@Health Medical Centre

COVID-19 brought with it many frustrations and challenges. When the hard lockdown was finally lifted and we were able to venture into the world again many people encountered a new enemy: mask acne. People who thought they conquered this monster years ago, now found themselves battling like in their teenage-years again. But strangely, those few who were lucky enough to skip that dreaded phase of puberty now faced the same beast. So what is causing this dilemma? Are we being punished for behaving like our younger selves, living in our pyjamas on the couch while gulping down junk food?

The good news is, probably not. While the unhealthy lifestyle that many adopted while isolated from society isn’t helping, the main culprit is a condition called acne mechanica. Acne is caused by the pores on the skin getting blocked by oil and other debris. This is caused by a combination of factors:

• excessive oil production
• abnormal shedding of skin cells
• inflammation
• acne-causing bacteria, called acnes
• hormonal changes

Acne mechanica is caused when the skin is in contact with fabric or another barrier for extended periods of time. It traps heat and debris, causing the pores to clog more easily. The constant friction irritates the skin, causing inflammation that leads to pimples and cysts. In the past sport’s equipment was often to blame, but now mandatory mask-wearing has made it a common phenomenon.

Unfortunately, we can’t just dispose of this little life-saving device. It will remain a part of our lives for the foreseeable future. Luckily there are many options to manage the situation:

Keep your mask clean: It is easy to throw your mask in the car and reuse it every day, but this does not do your skin any favours. Using a clean mask every day is the best way to limit the amount of debris that your skin is exposed to.

Follow a good skincare routine: Since excessive debris on the skin is the main cause of acne mechanica, the first thing to do is to cleanse your face every morning and evening. The right products will remove impurities, reduce inflammation and will normalise the skin’s oil production. Although excessive oil contributes to acne, it doesn’t mean that dry skin is immune against developing acne. Stripping the skin of all its natural oils damages the skin’s protective barrier and makes it more prone to inflammation. It may also stimulate the skin to produce more oil. A good moisturiser should restore the skin barrier without adding more oil.

Don’t over-exfoliate: It may sound like exfoliating is the answer to clearer skin, but it may make matters worse. It also causes irritation and inflammation, and may remove too much of the skin’s natural oils. Using a gentle cleanser and toner twice a day is sufficient.

Chemical peels: This is a procedure that removes dead skin cells and other impurities that may clog the pores. It also causes controlled inflammation that stimulates the skin to regenerate, leaving you with healthier, more radiant skin. This can be performed by aesthetic doctors and aestheticians.

Prescription skin products: Most treatments take several weeks to be effective. This is a frustrating process. An aesthetic doctor can prescribe products with higher concentrations of the active ingredients like salicylic acid and lactic acid that is usually found in skincare products. This is a great way to kick-start your journey to a clearer complexion.

Medication: It is often necessary to use topical or oral medication together with skincare products to manage acne. These medications are aimed at reducing inflammation, controlling the colonisation of acne-causing bacteria and reducing oil-production. In some cases a combination of treatments are utilised to give the best effect. Antibiotics can be used to decrease bacteria on the skin. In female patients oral contraceptives can also be beneficial.

If you noticed a deterioration in your complexion since wearing a mask, or if you have acne in general, go and see your doctor for assistance. There are options available to suit every lifestyle and budget. Your mask should be for protection, not to cover-up your acne.

According to Medscape, the US Food and Drug Administration (FDA) has issued guidance warning consumers against using the antiparasitic drug ivermectin (in its various brands) to treat or prevent COVID-19.

The agency says it issued the guidance on Friday in light of growing interest in the drug as a COVID-19 treatment and multiple reports of patients hospitalised or needing medical support “after self-medicating with Ivermectin intended for horses.”

Ivermectin, which is not an antiviral, has not been approved by the FDA for treating or preventing COVID-19, the guidance emphasised.

The guidance points out that the concentrations of ivermectin for cows and horses can be highly toxic to humans. If you have a prescription for Ivermectin for medically-approved use, get it from a legitimate source and take it exactly as prescribed,” the guidance says. “Taking large doses of this drug is dangerous and can cause serious harm.”

Adverse Effects

Interactions with other drugs, such as blood thinners, are also potentially dangerous even at the levels specified in approved uses, the FDA says.

“You can also overdose on ivermectin,” the FDA warns, adding that ivermectin can cause nausea, vomiting, diarrhea, hypotension, allergic reactions, dizziness, ataxia, seizures, coma, and even death.

The FDA has not reviewed data to support use of ivermectin to treat or prevent COVID-19, but research is beginning.

An article published on in JAMA found that ivermectin, tested in a randomised trial of 476 patients, did not significantly shorten duration of symptoms for adults with mild COVID-19 who received a 5-day course of ivermectin compared with placebo (median time to resolution of symptoms, 10 vs 12 days; hazard ratio for resolution of symptoms, 1.07).

As for adverse effects, the most commonly reported in the JAMA study was headache, reported by 104 patients (52%) in the ivermectin group and 111 (56%) in the placebo group. The most common serious adverse event was multi-organ failure, which occurred in four patients (two in each group).

“The findings do not support the use of ivermectin for treatment of mild COVID-19, although larger trials may be needed to understand the effects of ivermectin on other clinically relevant outcomes,” the authors write.

Excitement about the drug has grown after some smaller studies have shown positive results for the drug related to COVID-19.

However, the National Institutes of Health (NIH) says, “[M]ost of these studies had incomplete information and significant methodological limitations.”

The NIH’s COVID-19 Treatment Guidelines, in guidance last updated February 11, said there is insufficient evidence to recommend either for or against the use of ivermectin for the treatment of COVID-19.

That recommendation was upgraded from guidance in August that recommend against ivermectin’s use in treating or preventing COVID-19, as Medscape Medical News has reported.

“Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-19,” the NIH panel writes.