Face masks and your skin

Currently in South Africa, iis mandatory to wear face masks in public.  

As a result, all sorts of masks are available at thousands of outlets.  We see cotton cloth masks, surgical masks, designer masks made from specialised materials and even buffs acting as masks.  

But although wearing a face mask has been proven to reduce the spread of the COVID-19 virus, we do see a few possible effects to the skin due to wearing a face mask: Let’s talk about a few of these effects: 

Itch 

An Internet survey was completed on 1 393 people wearing a face mask for a week where 20% of the participants complained of itchingPatients with a history of sensitive skin, atopic dermatitis, seborrheic dermatitis and acne had a significantly higher risk of developing mask-induced itch.  

Wearing a mask for longer periods of time has been linked to more frequent episodes of itch. A mask-induced itch can lead to scratching. Keep in mind that scratching your face with the mask on can in turn lead to an incorrect fit and reduced protection.  

Pressure ulcers  

Face masks can induce pressure ulcers under the contours of the gear, for example at the bridge of the nose or the cheeks. The pressure ulcers look like skin erosions or tears. Moisture that builds up due to the mask can also play a role in skin damage.  

The presence of maskrelated skin damage may also increase the risk of infection by allowing an easy path for bacteria, fungi and viruses to penetrate the skin.  

Allergic or irritant contact dermatitis 

Face masks may contain ingredients which sensitise the skin to develop an irritant or allergic contact dermatitis, for example due to rubber straps or metal clips.   

Maskne 

Mechanical acne can occur due to a face mask repetitively rubbing the skin. Sweat, makeup and humidity inside the mask may also be contributing factors for developing or worsening of pre-existing acne.  

Pigmentation 

Prolonged use of a tight-fitting face mask can lead to pigmentation of the nasal bridge, cheeks and chin. 

The solution 

The good news is that there are ways you can avoid some of the complications when wearing a face mask. 

– Carefully lace the face mask on your face to ensure that there is a good fit. The face mask should cover the nose and mouth. There should not be any gaps between the mask and the face to minimisthe risk of transmission. An incorrect fit can lead to pressure-induced skin erosions.   

– Once on your face, avoid touching the face mask. Scratching your face with your face mask in place can result in a poor fit or skin irritation.  

– When removing a face mask make sure that you do not touch the front of the mask. Clean your hands with an alcohol-based hand sanitiser or soap and water after removing the mask.  

– Do not reuse masks intended for single-use and dispose of them immediately once removed. Replace masks if they become damp and replace with a clean, dry mask.  

– Keep your skin clean and well hydrated.  

– Barrier ointments (e.g. Vaseline petroleum jelly) can be used to protect against face mask related skin damage.  

– Apply a moisturiser at least 30 minutes before wearing your face mask.  

 

References: 

  1. Szepietowski JC, Matusiak L, Szepietowska M et al. Face Mask-induced Itch: A Self-questionnaire Study of 2,315 Responders During the COVID-19 Pandemic. Acta Derm Venereol. 2020 May 28;100(10).  
  1. Gefen A, Ousey K. Update to device-related pressure ulcers: SECURE prevention. COVID-19, face masks and skin damage. Journal of Wound Care. 2020 May 20 Vol. 29(5). 
  1. Gheisari M, Araghi F, Moravvej H et al. Skin reactions to non‐glove personal protective equipment: an emerging issue in the COVID‐19 pandemic. Letter to the editor: JEADV. 2020 April 17.