We've all seen the photos of healthcare workers with rashes, bruises, and indentations lining their faces. As these heroes suit up day after day to treat COVID-19 patients and help keep our hospitals functioning throughout the chaos, many are dealing with adverse skin reactions to the personal protection equipment. According to a recent paper published in the Clinics of Dermatology, several skin conditions have emerged as a result of the extended wear of medical masks, including pressure injury, contact dermatitis, pressure urticaria, and exacerbation of pre-existing skin diseases like acne and eczema. Not only does this lead to decreased moral, but studies have shown that damaged skin may not allow for masks to seal properly, increasing the risk of exposure. So to help those on the frontline, dermatologists have taken to social media to share their knowledge on treating and preventing the common skin conditions caused by medical masks. Scroll through for their smart and thoughtful tips.
When it comes to irritation caused by masks, protecting the skin barrier is key, according to Dr. Shari Marchbein, a dermatologist in New York City. "You want to use some sort of protective barrier, like Vaseline ointment, Aquaphor, CeraVe Healing Ointment, or even a zinc oxide barrier cream called Triple Paste is a great option," she said on an Instagram Story for Allure. Another thing Dr. Marchbein suggested is a protective dressing called DuoDerm. "Apply that to the skin first and that way the mask will rest on the dressing as opposed to your face," she said.
If irritation persists, Pittsburgh-based dermatologist Dr. Lindsey Zubritsky Pollock recommends laying it on thick. "As soon as the shift is over, apply an occlusive agent to the skin to help repair, rehydrate, and protect the compromised skin barrier," she wrote on Instagram. Her personal favorites are StrataMed, a film occlusive agent used for wound healing, and Biafine Emulsion Cream. "Be extra gentle to your facial skin at this time," Dr. Polluck continued. "Avoid all irritating agents or creams, such as retinoids, hydroxy acids, or scrubs." Streamline your routine, using a gentle face wash and non-comedogenic moisturizing cream instead.
For some people, wearing masks for long hours may cause skin to become drier than normal. "Friction from [masks] along with the humidity of enclosed environment leads to dry skin," Minneapolis-based dermatologist Dr. Jenny Liu wrote on Instagram. "Stick to hydrating serums and moisturizers with active ingredients such as glycerin, hyaluronic acid, [and] vitamin B5." She went onto explain that exfoliation is also an important step, but cautioned against physical exfoliation. "Friction from masks can cause microtears in the epidermis. Harsh exfoliation with scrubs can exacerbate this," she explained. Instead, Dr. Liu recommends chemical exfoliating ingredients like alpha hydroxy acids.
According to San Francisco-based dermatologist Dr. Joyce Park, acne is one of the top skin conditions caused by wearing masks for long hours. It's become so common, in fact, that she's started calling it "maskne." "Acne mechanica, or 'maskne' in this case, occurs in skin areas that are under occlusion," she explained in an Instagram post. "Commonly we see this in athletes who wear helmets and shoulder pads. Occlusion of the hair follicles and a warm sweaty environment predisposes to acne flares." It's important to keep your face clean, wiping off sweat and oils as much as you can throughout the day, and washing it immediately after your shift ends, she said.
To treat "maskne," Dr. Park recommends using a benzoyl peroxide or salicylic acid face wash, and then applying a topical retinoid like Differin Gel or prescription-strength Tretinoin to help exfoliate. However, avoid retinoids if you are also experiencing irritation or broken skin. Finish with a non-comedogenic moisturizer, such as Cetaphil Moisturizing Lotion, to hydrate and protect the skin barrier.
In a recent Instagram post, Los-Angeles based dermatologist Dr. Jessica Wu said she has received concerns from patients who say facial sweat is affecting the way their masks stay put. If you are sweating under your mask, Dr. Wu recommends applying an antiperspirant -- not deodorant -- on the face. "I use Dove Clinical Protection, the same one I use on my underarms," she said. And when asked by a follower if this would cause breakouts, Dr. Wu responded, "Antiperspirant ingredients block sweat ducts. Wouldn't necessarily expect acne flare-ups unless it causes irritation-associated pimples." She added that controlling sweat can often help with breakouts.
To prevent bruising, Chicago-based dermatologist Dr. Caroline Robinson suggests using a thick ointment like Vaseline. "Apply to areas of skin that experience the most friction/pressure from PPE -- bridge of the nose, forehead, lateral cheek, around the eyes," she wrote on Instagram. If this doesn't help, she recommends applying band-aids or gentle skin tape over the nasal bridge and cheeks where the mask rests; however, she warns that these may interfere with mask fit, so it's important to be extra cautious when applying. To treat facial bruising, Dr. Robinson suggests using a vitamin K serum and/or arnica gel.
Allergic Contact Dermatitis
Allergic contact dermatitis is a form of dermatitis caused by an allergic reaction to a material in contact with skin, causing redness, itching, and burning. Some healthcare workers are experiencing this from the release of free formaldehyde found in certain N95 masks, dermatologist Dr. Adeline N. explained on Instagram. To help reduce redness, relieve itching, and decrease inflammation, she recommends using a low potency, over-the-counter hydrocortisone cream. "Rub a thin layer to the affected area twice daily, or as needed before and after removing mask, for about a week or two," she advised. She also suggested using moisturizers with ceramides, which are "essential in maintaining the skin barrier," and niacinimide to ease redness and irritation.
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