Maskne Treatments

Modality Options to Increase Spa Revenue

Face mask acne is an entirely new clinical condition arising from the COVID-19 virus response. There is a strong need for care and savvy skin care professionals recognize the business opportunity. In this article, I will address service modalities for the treatment of this condition.

Your clients are new to the practice of wearing a mask. Masks present a barrier collecting virus, bacteria, molds and fungus. Your clients will be utilizing a variety of different mask materials for varying amounts of time. Some clients will be wearing the mask for many hours continuously, while others will wear a mask intermittently. The effects on facial skin are a result of time worn, frequency of replacement and type of material.


Mask wearing exposes skin to a number of undesirable effects. Skin is exposed to excess moisture, heat, microbial proliferation, mechanical irritation, anaerobic environment and allergic stimulus. Tight fitting elastic band masks cause compression, impairing lymphatic drainage and proper blood flow. Skin which has evolved to be open and breathing, is now thrust into an unfamiliar environment.

The mask creates a comodonogenic environment. Bacteria proliferation is promoted by moisture, heat and increased anaerobic environment. Bacteria are able to thrive where they were once held in check. Homeostasis balance is shifted in favor of the P Acne bacteria. These P acne bacteria thrive in the depths of pores and hair follicles.

Skin which has evolved to be open and breathing is now thrust into an unfamiliar environment.

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At my clinic, we have begun the process of modality-based protocol development for face mask acne and associated conditions. Modality protocols currently under development include the use of aqua exfoliation, oxygen mist and plasma. Each of these modalities represent a service provided by the spa. These services provide the esthetician with valuable income for the spa.

Each modality provides for a specific element of client need. Aqua exfoliation deep cleanses pores, increases lymphatic drainage, increases blood flow and exfoliates the epidermis. Oxygen mist is used to deeply oxygenate the skin for microbe control, healthy glow and speed of recovery. Plasma is used for spot treatment of comedones.


Aqua exfoliation systems draw serums from canister stations. These serums are delivered to a hand piece for placement on the skin. Acid-based serum emulsifies the outer dead layers of skin. The hand piece has a vacuum side which then collects the serum. Serum and skin debris are returned to a collection canister.

Hand pieces have tips designed to control the flow of the serum. There is an inflow port and a vacuum return port. Between the ports, there are channels designed to carry the liquid serum. Vacuum pressure allows for deep pore cleansing as well as mechanical traction of the skin for debris loosening. Skin is pulled against the edges of the tip resulting in a stretch effect. This stretch effect promotes lymphatic drainage and increased blood flow.


Oxygen mist penetrates deep to the base of the pore raising tissue oxygen levels. This allows for the suppression of anaerobic bacteria. Skin is good at resisting wind but not good at resisting mist. The mist penetrates deep through the epidermis.

These systems are three parts. An oxygen concentrator is used to create and provide unlimited 90% ground state oxygen at pressures necessary to drive a nebulizer or air brush. Within the application handpiece, a serum is placed. The pressurized oxygen spins the serum creating a venturi effect. The venturi effect mixes the oxygen into the serum. This results in the creation of an oxygen rich mist which is channeled through a tip.


Plasma is new to skin care. Simply put, everything exists as a solid, liquid, vapor or plasma. Plasma is considered the fourth state of matter. The use of plasma in skin care is being investigated as a standalone modality. Plasma devices create a stream of electrons and protons. Specific comedones can be targeted for bacterial disruption.

When the plasma generator is activated, a stream of electrons and protons is directionally emitted. Plasma devices have an emission head which is ergonomically designed to be placed over an active acne lesion. The plasma output is then directed into that lesion. The stream of electrons and protons causes disruption of the bacteria cell membrane. Bacteria are targeted and destroyed through cell membrane damage.

Providing any of these modalities will get you started with promoting face mask acne care. If your spa has one of the modalities, begin promoting this service. If you have to purchase equipment consider your return on investment. Oxygen Facial is a relatively low-cost initial investment. Aqua Exfoliation can be a costly investment. Excessively high monthly loan payments cause higher per service fees or force you to hustle for more services. Low-end Aqua systems provide immediate return on investment but will present problems. These systems often provide poor fluid control and vacuum pressure. This combination creates a situation where as much serum is on the floor as on your clients face.

General purchase recommendations are as follows. With oxygen systems, make sure you are purchasing an actual oxygen concentrator. Some systems being sold as oxygen facial only blow room air on the skin. South Korean manufacturers of Aqua Exfoliation systems provide a well manufactured system. You can expect precise serum control, at a middle of the road price.

The condition we call face mask acne can be effectively treated with spa-based modalities. Modality driven procedures provide the skin care professional with service income. As I describe these modalities, I realize that many spas have the equipment already available within the spa. This means that immediate implementation can occur without capital outlay.

Face mask acne is here for the foreseeable future. Spas should quickly jump on this service and promote it. There is a strong need for care with estheticians being the critical care givers of this service. Spas have been hard hit financially through shutdowns and lower client numbers. Promoting services to directly address this condition is a savvy business decision. Combining service modalities with retail products, represents the way to thrive during these troubling times.