Indian Cosmetologist Journal Digital Jan'26 Issue

Total Pages : 26 January 2026 Vol 7* Issue - 10 100

Aesthetic Treatment Protocols

for Acne Scarring

Winter Hair Fall Spike: Why Hair Shedding

Increases in Cold Weather

Winter Maskne 2.0:

Cold-Weather Mask-Induced Acne and Skin Irritation

Face Mapping for Acne

EXECUTIVE EDITOR & PUBLISHER DOM DANIEL

CORPORATE OFFICE 22, SHREEJI BHAVAN, 275-279, SAMUEL STREET, MASJID BUNDER (W), MUMBAI-4000 03, INDIA. EMAIL: info@indiancosmetologistjournal.com WEBSITE: indiancosmetologistjournal.online PRINTED, PUBLISHED, EDITED AND OWNED BY DOM DANIEL PRINTED AT SWASTIK PRINTER, GALA NO.9 & 10, VISHAL INDUSTRIAL ESTATE, BHANDUP (WEST), MUMBAI400078.

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Adapting Aesthetic Care to Seasonal and Lifestyle Changes As we begin the New Year, seasonal and lifestyle factors continue to influence everyday aesthetic practice. This issue highlights timely topics relevant to the winter months, providing insights for THIS ISSUE clinicians navigating the HIGHLIGHTS challenges posed by TIMELY TOPICS colder weather. Aesthetic RELEVANT TO THE Treatment Protocols for WINTER MONTHS, Acne Scarring explores structured, multimodal PROVIDING approaches that prioritize INSIGHTS FOR safety, predictability, CLINICIANS and optimal aesthetic NAVIGATING THE outcomes, offering CHALLENGES practical guidance for POSED BY COLDER managing post-acne skin WEATHER. concerns. Winter Hair Fall Spike examines why hair shedding increases during colder months and presents strategies to support hair health and patient education. Winter Maskne 2.0 revisits mask-related acne and skin irritation, focusing on barrier repair, hydration, and customized skincare solutions suited to low-humidity environments.

Finally, Face Mapping for Acne emphasizes the importance of understanding lesion patterns to identify triggers and improve counselling. Together, these articles underscore the need to adapt aesthetic care to seasonal variations, environmental stressors, and individual skin characteristics as the year begins.

- DOM DANIEL

EXECUTIVE EDITOR & PUBLISHER

Content

CONTENT 06 16

WINTER MASKNE A E S T H E T I C . . . . . . . . . 2.0: COLD-WEATHER MASKT R E A T M E N T . . . . . . . INDUCED ACNE AND SKIN PROTOCOLS SCARRING

FOR

ACNE

IRRITATION

11

WINTER

HAIR

FALL

SPIKE: WHY HAIR SHEDDING COLD INCREASES IN WEATHER

20 FACE MAPPING FOR ACNE

January 2026

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Scar Treatment

AESTHETIC TREATMENT

PROTOCOLS FOR ACNE SCARRING

INTRODUCTION

A

cne commonly affects the face, chest, and back, and even after breakouts subside, it can leave behind visible marks or scars. Continued skin stress may result in lingering redness, uneven pigmentation, and changes in texture, which can be more noticeable in darker skin tones where discoloration tends to

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fade slowly. Most acne scars appear as shallow or sunken areas with varying shapes and depths, and it is common for multiple scar patterns to exist on the same skin.1, 2 These scars can take different forms, each influencing the skin’s appearance uniquely. Ice-pick scars are narrow, deep pits that

create a sharp, pinpointed texture, while rolling scars produce soft, wave-like unevenness. Boxcar scars are broader depressions with clearly defined edges, and papular scars are raised, firm bumps that contribute to an uneven, textured surface. Often, more than one scar type appears simultaneously, which further highlight imperfections and

Scar Treatment make the skin can look uneven.1, 3

1. Chemical Peels5

Recognizing these variations early is crucial, as it helps guide appropriate interventions to achieve smoother, clearer, and more balanced-looking skin.

PRINCIPLES OF ACNE SCAR MANAGEMENT Chemical peels are a commonly used and costeffective modality for improving acne-affected skin.

They are effective in managing early scarring, uneven skin tone, dullness, and post-acne marks by promoting controlled exfoliation of the superficial skin layers. This process results in improved texture and overall skin appearance.

Effective management of acne scars requires a structured, stepwise approach rather than a one-time solution. Gradual, carefully planned interventions allow for progressive improvement while preserving the skin’s overall balance and safety.

The process typically begins with enhancing skin readiness and surface quality, preparing it for subsequent treatments. The next stage focuses on softening more pronounced scars, addressing depth and texture irregularities. The final phase aims to refine the skin’s surface, improving overall smoothness and uniformity.

Following this staged approach ensures consistent, natural-looking results, optimizes skin appearance, and minimizes the risk of complications, making it the foundation of successful acne scar management.4

Mechanism of Action (MOA): Chemical peels facilitate the removal of damaged superficial skin, stimulating epidermal renewal and enhancing skin clarity. This leads to smoother texture, gradual lightening of dyschromia, and improved skin uniformity.

Benefits: • Improves skin smoothness and texture • Reduces post-acne marks and uneven tone • Enhances overall skin brightness and clarity • Can be safely performed with appropriate patient selection and technique

2. Microneedling6

TREATMENT

MODALITIES Acne scars can differ widely in depth and appearance, necessitating a tailored, multimodal approach. Modern strategies aim to enhance skin texture, promote renewal and firmness, and reduce uneven pigmentation. Treatments such as chemical peels, microneedling, and dermal fillers are selected according to scar type and skin sensitivity, offering effective and safe results.

Microneedling is a gentle, minimally invasive procedure used to improve acne scars, uneven skin tone, fine lines, and skin texture. It works by creating January 2026

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Scar Treatment controlled surface stimulation that supports natural skin repair and renewal, while also improving the effectiveness of skincare products. The treatment is suitable for Indian skin and a wide range of skin tones.

Mechanism of Action (MOA): Microneedling activates the skin’s natural renewal process, leading to improved texture, better firmness, and gradual reduction of uneven pigmentation.

downtime • Suitable for a wide range of skin tones, including darker skin types

4. Radiofrequency Microneedling8

Benefits: • Improves skin smoothness and firmness • Gradually softens acne scars • Reduces dark marks and uneven tone • Suitable for all skin tones with minimal downtime

3. Dermal Fillers7 Radiofrequency microneedling is a minimally invasive treatment that combines gentle skin stimulation with controlled heat to improve acne scars and overall skin quality. It helps smoothen uneven texture, improve scar depth and enhance skin firmness, making it suitable for Indian skin.

Mechanism of Action (MOA): The treatment activates the skin’s natural repair process through controlled stimulation and warmth, leading to gradual tightening, improved texture, and scar improvement.

Dermal fillers offer a refined, minimally invasive option for improving sunken acne scars by restoring lost volume beneath the skin. By gently filling the depressed areas, they help elevate uneven surfaces and create a smoother, more balanced appearance. This approach enhances facial contours and overall skin finish, delivering natural-looking results with minimal downtime and good suitability for Indian skin.

Mechanism of Action (MOA): Dermal fillers act as a supportive cushion beneath depressed scars, replacing lost volume and lifting the skin from below. This immediate structural support improves surface smoothness while contributing to better skin appearance over time.

Key benefits: • Immediate visible correction of sunken scars • Restores volume for a smoother, more even skin surface •

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Natural-looking

enhancement

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with

minimal

Benefits: • Improves scar depth and skin firmness • Smoothens texture and refines pores • Lower risk of dark marks compared to lasers • Suitable for all skin types, including darker skin tones

5. Dermabrasion and Microdermabrasion9

Scar Treatment The CROSS technique is a focused method used to improve deep acne scars. In this approach, a small amount of a peeling agent is carefully applied only within individual scars. This controlled process encourages natural skin renewal, leading to gradual improvement in scar depth, texture, and overall appearance.

Dermabrasion and microdermabrasion are skinpolishing procedures used to improve surface texture, brightness, and mild acne-related scars. Dermabrasion works at a deeper level and is useful for more noticeable surface scars, while microdermabrasion gently refreshes the outer skin layer, offering visible improvement with minimal recovery time.

Mechanism of Action (MOA): These treatments work by gradually removing damaged surface skin, allowing fresh and healthier skin to appear. This process improves smoothness, helps lighten uneven colour, and enhances the skin’s ability to absorb skincare products.

Benefits: • Smoother and brighter skin appearance

Mechanism of Action (MOA): The technique works by creating controlled stimulation inside the scar, which allows fresh skin to form from within. This results in gradual filling of the scar and smoother skin, while keeping the surrounding skin unaffected.

Benefits: • Targeted treatment for deep acne scars • Gradual improvement in scar depth and texture • Preserves surrounding healthy skin with minimal recovery time • Can be combined with other treatments for better results

7. Subcision11

• Improvement in mild surface scars and uneven texture • Options available from gentle to deeper correction based on need • Microdermabrasion is suitable for most skin types, including Indian skin

6. TCA CROSS Technique10

Subcision is a focused aesthetic technique used to improve depressed acne scars by releasing the tight strands beneath the skin that pull scars downward.

By freeing these underlying attachments, the skin is allowed to rise naturally, leading to a smoother and more even surface. This technique is often combined with other aesthetic procedures to enhance overall results.

How it works: The procedure gently breaks the fibrous connections beneath the scar, allowing the skin to lift.

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Scar Treatment The natural healing response that follows supports new collagen formation, further improving skin texture and scar depth over time.

Key benefits: • Effectively improves depressed and uneven scars • Releases underlying tension that causes skin to appear sunken • Encourages natural skin renewal and texture improvement • Minimal downtime with high patient satisfaction

CONCLUSION:

Acne scars can affect appearance and confidence, especially in pigmentation-prone skin. Aesthetic treatments such as chemical peels, microneedling, dermal fillers, radiofrequency microneedling, and dermabrasion improve texture, contour, and pigmentation by supporting skin renewal and structural improvement. Careful treatment selection, along with consistent skin protection and aftercare, helps achieve lasting results.

REFERENCES 1. Connolly D, Vu HL, Mariwalla K, Saedi N. Acne Scarring-Pathogenesis, Evaluation, and Treatment Options.

J Clin Aesthet Dermatol. 2017 Sep;10(9):12-23. Epub 2017 Sep 1. PMID: 29344322; PMCID: PMC5749614.

2. Gan SD, Graber EM. Papular scars: an addition to the acne scar classification scheme. J Clin Aesthet Dermatol. 2015 Jan;8(1):19-20. PMID: 25610520; PMCID: PMC4295854.

3. Lawrence E, Syed HA, Al Aboud KM. Postinflammatory Hyperpigmentation. [Updated 2024 Nov 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan Available from: https://www.ncbi. nlm.nih.gov/books/NBK559150/ 4. Whang KK, Lee M. The principle of a three-staged operation in the surgery of acne scars. J Am Acad Dermatol. 1999 Jan;40(1):95-7. doi: 10.1016/s0190-9622(99)70534-7. PMID: 9922019.

5. Rendon MI, Berson DS, Cohen JL, Roberts WE, Starker I, Wang B. Evidence and considerations in the application of chemical peels in skin disorders and aesthetic resurfacing. J Clin Aesthet Dermatol. 2010 Jul;3(7):32-43. PMID: 20725555; PMCID: PMC2921757.

6. Jaiswal S, Jawade S. Microneedling in Dermatology: A Comprehensive Review of Applications, Techniques, and Outcomes. Cureus. 2024 Sep 23;16(9):e70033. doi: 10.7759/cureus.70033. PMID: 39449889; PMCID: PMC11499218.

7. Wollina U, Goldman A. Fillers for the improvement in acne scars. Clin Cosmet Investig Dermatol. 2015 Sep 29;8:493-9. doi: 10.2147/CCID.S86478. PMID: 26491364; PMCID: PMC4598204.

8. Shauly O, Marxen T, Menon A, Gould DJ, Miller LB, Losken A. Radiofrequency Microneedling: Technology, Devices, and Indications in the Modern Plastic Surgery Practice. Aesthet Surg J Open Forum. 2023 Nov 6;5:ojad100. doi: 10.1093/asjof/ojad100. PMID: 38887534; PMCID: PMC11181949.

9. Alkhawam L, Alam M. Dermabrasion and microdermabrasion. Facial Plast Surg. 2009 Dec;25(5):301-10. doi: 10.1055/s-0029-1243078. Epub 2009 Dec 18. PMID: 20024871.

10. Bhardwaj D, Khunger N. An Assessment of the Efficacy and Safety of CROSS Technique with 100% TCA in the Management of Ice Pick Acne Scars. J Cutan Aesthet Surg. 2010 May;3(2):93-6. doi: 10.4103/09742077.69020. PMID: 21031068; PMCID: PMC2956965.

11. Ahramiyanpour N, Rastaghi F, Parvar SY, Sisakht AK, Hosseini SA, Amani M. Subcision in acne scarring: A review of clinical trials. J Cosmet Dermatol. 2023 Mar;22(3):744-751. doi: 10.1111/jocd.15480. Epub 2022 Oct 31. PMID: 36315903.

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Hair Fall Spike

HAIR FALL SPIKE: WHY HAIR

WINTER

SHEDDING INCREASES IN

COLD WEATHER

INTRODUCTION

T

he onset of winter brings sudden environmental changes that the scalp often responds to before the rest of the body. As temperatures drop and humidity levels fall, the scalp

environment changes in ways that can disturb the natural balance of hair growth. For many individuals, this results in a noticeable increase in hair fall during the colder months. While this seasonal

shedding can be alarming, it is usually temporary and reflects the scalp’s response to winter conditions rather than permanent hair damage.1 January 2026

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Hair Fall Spike

HOW SEASONAL CHANGES INFLUENCE

THE HAIR CYCLE

One of the most important contributors is the drop in humidity during colder months. Dry air draws moisture from the scalp, weakening its protective barrier and making it more sensitive to daily stresses. A dehydrated scalp cannot anchor hairs as effectively, so strands loosen more easily during washing, combing, or routine handling. This moisture imbalance also leads to flaking, tightness, and mild itching, all of which amplify winter hair shedding.3

2. Scalp Irritation and Subtle Inflammation

Hair growth follows a natural cycle of anagen (growth), catagen (transition), and telogen (resting) phases, with a proportion of hairs actively growing while others prepare to shed at any given time. Seasonal variations can influence this cycle by altering scalp conditions and overall physiological balance.2 During winter, factors such as cold temperatures, low humidity, reduced sunlight exposure, and lifestyle changes may cause a greater number of hairs to simultaneously enter the resting (telogen) phase, resulting in noticeable shedding over a relatively short period.2 Importantly, this shedding does not indicate a cessation of hair growth; new hairs continue to develop beneath the scalp, and as seasonal stressors diminish, the hair growth cycle gradually returns to its normal equilibrium.2

Winter dryness can also provoke subtle irritation and low-grade inflammation, even without visible redness or rash. This underlying sensitivity disrupts the scalp’s support for hair growth, causing more hairs to enter the resting phase sooner than usual. Mild itching or increased flaking during winter generally reflects this seasonal stress rather than an underlying scalp disorder.4

3. Reduced Blood Flow in Cold Weather

Several key factors contribute to the seasonal increase in hair shedding, each reflecting the unique stresses imposed by colder weather conditions.

1. Dry Air, Moisture Loss, and Scalp Health Another important factor contributing to winter hair shedding is the body’s natural heat-conservation response, which redirects blood flow away from the skin and scalp toward vital organs to maintain core temperature. This reduced circulation can limit the supply of oxygen, essential nutrients, and growth factors to hair follicles.5 Over time, the decreased follicular support can slow the growth of existing hairs and make shedding more noticeable. When this effect is combined with winter-induced dryness and subtle scalp irritation, 12

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Hair Fall Spike hair follicles experience compounded stress, further increasing the likelihood of seasonal shedding.5

4. Reduced Sunlight and Seasonal Body

Changes

LIFESTYLE FACTORS THAT MAY EXACERBATE WINTER HAIR FALL Seasonal changes during winter can alter daily routines, potentially placing additional stress on the scalp and hair. When combined with environmental challenges such as cold, dryness and reduced sunlight, certain lifestyle habits may contribute to increased hair shedding.

In addition to temperature-related effects, shorter days and reduced sunlight exposure during winter impact overall physiological balance. Sunlight is a key factor in vitamin D synthesis, which influences keratinocyte function and hair follicle health.6 Lower vitamin D levels, along with subtle seasonal changes in metabolism, circulation and hormonal regulation, can reduce hair strength and resilience. Individuals with pre-existing hair thinning or nutritional gaps may notice this effect more prominently, as the follicles are less able to maintain their normal growth cycle. Collectively, these seasonal factors interact to increase the proportion of hairs entering the resting (telogen) phase, resulting in the characteristic spike in hair shedding during colder months.6

COMMON PATTERNS OF HAIR FALL SEEN

1. Reduced Water Intake

During winter, the sensation of thirst often diminishes, leading to reduced water intake.

Insufficient hydration impacts the scalp similarly to the skin, lowering moisture levels and compromising its natural protective barrier. A dehydrated scalp becomes less resilient and less able to anchor hair effectively, increasing the likelihood of hair loosening and shedding during routine grooming or handling.

2. Seasonal Changes in Diet

DURING WINTER

Hair shedding in winter can vary between individuals, presenting in several common patterns: ➢ Seasonal shedding: A temporary increase in daily hair fall without visible scalp damage.2 ➢ Dryness-related shedding: Hair fall associated with scalp dryness, flaking, itching, or tightness.2 ➢ Stress-related shedding: Increased hair fall linked to physical or emotional stress during the winter months.2 ➢ Exacerbation of existing thinning: Individuals with ongoing hair thinning may notice a rise in shedding.2 In most cases, the hair follicles remain healthy, and natural regrowth occurs once seasonal conditions improve.2

During winter, dietary habits often shift, with decreased consumption of fresh fruits, vegetables, and other nutrient-dense foods. This reduction may limit the availability of essential nutrients that support scalp integrity and hair strength. Over time, such nutritional imbalances can compromise hair structure, increasing susceptibility to seasonal shedding, especially in individuals with fine or thinning hair.

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Hair Fall Spike

3. Frequent Hot Showers

during grooming. Together, these mechanical and environmental stressors compromise hair integrity, making strands more susceptible to breakage and contributing to increased hair shedding.

6. Reduced Scalp Cleansing and Care

In colder months, frequent warm showers, while comforting, may inadvertently promote increased hair shedding. Prolonged exposure to hot water removes natural oils from the scalp and hair, resulting in dryness and compromising the scalp protective barrier. This can induce mild irritation and disrupt the normal equilibrium that maintains healthy hair retention.

4. Prolonged Exposure to Indoor Heating

To minimize cold exposure, some individuals decrease the frequency of hair washing during winter. However, infrequent cleansing can lead to the accumulation of sweat, sebum, and product residues on the scalp. This build-up can exacerbate dryness, irritate the sensitive scalp, disrupt the scalp microenvironment, and indirectly contribute to increased hair shedding during the colder months.

INDICATIONS FOR SEEKING Prolonged exposure to heated indoor environments in colder months exposes the scalp to persistently dry air. The reduced humidity associated with indoor heating accelerates moisture loss from both the scalp and hair shafts, impairing scalp barrier function, increasing sensitivity, and weakening hair fibers, thereby exacerbating seasonal hair shedding.

PROFESSIONAL EVALUATION

5. Mechanical and Environmental

Stressors on Hair in winter

Prolonged use of caps, scarves, or helmets during colder months can increase friction and reduce scalp ventilation, leading to mechanical irritation of the scalp and weakening of hair shafts. Simultaneously, dry winter air elevates static electricity, particularly when hair contacts wool, synthetic fabrics, or plastic combs, causing tangling and increased tension 14

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Seasonal hair shedding during winter is typically temporary and resolves as environmental conditions improve. However, professional evaluation is recommended under certain circumstances to ensure that hair loss is not indicative of an underlying pathology. Individuals experiencing excessive or prolonged shedding that persists beyond the winter months, noticeable thinning, widening of the hair part, or sudden changes in hair density should seek medical advice. Additionally, hair fall accompanied by scalp symptoms such as pain, redness, persistent scaling, itching, or inflammation warrants further assessment.

A history of chronic, progressive, or recurrent hair loss also justifies consultation. Early evaluation

Hair Fall Spike helps differentiate normal seasonal shedding from conditions such as telogen effluvium, androgenetic alopecia, or inflammatory scalp disorders, enabling timely reassurance, targeted guidance, or intervention to preserve hair health and prevent long-term damage.

EMOTIONAL IMPACT AND PREVENTION OF

SEASONAL HAIR SHEDDING

Even when hair fall is temporary, it can be emotionally distressing for many individuals. Visible

shedding is often misinterpreted as permanent hair loss, leading to anxiety, stress, or unnecessary treatments. Clear explanation and reassurance are crucial in managing concern and providing appropriate guidance. Preventive measures can also help minimize shedding and maintain scalp health, including adequate hydration, gentle hair handling, and proper nutrition, limiting exposure to extreme temperatures, and maintaining a balanced hair care routine. These steps support hair strength, reduce breakage, and promote overall scalp resilience during periods of seasonal stress.

CONCLUSION Seasonal hair shedding represents a natural and temporary response to environmental and lifestyle changes that influence scalp health and hair follicle function. Although increased hair fall may be concerning due to its visibility, it is typically reversible, with normal growth resuming as the scalp environment stabilizes. Awareness of the contributing factors, along with appropriate preventive measures and supportive care, helps maintain hair integrity, minimizes excessive shedding, and supports overall scalp health during periods of seasonal stress.

REFERENCES 1. Kunz M, Seifert B, Trüeb RM. Seasonality of hair shedding in healthy women complaining of hair loss.

Dermatology. 2009;219(2):105-10. doi: 10.1159/000216832. Epub 2009 Apr 29. PMID: 19407435.

2. Randall VA, Ebling FJ. Seasonal changes in human hair growth. Br J Dermatol. 1991 Feb;124(2):146-51. doi: 10.1111/j.1365-2133.1991.tb00423.x. PMID: 2003996.

3. Trüeb RM, Henry JP, Davis MG, Schwartz JR. Scalp Condition Impacts Hair Growth and Retention via Oxidative Stress. Int J Trichology. 2018 Nov-Dec;10(6):262-270. doi: 10.4103/ijt.ijt_57_18. PMID: 30783333; PMCID: PMC6369642.

4. Vázquez-Herrera NE, Sharma D, Aleid NM, Tosti A. Scalp Itch: A Systematic Review. Skin Appendage Disord. 2018 Aug;4(3):187-199. doi: 10.1159/000484354. Epub 2017 Nov 29. PMID: 30197900; PMCID: PMC6120392.

5. Institute of Medicine (US) Committee on Military Nutrition Research; Marriott BM, Carlson SJ, editors.

Nutritional Needs In Cold And In High-Altitude Environments: Applications for Military Personnel in Field Operations. Washington (DC): National Academies Press (US); 1996. 7, Physiology of Cold Exposure. Available from: https://www.ncbi.nlm.nih.gov/books/NBK232852/ 6. Nioi A, Roe J, Gow A, McNair D, Aspinall P. Seasonal Differences in Light Exposure and the Associations With Health and Well-Being in Older Adults: An Exploratory Study. HERD. 2017 Oct;10(5):64-79. doi: 10.1177/1937586717697650. Epub 2017 Mar 15. PMID: 29056090; PMCID: PMC5656103.

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Maskne 2.0

WINTER MASKNE 2.0: COLDWEATHER MASK-INDUCED

ACNE AND SKIN IRRITATION

INTRODUCTION

M

askne, or mask-induced acne, refers to breakouts and skin irritation that develop in areas covered by face masks. While initially more common in warmer months due to heat and sweat, maskne persists and can intensify during winter. The cold, dry air outside combined with the warm, humid environment inside the mask creates a unique microclimate that

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makes the skin more sensitive and prone to clogging. In today’s world, people have become habitual mask users, wearing them for extended periods during work, travel, and daily activities, which further increases the risk of irritation and breakouts.1 The primary problems associated with winter maskne include increased pore blockage, friction-

induced irritation, redness, inflammation, and the formation of small bumps or acne lesions, particularly around the mouth, chin, and cheeks. The ongoing and prolonged use of masks during cold weather can exacerbate these issues, making preventive skincare and mask hygiene essential to maintain skin health throughout the winter season.1

Maskne 2.0

WHY WINTER MAKES MASKNE WORSE Winter creates a unique combination of environmental and physiological stressors that intensify mask-induced acne, commonly known as “maskne.” The contrast between cold, dry outdoor air and the warm, humid environment beneath a face mask disrupts the skin barrier, increases irritation, and raises the likelihood of breakouts—particularly around the nose, mouth, and chin.

and bacterial growth, increasing the risk of clogged pores and inflammatory breakouts. The constant cycle of moisture and occlusion plays a key role in winter maskne flare-ups.2

3. Increased Face Touching

1. Dry Skin and Mask Occlusion

Dry, itchy winter skin often leads to frequent mask adjustments and face touching. Each contact transfers dirt, oil, and bacteria from the hands to the skin, compounding irritation and raising the risk of breakouts in already sensitive areas.2

4. Disruption of the Skin Microbiome During winter, reduced humidity and cold air lead to increased skin dehydration and sensitivity.

When a mask sits against this already compromised skin, repeated friction and pressure can weaken the protective barrier further. This disruption makes the skin more vulnerable to irritation, redness, and small acne-like bumps, especially in areas of constant mask contact.2

2. Warm and Humid Microenvironment Healthy skin relies on a balanced microbiome to maintain resilience and protection. Winter dryness combined with prolonged mask wear alters this balance, making the skin more reactive. Such disruption can contribute to mask-related acne, irritation, and increased overall sensitivity.2

5. Barrier Stress from Cold Air Exposure

Despite cold external temperatures, breathing inside a mask creates a warm, moist microclimate. This trapped heat and humidity encourage sweat buildup

Cold winds and low humidity strip the skin of its natural oils, leaving it fragile and reactive. When the skin barrier is already stressed by winter dryness, even soft mask fabrics can cause irritation. This often results in visible redness and tiny pimple-like rashes around the nose, mouth and chin.2 January 2026

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Maskne 2.0

MASK-RELATED SKIN IRRITATION: MORE

THAN JUST ACNE

remains trapped against the skin for extended periods, it softens the outer skin layer, disrupts the microbiome, and encourages bacterial growth. This combination makes the skin more susceptible to irritation and maskrelated breakouts.3 Masks amplify these triggers by creating friction and trapping heat, making symptoms more noticeable and persistent.

A WINTER-FRIENDLY

SKINCARE ROUTINE FOR MASK WEARERS Not all bumps under a mask are traditional pimples.

Many people experience skin irritation around the mouth, characterized by clusters of small red bumps, dryness, and a burning or stinging sensation. This irritation is often triggered by external factors such as:

Managing winter maskne requires a gentle, barrierfocused approach. Over-cleansing or using harsh treatments can strip the skin further, leading to more breakouts and irritation.

Thick, occlusive moisturizers: While rich creams are often used in winter to combat dryness, overly thick or occlusive formulations can trap heat, sweat, and bacteria under the skin— especially beneath a mask. This occlusion may clog pores and disrupt the skin barrier, increasing the risk of irritation and acne-like breakouts around the mouth and chin.3

Heavy or long-lasting makeup: Full-coverage foundations, matte formulas, and long-wear lip products are designed to adhere firmly to the skin. Under a mask, these products can mix with sweat and moisture, leading to pore blockage and inflammation. Repeated friction from the mask further aggravates the skin, making breakouts and redness more likely.3

Frequent lip licking to relieve dryness: Lip licking provides only temporary relief from dryness. Saliva evaporates quickly and strips natural moisture from the surrounding skin, leading to increased irritation, redness, and sensitivity around the mouth. This repetitive action can weaken the skin barrier and contribute to persistent irritation.3

Prolonged moisture trapped under the mask: Breathing and speaking create a warm, humid environment beneath the mask. When moisture 18

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Morning Routine • Gentle Cleansing Use a mild, hydrating cleanser that removes impurities without stripping natural oils. Avoid foaming or exfoliating cleansers in the morning, as they can increase dryness.4 • Lightweight Moisturization Apply a non-greasy moisturizer with barriersupporting ingredients such as ceramides, glycerine, or hyaluronic acid. These ingredients hydrate while strengthening the skin barrier without clogging pores.4 • Sun Protection Sunscreen is essential even in winter. UV exposure can worsen inflammation and delay healing. Choose a lightweight, non-comedogenic formula.4 • Minimal Makeup Keep makeup under the mask to a minimum. If

Maskne 2.0 coverage is needed, opt for breathable formulas like tinted moisturizers or mineral powders.4

Before Wearing a Mask ➢ Apply a thin layer of moisturizer to reduce friction ➢ Ensure the mask is clean and completely dry ➢ Choose breathable fabrics with a soft inner layer ➢ Make sure the fit is snug but not tight, avoiding unnecessary pressure

Evening Routine • Gentle Cleanse Remove sweat, makeup, and environmental debris using a hydrating cleanser.

• Soothing and Repairing Care Apply a calming moisturizer or barrier-repair cream to restore hydration overnight. Ingredients like niacinamide, panthenol, or colloidal oatmeal can help reduce inflammation.

• Targeted Treatments Only Use spot treatments sparingly on active breakouts.

Avoid applying strong acids or retinoids over the entire face if the skin feels dry or irritated.

Weekly Care ➢ Use gentle chemical exfoliation once a week only if the skin is calm ➢ Avoid physical scrubs, which can damage the barrier ➢ Consider hydrating masks rather than purifying or clay-based ones

Mask Hygiene Matters Skincare alone cannot prevent winter maskne if mask hygiene is overlooked.

Wash reusable masks daily with a fragrance-free detergent ➢ Avoid fabric softeners, which can irritate sensitive skin ➢ Change disposable masks frequently ➢ Store clean masks in a dry, breathable container

Lifestyle Adjustments That Help Hydration, both internal and external, plays a crucial role. Drinking adequate water supports skin function, while humidifiers can restore moisture to dry indoor air. Managing stress and ensuring adequate sleep also help regulate inflammation and oil production.

CONCLUSION

Winter Maskne 2.0 is the result of a complex interaction between cold weather, low humidity, prolonged mask wear, and a compromised skin barrier. Unlike typical acne, it requires a thoughtful, gentle approach focused on hydration, protection, and barrier repair rather than aggressive treatments.

By understanding the unique challenges winter poses and adapting skincare and mask habits accordingly, it is possible to keep skin calm, clear, and resilient throughout the colder months.

REFERENCES 1. Rathi, S. K., & Dsouza, J. M. (2022). Maskne: A New Acne Variant in Covid-19 Era. Indian journal of dermatology, 67(5), 552–555. https://doi.org/10.4103/ijd.ijd_1054_21 2. Rathi, S. K., & Dsouza, J. M. (2022). Maskne: A New Acne Variant in Covid-19 Era. Indian journal of dermatology, 67(5), 552–555. https://doi.org/10.4103/ijd.ijd_1054_21 3. Feng L, Zhang Q, Ruth N, Wu Y, Saliou C, Yu M. Compromised skin barrier induced by prolonged face mask usage during the COVID-19 pandemic and its remedy with proper moisturization. Skin Res Technol. 2023 Jan; 29(1):e13214. doi: 10.1111/srt.13214. Epub 2022 Nov 25. PMID: 36428277; PMCID: PMC9838772.

4. Techasatian L, Lebsing S, Uppala R, Thaowandee W, Chaiyarit J, Supakunpinyo C, Panombualert S, Mairiang D, Saengnipanthkul S, Wichajarn K, Kiatchoosakun P, Kosalaraksa P. The Effects of the Face Mask on the Skin underneath: A Prospective Survey during the COVID-19 Pandemic. J Prim Care Community Health. 2020 JanDec; 11:2150132720966167. doi: 10.1177/2150132720966167. PMID: 33084483; PMCID: PMC7786409.

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Face Mapping

FACE MAPPING FOR ACNE

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Face Mapping

INTRODUCTION

D

ry skin and acne studies have consistently demonstrated that facial skin is far from uniform. Various regions of the face differ significantly in sebum production, hydration, skin barrier function, and surface pH, even across very small areas. These variations mean that each section of the face operates as a distinct skin zone, responding differently to internal and external factors. To better understand these differences, modern facial skin mapping techniques have been

developed, which create continuous facial maps rather than relying on single-point measurements.

These maps provide a detailed visualization of how each area of the face behaves, offering valuable insights into why certain zones are more prone to acne, dryness, or other skin concerns. By capturing these subtle regional differences, skin mapping serves as a foundation for more precise, individualized approaches to skincare and acne management.1

WHY FACE MAPPING MATTERS Facial skin is not uniform; different regions of the face vary in sebum production, hydration, barrier function, blood flow, temperature, and surface pH. These regional differences play a key role in why acne often appears in specific areas and recurs repeatedly. Treating the face as a single, uniform surface may overlook these variations, leading to suboptimal outcomes. Face mapping addresses this gap by identifying zone-specific characteristics and linking them to potential triggers such as hormonal fluctuations, lifestyle habits, diet, and environmental exposures. By understanding these patterns, face mapping enables a targeted approach to acne management, helping clinicians and individuals tailor skincare routines, interventions, and preventive strategies to each facial zone. Ultimately, it provides a practical framework to improve treatment effectiveness, minimize unnecessary interventions and support healthier, balanced skin.2

THE 10 ZONES OF THE FACE AND ACNE INSIGHTS Zone 1: Forehead3

The forehead is commonly one of the first areas affected by acne, particularly in adolescents. As part of the T-zone, it exhibits elevated sebaceous gland activity, predisposing the region to follicular blockage and the formation of comedones, which can subsequently progress to inflammatory lesions.

Likely Contributing Factors ➢ Elevated sebum production in the T-zone ➢ Accumulation of hair oils and styling products ➢ Sweat and occlusion from helmets or headwear ➢ Insufficient or irregular cleansing Targeted Care Recommendations ➢ Utilize non-comedogenic hair and skincare products ➢ Cleanse the skin promptly after sweating ➢ Minimize prolonged occlusion over the forehead ➢ Address comedones early to reduce the risk of inflammatory progression

Zone 2: Between the Eyebrows (Glabellar Area)4

Acne in the glabellar region typically manifests as persistent papules or inflamed lesions. This area January 2026

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Face Mapping is prone to trapping makeup, sunscreen and other topical products, which can contribute to follicular blockage and lesion formation.

Zone 4: Upper Cheeks (Malar Region)5

Contributing Factors ➢ Accumulation of cosmetic and skincare products ➢ Localized sebaceous gland hyperactivity ➢ Stress-induced inflammatory responses Zone-Specific Management Recommendations ➢ Perform gentle and thorough cleansing each evening ➢ Avoid heavy or occlusive creams in this region ➢ Incorporate anti-inflammatory skincare formulations to reduce irritation and support lesion resolution

Zone 3: Nose3

Cheek acne often presents as inflamed papules, pustules, and post-acne marks, particularly in adults.

Frequent contact with phones, hands and pillowcases can transfer microbes and irritants, exacerbating breakouts.

Likely Influencing Factors ➢ Repeated contact with surfaces such as phones and pillowcases ➢ Environmental pollutants and exposure to smoke ➢ Contaminated makeup tools ➢ Irritation from skincare or cosmetic products Area-Specific Care Tips ➢ Maintain cleanliness of frequently contacted surfaces ➢ Use gentle, fragrance-free skincare products

The nose has a high concentration of sebaceous glands, making it prone to blackheads (open comedones), whiteheads (closed comedones), enlarged pores, and small bumps. Excess oil production combined with humidity and sweat can worsen congestion.

➢ Apply barrier-repair moisturizers to support skin resilience

Zone 5: Chin and Jawline6

Likely Influencing Factors ➢ High sebum production ➢ Humidity and sweat ➢ Inadequate exfoliation Area-Specific Care Tips ➢ Cleanse regularly with oil-control or gentle foaming cleansers ➢ Use mild chemical exfoliants such as salicylic acid to prevent pore blockage ➢ Avoid aggressive squeezing or manipulation

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Acne in the chin and jawline region often manifests as deeper, more persistent lesions, commonly

Face Mapping influenced by hormonal fluctuations. This pattern is particularly observed in adult women.

Zone 7: Temples and Hairline4

Likely Influencing Factors ➢ Hormonal fluctuations, including menstrual cycles or conditions such as PCOS ➢ Stress-induced hormonal changes ➢ Frequent touching or pressure on the area Area-Specific Care Tips ➢ Avoid picking scarring

or

squeezing lesions to prevent

➢ Use calming and anti-inflammatory ingredients such as niacinamide or azelaic acid ➢ Seek professional dermatological advice for recurrent or persistent breakouts

Zone 6: Perioral Area (Around the Mouth)7

Acne along the hairline is often linked to hair care products and sweat accumulation. This area is frequently overlooked during cleansing, as attention is primarily given to the central face.

Likely Influencing Factors ➢ Residue from hair oils, serums, or conditioners ➢ Sweat mixing with product buildup ➢ Insufficient cleansing near the hairline Area-Specific Care Tips ➢ Include the hairline when cleansing the face ➢ Opt for lighter, non-comedogenic hair product formulations ➢ Avoid leaving heavy conditioners or styling products in contact with facial skin

Zone 8: Under-Eye Area and Upper Cheeks8 Breakouts around the mouth often mimic acne but are frequently associated with irritation and typically lack classic comedones.

Likely Influencing Factors ➢ Moisture retention due to prolonged mask use ➢ Heavy or occlusive lip balms and creams ➢ Barrier disruption from habitual lip licking Area-Specific Care Tips ➢ Use lightweight, non-occlusive moisturisers ➢ Opt for breathable face masks ➢ Avoid applying heavy products directly around the mouth

Acne in the under-eye and upper cheek area is uncommon. Lesions in this zone are often milia, minor irritation, or small blocked follicles rather than true acne.

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Face Mapping Likely Influencing Factors ➢ Delicate skin with reduced barrier function ➢ Heavy or occlusive eye creams ➢ Overuse of active ingredients Area-Specific Care Tips ➢ Use gentle, eye-safe skincare products ➢ Avoid harsh exfoliants in this sensitive area ➢ Focus on maintaining and protecting the skin barrier

Zone 9: Lower Cheeks (Jaw to Neck Angle)9

Acne in the neck and submandibular region often manifests as follicular, persistent lesions. This area is susceptible to friction, sweat accumulation, and mechanical pressure, which can exacerbate breakouts.

Likely Influencing Factors ➢ Friction from tight or restrictive clothing ➢ Accumulation of sweat ➢ Mechanical irritation from shaving or other activities Area-Specific Care Tips ➢ Opt for loose, breathable garments to minimize friction ➢ Shower promptly after sweating ➢ Use gentle, low-irritant cleansers to maintain skin barrier integrity

COMMON FACTORS Acne in the lower cheeks, extending from the jaw to the neck angle, often presents as deeper, inflammatory lesions. This zone is particularly prone to flare-ups influenced by both internal and external factors.

Likely Influencing Factors ➢ Hormonal fluctuations ➢ Mechanical irritation from clothing or collars ➢ Sweat retention in the area Area-Specific Care Tips ➢ Wear breathable fabrics to reduce friction and moisture ➢ Gently cleanse the area after sweating ➢ Initiate early, appropriate topical interventions under guidance

Zone 10: Neck and Upper Chest10

ACROSS FACIAL ZONES ➢ Pore blockage: Excess sebum and dead skin cells clog follicles. ➢ Bacterial overgrowth: Cutibacterium acnes triggers local inflammation. ➢ Hormonal influence: Androgens increase oil production in multiple zones. ➢ Barrier disruption: Harsh products or overcleansing worsen irritation. ➢ Lifestyle factors: Stress, diet, environmental exposure affect all zones.

sleep,

and

➢ Barrier support: Gentle skincare and ceramide/ hyaluronic acid moisturisers aid long-term control.

CONCLUSION Face mapping demystifies acne patterns by linking breakouts to underlying conditions and lifestyle triggers in specific facial areas. From forehead breakouts associated with hair products to chin acne influenced by hormonal fluctuations, understanding these patterns enables more targeted skincare and lifestyle adjustments. When combined with consistent, gentle skincare and professional guidance, face mapping empowers individuals to manage acne effectively.

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REFERENCES 1. Voegeli R, Gierschendorf J, Summers B, Rawlings AV. Facial skin mapping: from single point bio-instrumental evaluation to continuous visualization of skin hydration, barrier function, skin surface pH, and sebum in different ethnic skin types. Int J Cosmet Sci. 2019;41(5):411-424. doi:10.1111/ics.12562 2. Wa CV, Maibach HI. Mapping the human face: biophysical properties. Skin Res Technol. 2010 Feb;16(1):3854. doi: 10.1111/j.1600-0846.2009.00400.x. PMID: 20384882.

3. Thiboutot D. Acne: hormonal concepts and therapy. Clin Dermatol. 2004 Sep-Oct;22(5):419-28. doi: 10.1016/j.clindermatol.2004.03.010. PMID: 15556729.

4. Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037 5. Dréno B, Layton A, Zouboulis CC, et al. Adult female acne: a new paradigm. J Eur Acad Dermatol Venereol.

2013;27(9):1063-1070. doi:10.1111/jdv.12061 6. Preneau S, Dreno B. Female acne - a different subtype of teenager acne? J Eur Acad Dermatol Venereol.

2012 Mar;26(3):277-82. doi: 10.1111/j.1468-3083.2011.04214.x. Epub 2011 Aug 16. PMID: 21848892.

7. Lipozencic J, Ljubojevic S. Perioral dermatitis. Clin Dermatol. 2011 Mar-Apr;29(2):157-61. doi: 10.1016/j. clindermatol.2010.09.007. PMID: 21396555.

8. Draelos ZD. Cosmeceuticals: undefined, unclassified, and unregulated. Clin Dermatol. 2009 SepOct;27(5):431-4. doi: 10.1016/j.clindermatol.2009.05.005. PMID: 19695473.

9. Poli F, Auffret N, Leccia MT, Claudel JP, Dréno B. Truncal acne, what do we know? J Eur Acad Dermatol Venereol. 2020 Oct;34(10):2241-2246. doi: 10.1111/jdv.16634. Epub 2020 Jun 8. PMID: 32421879.

10. Woo YR, Kim HS. Truncal Acne: An Overview. J Clin Med. 2022 Jun 24;11(13):3660. doi: 10.3390/ jcm11133660. PMID: 35806952; PMCID: PMC9267677.

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R.N.I No. MAHENG/2015/62615

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