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Understanding of underlying pathophysiology directly relates to the novel skin microenvironment and textile\u2013skin friction created by mask\u2010wearing, distinct from nontextile\u2010related acne mechanica previously linked to wearing of headgear. Specifically, the occlusive microenvironment leads to microbiome dysbiosis, which is linked to various dermatological conditions. Additional textile\u2013skin interactions include factors such as breathability, stickiness sensations, moisture saturation, and hygiene maintenance. Increased skin temperatures can trigger sweat\/heat\u2010related dermatoses, and ear loops potentially trigger pressure\u2010induced dermatoses. Important therapeutic considerations include increased skin irritation potential of conventional acne treatments under occlusion, exacerbation of chronic dermatoses, that is, perioral dermatitis, rosacea, and eczema, and susceptibility of these same patient groups to heightened discomfort with mask\u2010wearing. Cotton, as the traditional fabric of choice for dermatology patients, has limited benefits in the context of face masks \u2013 increased subjective discomfort relates to increased moisture saturation and stickiness, inevitable because of high biofluid load of the nasal and oral orifices. 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