What are Para-Pandemic Conditions?

When an event rapidly spreads and makes a tremendous public impact, words and phrases seem to be created as a result, almost like a mile marker for the future to remember the past.


Coronavirus (COVID) is such an event. It has spawned such phrases as “social distancing,” “maskne,” and “coronasomnia.” The first is a practice that may or may not last after the pandemic itself is history. The latter two are reflective of conditions that the pandemic is afflicting upon the masses. Make no mistake, however, both are very real, and not just trendy buzzwords. “Para” means “extra.” In the case of the COVID-19 pandemic, two para-pandemic conditions, maskne and coronasomnia, are most commonly encountered.


Maskne

Just as it sounds, this portmanteau combines “mask” and “acne.” But, it is more than just acne; rather it is an umbrella term. Constant mask-wearing can also cause bumps, rash, redness and irritation, which are both uncomfortable and embarrassing.


These conditions are typically instigated by clogged pores. Your skin has an outermost veneer of bacteria, oil and dead skin cells. Wearing a mask blocks the natural removal of the substances, so they build up and clog the pores. Masks also trap the humidity from your breath – as those who wear glasses while trying to read product labels in the store can vociferously attest.


The common acne form is called acne mechanica, caused largely by bacteria (eg, Cutibacterium acnes), which exists normally but turns problematic when trapped beneath the surface, in pores, which causes inflammation, eruptions and sometimes, infection. Mask-wearing can increase risk of acne mechanica.


Another contributing factor, especially for those with sensitive skin, is friction. Amanda Champlain, MD, FAAD, board certified dermatologist with US Dermatology Partners Carrolton (TX), explains, “In addition to acne, mask use may also cause flareups of other skin conditions such as rosacea or perioral dermatitis.  Perioral dermatitis is a skin condition that causes irritation, inflammation, and pimples around the nose and mouth. All of these conditions require a specialized skin care routine to limit symptoms and avoid unnecessary flareups. If you notice signs of maskne, you should work with your dermatologist to create a care plan as soon as possible.”


How to Reduce Maskne Outbreaks

If we go out in public, we need those masks or gaiters adorning our faces. But there are several steps you can take to reduce the potential to develop maskne and nourish your skin in the process. 


First, take a good look at your mask because the type of mask can make a hug difference. According to one source, it should have tow or more layers of fabric, and be made of cotton or other natural soft material. Avoid the synthetic fabrics (eg, rayon, nylon), as these can cause itchiness, redness and irritation, especially in sensitive skin.


According to the American Academy of Dermatology Association (AAD), before venturing out to put on your mask, apply moisturizer, and protect your lips with a coat of petroleum jelly. Women may want to go makeup-free as this will dramatically increase pore clogging (hello, maskne!). In addition, AAD recommends that if your work requires your mask to be on all the time (retail, restaurants, etc.), then find a way to remove it for 15 minutes every four hours. 


Wash the fabric mask frequently with hypoallergenic laundry detergent. If you are wearing disposable masks, simply put – one and done. Dispose of after each use. Wash your face after taking the mask off.


Add Probiotics

A comprehensive review examined the role of the microbiome in acne.  The authors explain, “the emotions of stress (e.g., depression and anxiety) have been hypothesized to aggravate acne by altering the gut microbiota and increasing intestinal permeability, potentially contributing to skin inflammation. Over the years, an expanding body of research has highlighted the presence of a gut–brain–skin axis that connects gut microbes, oral probiotics, and diet, currently an area of intense scrutiny, to acne severity. 


As some examples of studies, one showed that 8 weeks of a topical application of Enterococcus faecalis reduced inflammatory acne count by 50% over the placebo. Another topical application of Lactobacillus plantarum reduced skin erythema (reddening) and repaired the skin barrier. One study revealed that participants with acne who supplemented with Bifidobacterium bifidum and Lactobacillus acidophilus showed greater resolution of their acne than the placebo group.


Coronasomnia

Another portmanteau, the combination of COVID and insomnia, easy to figure out – losing sleep because of the pandemic. Even before the virus went viral, insomnia and poor sleep were dramatically on the rise. A Kaiser Family Foundation study found that 36% of Americans suffered insomnia and poor sleep patterns during the summer which they attributed directly to worry about the pandemic.


Sleep medicine physician Dr. Ilene Rosen explained,“‘Coronasomnia’ is the term used for sleep problems related to the pandemic. It is the impact of the uncertainty and the barrage of information that we are getting.”


With the sweeping fears of a continued pandemic – almost a full year – stress and sleep insufficiencies have climbed. A poll by the American Psychiatric Association found that 48% of Americans are anxious about the possibility of getting COVID-19, and nearly 4 in 10 Americans are anxious about devastating outcomes to themselves, and 62% are anxious about a family member/loved one getting the disease.


According to one expert sleep source, there are four factors that contribute to coronasomnia:

  • Information overload (news and social media)
  • Excessive blue-light exposure (from screens)
  • Impairment and loss of routines/structure
  • Daytime napping from depression/low mood

Suggestions to help reduce sleep issues are many, and you can choose what works best for you. Exercise is almost universally recommended, and it creates endorphins that lift mood. Keep a journal to clear your mind. Stop watching news or engaging in social media incessantly; restrict yourself to certain times and amounts of time to simply catch up (don’t read comments, much less post any!). Calming herbs such as chamomile, valerian and others will help. 


Set up a routine you can stick to and don’t vary from it. If you realize you’ve lost control of a once-productive schedule, recreate it to the best of your ability. 


Conclusion

Being highly aware of your environment and how you treat yourself will go a long way to helping you endure the pandemic. Follow the guidelines (disinfection of hands, surfaces; social distancing, mask wearing), as well as the mask hygiene recommendations, and take back control. You’ll feel better and better sleep will follow. 

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