Impact of Face Mask Wearing on Demodex Infestation and Facial Skin Symptoms

Objective: Demodex folliculorum and Demodex brevis are common components of the human cutaneous microbiome, and their pathogenic proliferation has been associated with several inflammatory facial dermatoses. Prolonged face mask use creates an occlusive microenvironment that may influence Demodex density; however, evidence on this association remains limited. This study aimed to evaluate the relationship between face mask use, Demodex infestation, facial symptoms, and skincare behaviors in adults.Material and Methods: This cross-sectional study included 287 adults attending a dermatology clinic.Participants completed a structured questionnaire on demographic characteristics, mask-wearing habits, skin symptoms, and skincare practices. Demodex density was assessed using standardized skin surface biopsy, and >5 mites/cm2 was considered positive.Results: Demodex infestation was detected in 7.6% of participants. Participants in the regular mask-use group (≥6 hours/day) had significantly lower infestation rates than those in the no-mask group (4.9% vs. 11.4%, p = .040). Individuals with Demodex infestation more frequently reported scaling (p = .012) and burning/tingling sensations (p = .006). Regular mask users reported higher moisturizer and facial cleanser use, which may contribute to reduced mite density. Gender distribution and dryness did not differ significantly between groups.Conclusion: Regular mask use was inversely associated with Demodex infestation, suggesting that mask-related changes in humidity, temperature, and hygiene routines may create an unfavorable microenvironment for mite survival. Scaling and burning/tingling emerged as meaningful clinical indicators of Demodex infestation. Behavioral and microenvironmental factors should be considered when evaluating patients with suspected Demodex-related symptoms. Prospective studies are warranted to elucidate underlying mechanisms.