestion; our digestion impacts our stress levels.”

A history of antibiotic use, or consuming more alcohol in your lockdown, can impact your microbiome, too. Either way: “Your gut bacteria has changed and then you’re not releasing those neurotransmitters properly,” says Lytle. “We’re seeing increased stress levels and anxiety.”

To avoid getting yourself (and your face!) caught in an endless cycle of bad moods, she suggests adding a probiotic supplement to your routine. “Especially in times of stress it can be helpful for people to be taking a probiotic supplement,” says Lytle. “They work as long as you’re taking them, but you need a prebiotic to help grow the good bacteria, too.”

*A crash course of prebiotics: Prebiotics are plant fibres your body can’t digest, so they travel to your lower digestive tract to be a food source for the healthy bacteria (probiotics) in your gut. They’re found in a lot of foods you already might be eating, like apples, asparagus, onions, garlic and leeks, but you can also get supplements that include them, too.

Incorporate deep breathing

Adding in deep breathing throughout the day is an ultra-accessible way to bring down stress levels. You don’t need to purchase any fancy apps to do so: Lytle suggests box breathing, where you breathe in for four seconds, hold that breath for four seconds, then breathe out for four seconds, and hold for four seconds. She suggests doing it three or four times, every hour on the hour, just for a minute. “You can also do that prior to eating a meal,” adds Lytle. “It helps you to slow down and helps you to digest a bit better, too.”

Walk the walk

Lytle knows it sounds simple, but it’s so simple it works. “Some people want to exercise really hard, but that doesn’t often work out for them if they’re really stressed.” Rather than incorporating a new workout to the to-do list, just adding something like a walk to your day is better on your cortisol levels. “It keeps everything a little more balanced, and that can help with skin more than a HIIT spin class.”

These strategies can make a serious dent in how you’re feeling, and hopefully help your stressed-out skin in turn. But hey, even if it doesn’t solve your skin woes completely, feeling less stressed is a pretty good consolation prize.

Welcome to Pretty Healthy, FLEETSTREET’s in-depth series. Beauty starts with healthy skin and hair, and this column delivers the goods on making that a reality.