Signs encouraging mask-wearing compliance during the COVID-19 pandemic are posted in English and Spanish at my hospital. I was fascinated that a Spanish word for mask is máscara, since “mascara” in English signifies the cosmetic that darkens the eyelashes. While I am vigilant about wearing my máscara, I can’t remember the last time I put on mascara.

While I typically eschew make-up, one concession I make is lipstick when public speaking. Preparing for an in-hospital presentation this summer, I rummaged through purses and pockets for my infrequently-used lipstick. I realized, though, that with the requisite hospital mask donned, if I’d put on lipstick, who would see it?

Many women have bemoaned changes to their beauty regimen secondary to COVID-19. For example, a common concern is covering up gray hairs, generating mixed reactions on social media. “Embrace the gray!” “Continue coloring if that feels best for you.”

A woman’s beauty routine should present her authentic image. The problem is when women internalize a message suggesting she, and specifically a woman physician, has to look a certain way. Do I have to wear/not wear [insert cosmetic] to be taken seriously? Why don’t male physicians fret as much whether or not to dye their hair? Competent practice of my profession should be enough to be “professional,” not aesthetics.

Evidence for make-up is mixed. Many maintain a certain look appears more attractive or may instill a greater sense of competence, trustworthiness, and, a sticking point for women in particular, likability. Other research has found that cosmetics have a negligible effect on perceptions or may even lead to more negative opinions.

One study on physician hair color did not find a difference in patients’ impression of the quality of care. Patients who were cared for by gray-haired physicians had decreased mortality compared to other hair colors. Perhaps those statistics would have changed if the surveyed physicians reported whether hair color was natural or dyed.

With COVID-19 has come other fashion expectations. Traditional white coats are discouraged for fear of transmission between patients. Scrubs are now de rigueur to avoid clothing that cannot be laundered daily. I rarely wore scrubs, with the exception of being the inpatient attending. With my youthful appearance, I thought my white coat and work clothes helped me look more mature. Too often a male resident on the team was mistaken for the attending while we were rounding (anger, not shame, would make me blush), so I compensated by dressing “older.” Now I am denied these sartorial crutches, I have not noticed any difference in patients’ perception of my clinical skill.

I support physicians keeping kempt and professional. We should not need to look dowdy or airbrushed to be taken seriously. Women physicians during the current pandemic may welcome the opportunity to revisit the foundation of their beauty regimen and do what is best for them, not for the sake of anybody else.

In preparation for residency interviews, among my many stressors was finding matching heels for my navy blue suit. I bemoaned my sartorial plight to a fellow classmate, who quizzically asked, “Why don’t you just wear black shoes?” I responded, “You’re a guy! People have different perceptions of a woman’s appearance.” My mind flashed to preparing travel accoutrements: mascara, eyeliner, blush, foundation, and lipstick resurrected from the back of the cabinet. I thought, “You’re right! Why should it matter if my shoes aren’t the exact same color as my suit?”

While I worry about many things during COVID, my aesthetic routine is not one of them. My longer-than-usual ponytail, overdue for its biennial trim since I do not deem going to the salon essential, is tucked under a surgical cap, which I do choose to complement the color of my scrubs. On top of it all, I wouldn’t dream about leaving the house without my daily máscara.

Lealani Mae Acosta is a neurologist.

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