We spoke with Sarah T. Arron, MD, PhD, a dermatologist in Burlingame, California. For The Waiting Room, she has contributed a post on “How to Fight Skin Cancer: Self-Examination and Prevention”. Furthermore, she has published the booklet “Fast Facts for Patients and their Supporters: Advanced Cutaneous Squamous Cell Carcinoma” with Karger. Both resources are freely available online.


Dr Arron, we would like to ask you about „Digital Aging“ and „Mascne“ – two conditions that are connected to the COVID-19 pandemic. With people spending more time in front of a computer screen due to the pandemic, they are increasingly exposed to blue light. Can you tell us how blue light affects the skin?

Blue light can be potentially helpful or potentially harmful to the skin – depending on the setting and dose. The majority of the blue light we receive comes from sunlight, but the increased time spent in front of screens means even more blue light affecting our eyes, sleep cycle, and potentially our skin. In some settings, dermatologists use blue light as a safe and effective therapeutic for skin conditions like acne and sun damage. However, we don’t have as much information on the long-term effects of blue light on aging, and it seems that blue light exposure can increase pigmentation in the skin, which could lead to photoaging or “digital aging”.

What is your advice on “Digital Aging”?

Fortunately, the recent interest in blue light exposure means there is more research coming out on this topic and more testing of cosmetic products to protect against unwanted blue light. Mineral sunscreens such as titanium and zinc already protect us from blue light, so look for one that you can wear every day, and apply even if you plan to be indoors working at your computer. I like EltaMD® UV Clear Broad-Spectrum SPF 46, which doesn’t leave a white film typical of some zinc sunscreens. There is also some evidence that blue light damages the skin by generation of reactive oxygen species, which can be combatted by using topical antioxidants such as a vitamin C serum. The Ordinary Ascorbic Acid 8% + Alpha Arbutin 2% is a cost-effective option. Don’t forget that blue light can also impact your sleep cycle, which impacts your skin. Try to unplug in the evening and get your well-deserved rest.

Since masks have become an everyday object, and wearing them is required for many activities, people more and more complain about red spots on nose, chin and cheeks. Can you tell us how “mascne” develops?

Mascne is a big problem for many people. It is a type of “acne mechanica”, an acne flare due to friction, heat and pressure. We can also see this from sports helmet chinstraps, or on the forehead due to chronic baseball caps. The heat and occlusion from the masks allow bacteria, skin cells, and oil to clog the pores and cause pimples, and the physical rubbing exacerbates that inflammation.

What can be done to avoid and/or treat this condition?

If you are acne-prone, try to establish a good preventive regimen with over-the-counter benzoyl peroxide to target bacteria and reduce inflammation, and salicylic acid to unclog pores. These may dry out the skin, which leave it prone to more irritation from the mask, so don’t forget a gentle moisturizer such as Vanicream™. Try to avoid wearing makeup underneath your mask, as this further clogs the skin. It is also important to consider the mask you are wearing – look for 100% cotton and wash them daily, or use disposable surgical masks. If you find your mask rubs a certain place on your lip or chin, consider swapping for a different style and fit – there are so many to choose from! And if it persists, see your dermatologist who can prescribe stronger treatments as needed.

I’ve also noticed patients with flaring and spreading cold sores (herpes simplex) under their masks. If you are prone to cold sores and feel one coming on, take your antiviral medication or call your dermatologist right away. Consider covering your cold sore with a band-aid to avoid friction from your mask – if the blisters pop open, the mask can spread the viral fluid to other areas on your lips.

Are there other new or unexpected conditions you see in your practice due to the pandemic?

My biggest concern is the patients who have delayed getting their skin checked because of the lockdowns last year. Patients started coming back to the office after the vaccines came out, and I saw a number of new or changing skin lesions that had grown during 2020 and turned out to be skin cancer. The sooner we diagnose and treat, the better the outcome for the patient, so if you have skin concerns, don’t hesitate to come in and get checked!

Dr Arron, we thank you for your insights!

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