International Academic Journal of Applied Bio-Medical Sciences ISSN Print : 2709-328X | ISSN Online : 2709-3298 Frequency : Bi-Monthly Language : English Origin : Kenya Website : https://www.iarconsortium.org/journal-info/iajabms Review Article The Basic Understandings and Managements of Maskne Article History Abstract: Maskne is an emerging terminology within the society, derived from Received: 30.04.2021 the word „Mask‟ and „Acne‟ that refers to the occurrence of Acne cause by Revision: 10.05.2021 wearing a mask. Maskne is a novel problem occur in the society due to the current Accepted: 20.05.2021 global mask-wearing activity which is strictly recommended during the pandemic. Published: 30.05.2021 Essentially, maskne is a part of mechanical acne, resulted from occlusions, Author Details frictions, and microenvironmental changes of the skin. The underlying mechanism of Maskne is almost identical to the general Acnogenesis, including increased Mikhael Aditya sebum production, hypercornification of the pilosebaceous ducts, abnormal Authors Affiliations bacteria colonization, and the process of inflammation. Therefore, management Faculty of Medicine and Health Sciences and prevention of Maskne should be focused on reducing the potential impact of Atma Jaya Catholic University of Indonesia, acne formation based on the acknowledged mechanism. Jl. Pluit Raya No.02, Jakarta 14440 Indonesia Keywords: Maskne, Acne Mechanica, Acne Vulgaris, Basic Science, Corresponding Author* Management, Prevention, COVID-19 pandemic. Mikhael Aditya How to Cite the Article: INTRODUCTION Mikhael Aditya. (2021); The Basic Understandings and Managements of Maskne. Int The world is going through a pandemic of the Severe Acute Aca. J App Biomed Sci. 2(3) 23-29 Respiratory Syndrome Coronavirus-2 (SARS CoV-2) infection which Copyright @ 2021: This is an open-access article cause the Coronavirus Disease-19 (COVID-19) since 2019. By March distributed under the terms of the Creative 2020, the World Health Organization (WHO) stated the disease as a Commons Attribution license which permits pandemic due to its global spread and announce some recommendation of unrestricted use, distribution, and reproduction health protocols, such as wearing a mask and keeping personal hygiene. in any medium for non commercial use (NonCommercial, or CC-BY-NC) provided the This is related to the transmission of the disease through droplets and air original author and source are credited. that people breathe. (Hidajat, 2020; Rosner, 2020) The mask wearing activity become a serious concern of the internet users by the reported adverse effects of daily mask usage, including the acne outbreaks.(Drozdowski et al., 2021; Hidajat, 2020; Kosasih, 2020) The internet then called the outbreaks as Maskne, derived from the word Mask and Acne.(Hidajat, 2020) Furthermore, the phenomenon become a global issue over the internet, as the outbreaks reported is worsen, particularly among the medical workers. This phenomenon lead to confusion and hesitation among the society to continue wearing their mask (Drozdowski et al., 2021). Maskne could bring a significant impact on people, physically and psychologically.(Kosasih, 2020) Physically, Maskne makes the patients feel uncomfortable and suffer from the sensations of the Acne, making it more difficult to maintain using the mask.(C. Han et al., 2020; Hidajat, 2020; Rosner, 2020) On the other hand, the psychological adverse effect could lead patients to further feel low on self-esteem, anxiety, and even depression.(Hidajat, 2020; Kosasih, 2020; Tahir, 2010) This phenomenon concerns clinicians, to be able to communicate the basic mechanism, management, and also ways to prevent the outbreak of Maskne.(Drozdowski et al., 2021) The right management and explanations would be beneficial to embrace the global society to keep wearing their mask and prevent further transmission of the disease. DISCUSSION Definition of Acne Acne is a disease of the skin, manifested as an acute to chronic inflammation.(Dorland, 2019) National Institute of Arthritis and Musculoskeletal and Skin Disease enhances the definition of Acne as an inflammation caused by hair follicle blockage due to dead skin cells and oil clogs, which later causing an outbreak on the skin surface.(National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2020) It is also characterized by the appearance of comedones papules, pustules, or even nodules and cysts in the more severe degrees of the disease.(Tahir, 2010) Acne predominantly found on the area in which hair follicles exist. It is commonly known as Acne Vulgaris (Dorland, 2019). Available: https://iarconsortium.org/journal-info/iajabms 23 Mikhael Aditya; Int Aca. J App Biomed Sci; Vol-2, Iss- 3 (May-Jun, 2021): 23-29 Prevalence of Acne The enhancement of sebum production is the most Acne is a highly prevalent skin disease. It is essential factor in the Acne outbreak mechanism. The previously expected to be the eighth most prevalent production of the sebum is determined by the stimulus disease worldwide.(Common et al., 2019) Acne occurs of Androgen hormone that is also influenced by the in 85-95% of adolescence with various endocrine system. This is due to the sebaceous gland is degrees.(Common et al., 2019; Tahir, 2010) The one of the end organs of the Androgens. The greater prevalence is more likely to occur at the age of 12-24, amount of Androgen regulated to the pilosebaceous contributed as much as 85% of the Americans.(Tahir, glands involved, the more sebum is produced. (Sitohang 2010) The number, however, expected to decrease over & Wasiatmadja, 2017; Tahir, 2010)This regulation 25 years old. There are a lot of discussions among occurs in both male and female individuals, even though studies to significant differences between sexes in the female adolescences are the most susceptible. (Common prevalence of Acne (Common et al., 2019). et al., 2019) Due to its common widespread globally, Indonesia Hypercornifiaction of the pilosebaceous ducts also reported the similarly high number of disease The Androgens also play contribution to the prevalence among the society. Sibero, et al., (2019) proliferation of the pilosebaceous unit, including the reported the prevalence of the disease among sebaceous glands. The greater number of cells that are Indonesians as high as 90% in the 2009, increased as proliferated and died, followed by the excess sebum much as 30% within three years, with 60% prevalence production, end up blocking the pilosebaceous ducts and in 2006.(Sibero et al., 2019) Kristiani, et al., (2017) also therefore, the sebum release pathway. This mechanism reported that 80% of the adolescences in Indonesia had led to the formation of comedones, a clogged the disease. The Incidence of Acne in Indonesia was pilosebaceous duct, which further complicate the sebum also presented to occur among the 14-17 years old excretions. female teenagers and 16-19 years old male teenagers, which accounted up to 60% (Kristiani et al., 2017). The comedones start as a microcomedones which invisible to the plain sight. Furthermore, comedones Types of Acne start to develop into a non-inflammatory lesion called Acne presented in a lot of different types, which can comedone, which manifested as oxidized opened be indistinguishable by the manifestation of the signs blackheads, or the closed whiteheads. Microscopically, and symptoms. Different types of Acnes shared similar comedones can be viewed as a dilated pilosebaceous characteristics to Acne Vulgaris as the bigger term of ducts, filled with a mixture of cornified follicular the disease. Several studies classified acne types based epithelium, sebum, and microorganism. The formation on their etiologies, including Occupational Acne, Drug- of comedones also play a role for the clinicians to induced Acne, Cosmetic Acne, or Mechanical Acne. determine whether a lesion of inflamed skin is an acne (Sitohang & Wasiatmadja, 2017) Another common way eruption by simply looking at the appearance of to classify Acnes are based on their appearance, such as comedones. (Common et al., 2019; Sitohang & Acne Conglobata, or based on the patients, such as Wasiatmadja, 2017; Tahir, 2010) Neonatal Acne, Infantile Acne, Tardive Acne, or Juvenile Acne (Hidajat, 2020). Abnormal bacterial colonization Human skin is a home of trillions of Basic Mechanisms of Acne microorganisms, and most of them are commensal The exact Mechanism of Acne has not been well bacteria, such as Staphylococcus, Corynebacterium, and established. There are a lot of factors contributing to the Propionibacterium. Microenvironmental changes of the disease pathogenesis, and not every aspect of the skin, can directly alter the structure of the skin flora mechanism is well understood. However, some studies balance and develop a disease.(Kumar et al., 2016) The hypothesized that there are four contributing factors that most well-known microorganism contributes to the are postulated as the major pathway of Acnogenesis. pathogenesis of the Acne is Propionibacterium acnes The four main factors that contribute to the occurrence (Kumar et al., 2016; Sitohang & Wasiatmadja, 2017). of Acne include: Increased sebum production, hypercornification of the pilosebaceous ducts, Propionibacterium acnes (P.acnes) is one of the two Abnormal bacterial colonization, and Inflammation highly suspected microorganisms that determined the process (Sitohang & Wasiatmadja, 2017; Tahir, 2010). occurrence of Acne, along with the Staphylococcus aureus (S.aureus) which also a commensal