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Between November 2021-January 2022 we conducted an exploratory, cross-sectional study evaluating the differences between the glabella and cheek-chin junction using clinical examination, fluorescent photography (FP), videodermatoscopy and in vivo reflectance confocal microscopy (RCM). Medical doctors from our country and 6th year medical students were invited. Participants self-identified as consistent MFM users during work hours. We analysed 19,432 images from 14 consecutive subjects, 11 females, 3 males, mean age,29.93 years (SD\u2009=\u20094.69). Clinical examination revealed more inflammatory lesions on the cheeks and chin (+\u20099.35;95%CI\u2009+\u20092.31to\u2009+\u200916.39;<jats:italic>d<\/jats:italic>\u2009=\u20090.76, <jats:italic>P<\/jats:italic>\u2009=.01). FP considered ultraviolet red fluorescing spots(UVRFs) from the glabella and the cheek-chin junction, with significantly more spots in the former (+\u20095.43;95%CI\u2009+\u20092.64to\u2009+\u20098.20; <jats:italic>d<\/jats:italic>\u2009=\u20091.12; <jats:italic>P<\/jats:italic>\u2009=.001). The average area in mm<jats:sup>2<\/jats:sup> covered by the spots was significantly larger in the glabella (+\u20093.26;95%CI\u2009+\u20091.43to\u2009+\u20095.08;<jats:italic>d<\/jats:italic>\u2009=\u20091.02; <jats:italic>P<\/jats:italic>\u2009=.002). RCM considered 9546 follicles, 4966 from the glabella, and 4580 from the cheek-chin junction. The cheek-chin junction had a significantly higher proportion of hyperkeratotic follicles than the glabella (+\u20099%;95%CI\u2009+\u20092%to +\u200916%;<jats:italic>d<\/jats:italic>\u2009=\u20090.79;<jats:italic>P<\/jats:italic>\u2009=.01). In the dermal-epidermal junction, the cheek-chin region had a significantly higher proportion of follicles with signs of inflammation than the glabella (+\u200910%;95% CI\u2009+\u20093%to +\u200918%; <jats:italic>d<\/jats:italic>\u2009=\u20090.80; <jats:italic>P<\/jats:italic>\u2009=.010). Perifollicular stratum corneum thickness was significantly lower in the cheek-chin junction, 19.56\u00a0\u03bcm (SD\u2009=\u20094.84) compared to the glabella, 24.25\u00a0\u03bcm (\u00b1\u20094.93) (-4\u00a0\u03bcm;95% CI-1\u00a0\u03bcm to\u2013 8\u00a0\u03bcm; <jats:italic>r<\/jats:italic>\u2009=.88; <jats:italic>P<\/jats:italic>\u2009=.01). The distribution of UVRFs, known to correlate with microbial activity and sebum production, is similar to pre-pandemic studies, suggesting that in acne mechanica associated to MFM, follicular hyperkeratinisation, inflammation, and irritation, may outweigh other possible alterations.<\/jats:p>","DOI":"10.1007\/s00403-025-04104-2","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T08:48:31Z","timestamp":1742201311000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A multimodal approach to acne mechanica associated to medical face masks using clinical examination, fluorescent photography, and in vivo reflectance confocal microscopy"],"prefix":"10.1007","volume":"317","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1127-5726","authenticated-orcid":false,"given":"Stefana","family":"Cretu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Iorga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4815-9227","authenticated-orcid":false,"given":"Mihai","family":"Dascalu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen Maria","family":"Salavastru","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"4104_CR1","doi-asserted-by":"publisher","first-page":"2","DOI":"10.3390\/jcm11071783","volume":"11","author":"A Alma","year":"2022","unstructured":"Alma A, Sticchi A, Chello C, Guida S, Farnetani F, Chester J, Bettoli V, Pellacani G, Manfredini M (2022) Dermoscopy, reflectance confocal microscopy and optical coherence tomography features of acne: A systematic review. 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