Dermatologists Are Sharing Thoughtful Tips For Skin Conditions Caused By Medical Masks

skin conditions caused by masks
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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.

 

 

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TIPS for relieving skin problems due to mask overuse in healthcare workers (HCW) during COVID-19😷⁣ .⁣ .⁣ We’ve all seen the photos – HCW with sores, skin tears, and indentations on their face from wearing PPE for hours (some up to 13+ hours for a shift!)⁣ ⁣ Recent studies show this complication can result in:⁣ 😷decreased morale in an already distressed HCW ⁣ 😷increased risk for developing infections of the skin (bacteria, fungal, viral) from poor barrier function and open sores⁣ 😷damaged skin may not allow for masks to seal properly👉increased exposure to COVID-19 particles⁣ ⁣ Over 97% of our HCW on the frontlines fighting COVID-19 will experience skin issues. Here’s how to help:⁣ ⁣ 😷Strips of Duoderm on areas of PPE contact👉acts as a barrier between the mask and skin, reducing friction and preventing further skin breakdown⁣ ⚠️CAUTION: if not used properly, may decrease how well the masks seals⁣ ⁣ 😷Can also use petroleum jelly (i.e. Vaseline) or zinc oxide barrier paste in areas of mask contact⁣ 👉lubrication effects reduce friction while occlusive nature prevents water loss (important for maintaining a healthy skin barrier)⁣ ⁣ 😷As soon as the shift is over, apply an occlusive agent to the skin to help repair, rehydrate, and protect the compromised skin barrier⁣ 👉My favorites are Stratamed or Biafine, but aquaphor or vaseline work well too!⁣ ⁣ 😷Be extra gentle to your facial skin at this time⁣ 👉Avoid all irritating agents or creams, such as retinoids, hydroxy acids, or scrubs⁣ 👉Clean with gentle face wash and use non-comedogenic moisturizing creams to the entire face⁣ ⁣ 😷Arnica and bromelain supplements may help mitigate bruising⁣ ⁣ 😷Be aware of potential allergic reactions from masks, which should be treated differently⁣ 👉Potential allergens include glue or metal (like nickel)⁣ 👉Topcial steroids can help⁣ ⁣ Tagging some of my colleagues for their recs! As always, stay safe and healthy and thank you 🙏🏻 HCW 🙏🏻 for your dedication and commitment⁣ ⁣ #COVID19 #COVID #coronavirus #PPE #PPEproblems #masks #skinproblems #skinrelief #stayhome #thankyouhealthcareworkers #corona #protectourhealthcareworkers

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Irritation

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.

 

 

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Skin care during #covıd19. Long periods of tight masks will increase dryness, irritate preexisting sensitive skin, and cause acne. Here are few easy tips I recommend for healthcare workers: Hydrate. Friction from 😷 along with the humidity of enclosed environment leads to dry skin. To repair skin barrier, stick to hydrating serums and moisturizers with active ingredients such as glycerin, hyaluronic acid, vitamin B5. Apply twice daily in the morning and before bedtime. If you have rosacea or sensitive skin, ingredients suchs as niacinamide helps to reduce inflammation and redness. Reapply sunscreen. Inevitably, your SPF will rub off. Don’t forget to reapply at the end of the day. My favorite way is powder sunscreen for easy application without touching your face. Minimize heavy makeup. Forget about heavy foundation or coverup; they can clog pores and worsen acne. Instead stick to tinted sunscreen and use concealers as needed. For those with acne prone skin, stick to non-comedogenic products. And make sure to remove your makeup before you sleep. Minimize physical exfoliation. Friction from masks can cause microtears in the epidermis. Harsh exfoliation with scrubs can exacerbate this. Exfoliation is important for healthy skin, so stick to chemical ingredients like AHAs. Cleansers are a great option, but limit in-leave treatments to once weekly or few times monthly to minimize skin irritation. Lip service. Lips can often get chapped. Simple layer of petrolatum jelly throughout the day is the most effective and affordable way of keeping them hydrated. Lastly, avoid touching your face and thoroughly wash hands before applying any products. Thanks @dermguru for starting this series. Love to hear your tips! #skinexpert #maskselfie #skincaretips #healthcareworkers

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Dry Skin

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.

 

 

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– Skin protection while wearing PPE – . I’ve seen a couple videos on social media, showing healthcare workers in China gearing up to care for #covid patients. While I am struck by the PPE they have available, I also notice that all the staff have skin protectant on. I want to do a follow up post to @dermguru and @derm.talk to share some tips about protecting your skin under masks. . According to a study out of Singapore during the SARS epidemic, mask wearers were most likely to develop acne followed by itch, rash, pigmentation, and scar at the nasal bridge. . Let’s tackle the top ones: acne and itch/rash. . Acne mechanica, or “maskne” in this case, occurs in skin areas that are under occlusion. 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. . To treat maskne: wash or wipe the sweat off your face as soon as you can or after your shift ends. Exfoliants are your friend. Use a benzoyl peroxide or salicylic acid wash in the areas affected by acne, and apply a topical retinoid like @differinus or prescription Tretinoin to help exfoliate. Then apply a non comedogenic moisturizer to protect the skin such as @cetaphilus or @cerave. . For itch/rash from the masks: irritant contact dermatitis from long periods of mask wearing is likely causing these symptoms. . To counter this, you need some sort of barrier to protect the skin. You can use Duoderm or a gentle skin tape over the nasal bridge and cheeks where the mask rests. You can also use a barrier cream like zinc oxide. Wash your face with a gentle cleanser and then apply a thick emollient to encourage healing such as @aquaphorus healing ointment or @vaselinebrand. Avoid exfoliants or retinoids here because your skin is already sensitive. . If the rash persists, you can use otc hydrocortisone or prescription strength steroid cream to decrease inflammation. . If you develop any open cuts or sores from the mask, you can apply Vaseline twice a day. I don’t recommend neosporin (can cause allergies). . Please help share with anyone who is wearing masks all day and can benefit from this info!

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Blemishes

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.

 

Sweating

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.

 

 

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𝐅𝐀𝐐’𝐬 𝐨𝐧 𝐒𝐤𝐢𝐧 𝐂𝐡𝐚𝐧𝐠𝐞𝐬 𝐢𝐧 𝐇𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 𝐅𝐫𝐨𝐧𝐭𝐥𝐢𝐧𝐞 𝗪𝐨𝐫𝐤𝐞𝐫𝐬 𝐚𝐧𝐬𝐰𝐞𝐫𝐞𝐝⁣⁣ As we continue to fight the battle against Covid19, our frontline workers suffer from increased exposure, inadequate PPE, and a myriad of related health issues. One of the most visually dramatic is the skin damage that occurs from repeated PPE use. In some instances, this is so painful that it prevents proper use/protection. Below are some tips on helpful topical interventions. Below this is a list of posts by my colleagues who have beautifully covered derm related topics in Covid. Tag a frontline worker who can benefit from this. #KeepOurFrontlineSafe⁣⁣ ⁣⁣ 𝐏𝐫𝐞𝐯𝐞𝐧𝐭𝐢𝐨𝐧, 𝐚𝐭 𝐫𝐢𝐬𝐤 𝐚𝐫𝐞𝐚𝐬:⁣⁣ Apply these to areas of skin that experience the most friction/pressure from PPE- bridge of the nose, forehead, lateral cheek, around the eyes 2x/day (before shift/before bed).⁣⁣ ✴️Thick, unscented ointment (i.e. @VaselineBrand jelly or stick)⁣⁣ ✴️Zinc Oxide Barrier cream (i.e. Triple Paste)⁣⁣ ✴️Bandaids/Duoderm (Caution: may interfere with mask fit)⁣⁣ ⁣⁣ 𝐆𝐞𝐧𝐭𝐥𝐞 𝐒𝐤𝐢𝐧𝐜𝐚𝐫𝐞, 𝐚𝐥𝐥 𝐨𝐯𝐞𝐫:⁣⁣ ✳️Gentle cleanser (i.e. @vanicreamskincare)⁣⁣ ✳️Moisturize your face w/ a non-comedogenic lotion w/ hydrating glycerin, HA, etc.⁣⁣ ✳️Hypoallergenic sunscreen daily (i.e. Neutrogena Sheer Zinc, 🚫sun damage & #hyperpigmentation)⁣⁣ ✳️Unscented balms for your lips (i.e. vaseline is great here too)⁣⁣ ✳️Thick hand cream 2x/day & after every wash⁣⁣ ⁣⁣ 𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭:⁣⁣ ❗️Inflamed areas: OTC 1% hydrocortisone until calmed⁣⁣ ‼️Cracked/broken skin: @VaselineBrand jelly to promote wound healing (Avoid Neosporin/Hydrogen Peroxide, etc), DuoDerm (hydrocolloid dressing)⁣⁣ ❗️Brusing: Vitamin K serums, Arnica gel⁣⁣ ❗️Overall wound healing: Vitamin C serums⁣⁣ ⁣⁣ 𝐂𝐎𝐕𝐈𝐃𝟏𝟗 𝐏𝐨𝐬𝐭𝐬 𝐛𝐲 #𝐃𝐞𝐫𝐦𝐚𝐭𝐨𝐥𝐨𝐠𝐢𝐬𝐭𝐬 (𝐁𝐂𝐃𝐬 𝐚𝐧𝐝 𝐫𝐢𝐬𝐢𝐧𝐠):⁣⁣ @dermguru – Skin issues related to mask overuse & Skin manifestations ⁣⁣ @brownskinderm – Skincare for N95 Mask Related Dermatitis⁣⁣ @teawithmd – Acne Mechanica/Irritant Contact Derm in Covid ⁣⁣ @derm.talk – Skincare in COVID19⁣⁣ @drsandralee – Skin findings in patients w/ Covid⁣⁣ ⁣ 📸: via @unilever

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Bruising

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.

 

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Painful bruised faces of healthcare personnel’s at the forefront of this pandemic such as the beautiful @iamnursepatti have been circulating online providing a glimps of the physical toll this is having on them. : Their #n95facemask worn regularly for long hours though necessasy, unfortunately can also contribute to #skin issues such as: 🛑Irritant contact dermatitis: due to constant friction especially on bony area of nasal bridge w/ metal clips & rubber straps causing bruises & scars. 🛑Allergic contact dermatitis-from release of free formaldehyde found in some N95 mask causing redness, itchiness & burning. 🛑Acne Flares: from occlusion of the pilosebaceous unit from tight fitting mask & humid microclimate created inside mask. 🛑Post inflammatory redness & #hyperpigmentation from constant irritation to skin // I created a #skincareroutine routine featuring products from my most trusted brands for sensitive skin @lorealusa @cerave & @larocheposayusa They have been so kind as to gift @iamnursepatti & her team of doctors, nurses, techs some gentle skincare products in support of their selfless service to us🤗 : ✔️A Gentle Cleanser: Use one that does not further strip skin of moisture. I recommend @cerave Hydrating cleanser & @larocheposayusa hydrating gentle soapfree cleanser for sensitive, dry & irritated skin. : // 👉🏾Low potency 1% OTC Hydrocortisone to help reduce itching, redness and inflammation related contact dermatitis. Rub thin layer to affected area twice daily as needed either before & after removing mask for abt a week or 2 for relief. // ✔️🧴Moisturizer: Use creams containing ingredients such as #ceramides, essential in maintaining skin barrier. #Glycerin & #hyaluronic acid:-naturally draw moisture into skin increasing hydration. #niacinamide /VitB3 antioxidant-ease redness & sooth irritated #skin-Cerave Moisturizing cream/ & LP tolerian double repair face moisturizer.// ✔️Protect: Lastly, apply silicone containing barrier cream to create protective seal layer over compromised skin & to lock in moisture. 👍🏾LP Cicaplast baume allows for easy non sticky glide. 👩🏽‍⚕️💪🏽 #brownskinderm #coronavid19 #nurses #larocheposay #cerave #skincare

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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.

You might also like: 8 Dermatologists To Follow On Instagram For Seriously Good Skin Advice

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