As the coronavirus lockdown is eased we’re being encouraged to wear a face covering or homemade mask in the supermarket, on public transport or when running or cycling. But just as frequent handwashing to combat the spread of COVID-19  has led to an increase in cases of dermatitis and hand eczema, the increasing use of masks that keep your nose and mouth covered for an extended period of time has led to reports of rashes, chafing, eczema and break outs on the face.

As though our wonderful NHS staff haven’t enough on their plates, doctors and nurses on the frontlines of the pandemic  have posted selfies of their skin covered in hives, red marks, and even bruises from prolonged use of face masks and other Personal Protective Equipment. 

Nearly all PPE is designed for single use – wear it then throw it away. But because of the massive global demand and subsequent shortage, health professionals have been wearing their PPE for an entire shift. Masks, (designed to be worn for no more than four hours), goggles, face shields, gloves and gowns when worn for several hours can cause skin problems induced or aggravated by heat, moisture, friction and lack of air circulation.

According to NYC-based dermatologist Joshua Zeichner MD, the problem lies  in the deliberate occlusive nature of a protective mask. “Protecting your face with a mask creates a moist, hot environment for your skin, as your breathing is being trapped," Dr Zeichner explains. "This can lead to a build up of sweat and oil on the skin under the mask, which can lead to inflammation, rashes, and even acne breakouts."

In particular there has been a marked increase in Intertriginous dermatitis, an inflammatory condition of folds of the skin, often made worse by the development of candida or other bacterial, viral or fungal infection.

Potential skin issues 

For most of us non-medics, wearing masks for short periods is unlikely to cause suffering to this extent. But even with cloth masks, skin can get irritated due to trapped moisture. Ties or loops that keep a mask tight against the face can increase the likelihood of redness and sensitivity. Elastics can encourage dermatitis from latex sensitivity.

If your skin becomes very dry in the areas around the nose and mouth, where the mask has been, there is an increased risk of infections and virus transmission via cracked skin.

How to protect your skin while wearing a mask

• Avoid the temptation to scratch or adjust your mask, or even reach under the mask and rub your nose subconsciously.
• Replace the elastic on a bought mask with Non-latex Elastic Bands  or use these when making your own cloth face covering.
• If your glasses fog up or the adjustable nose wire in the mask leaves sore pressure marks, stick a strip of Micropore tape where the mask meets the bridge of your nose.
• When removing your mask do this from the sides, avoid touching the front and wash your hands before washing your face so you’re not transferring germs from the mask into your mouth, nose, and eyes.
• Moisturise and hydrate your face lightly before wearing the mask, as thick layers of ointment can stop the mask working properly.  Gloves in a Bottle Shielding Lotion is ideal for this. After removing the mask we recommend SyrinxZa Natural Emollient as it gentle enough for your face, ears, neck and other sensitive areas.

• The chemicals in sunscreen can affect the integrity of your face mask, so choose one based on minerals such as Green Peoples's Unscented Sun Lotion SPF30 for Sensitive skin 

In a useful and interesting video Dermatologist and Cosmetic Surgeon Dr. Suzan Obagi demonstrates the proper way to wear and care for a mask, how to avoid contaminating yourself, and how to address skin care concerns like acne, eczema and sun protection in relation to mask wear.