The Psychological Effect of Masks Following COVID-19 and the Desire for Facial Cosmetic Procedures: A Cross-sectional Study

Abstract Background: The coronavirus disease (COVID-19) pandemic has globally impacted public health with swift measures like mask-wearing. Previous outbreaks as well as the COVID-19 pandemic revealed the correlation between anxiety and social avoidance behaviors. However, the psychological impact of mask-wearing on individuals’ self-esteem and body image and its potential influence on the demand for facial cosmetic procedures remain uncertain. Materials and Methods: This cross-sectional study, conducted in Saudi Arabia, employed a questionnaire-based design. Data was collected via an online self-administered survey with a non-probability, convenient sampling technique. It included sections on demographics, face mask usage, body image, self-esteem, body appreciation, and facial cosmetic procedures. Two validated scales were used for assessment: “Rosenberg Self-esteem Scale (RSES)” and “The 10-item Body Appreciation Scale-2 (BAS-2).” Results: A total of 1213 participants were included. The majority of the participants were female (81.9%). In relation to the effects of prolonged mask use, more respondents reported no change in their self-esteem (62.4%), self-consciousness regarding body image (55.3%), and body image satisfaction (61.9%). Participants who were unaffected by prolonged mask use on their body image had higher BAS-2 scores (median = 43.0, interquartile range = 31.0–50.0; P < 0.001). A total of 637 (52.5%) participants expressed a desire for non-surgical cosmetic enhancement, with fillers or Botox being popular choices among 43.2% of participants. Conclusion: The study found that wearing masks for extended periods had no negative effects on participants’ perceptions of confidence or body image. However, our study indicated that those with lower BAS-2 and RSES scores were more willing to consider surgical facial cosmetic procedures done in order to improve their appearance.