Dr Ian Webster
Dr Ian Webster

Respiratory masks during COVID-19 + Potential skin problems

From Friday, 1st May 2020 it became mandatory for all South African citizens to wear a cloth face mask when in public and when at the workplace.

This is essential to help slow the spread of the coronavirus through South Africa but It has the potential to create a few skin issues. On Dermastore support, we are already starting to see these issues especially with healthcare workers who wear masks for long periods of time. So what follows is some advice on how to prevent and deal with these problems:

Cloth Face Masks

A face mask can be made from various fabrics e.g. tightly woven cotton or thick t-shirt material but it is essential that you have two layers, with the outer layer being a tightly woven cotton fabric and the inner layer a soft fabric like washed cotton, soft t-shirt material, flannel or chiffon, as it is this layer that comes into contact with the skin. Some masks come with a pocket where you can insert a disposable filter but the inside layer should still be a soft material.

The mask should fit snugly but comfortably especially around the nose and cheeks. When wearing a mask, your glasses can fog up especially when shopping. You do not want to touch your face and remove your glasses. To prevent the fogging of glasses, the mask must have a tight fit around the nose. Some cloth masks can be bought that have a wire insert in the fabric so that the fit around the nose is tighter and can be shaped to the contour of your nose. This will help prevent fogging up of your glasses. If you are making a cloth mask yourself, you can insert a nose contour wire made from a pipe cleaner or from a tie that is found on a bag of coffee beans or that comes with plastic bags.

If you do decide to purchase a cloth face mask it would be advisable to buy at least two masks per person so that the mask can be washed daily with gentle foaming soap and hot water, rinsed and when dry, ironed.

If you purchase a new cloth face mask you should wash it before you use it for the first time. Some new fabrics contain formaldehyde biocides such as triclosan and sulfites which may cause an irritant or allergic contact dermatitis.

When removing the cloth face mask, it should be removed carefully without touching the front or back and it can be stored in a separate plastic container until it is washed with soap and water. This container should be washed in soapy water and rinsed or sprayed with an alcohol sanitizer after you remove the mask to wash it.

Remember to wash your hands thoroughly after removing your mask.

Surgical Masks & N95 Respirators

These masks should only be worn by healthcare professionals.

Potential Skin Problems with Wearing Respiratory Masks

By occluding your face with a mask, you get a build-up of your warm breath and moisture on your skin. This increases the hydration of the stratum corneum which can cause a blockage of the pilosebaceous unit and acne breakouts. The increased temperature and humidity on your skin can also cause a flare-up of rosacea.

As mentioned above, various chemicals in the cloth mask or surgical mask such as formaldehyde can cause irritant or contact dermatitis on your face.

If you are having to wear your mask for long periods of time, for instance, if you are healthcare worker, wearing a hard N95 mask or work in a retail store for long hours in a cloth mask, the physical rubbing on the skin could disrupt the skin’s natural epidermal barrier function. This can lead to irritation, erosions, and raw areas on the skin.

If you are using a face mask with elastic or rubber ear loops, it is possible you could develop an itchy allergic contact dermatitis to the latex in the ear loops. If this should happen, I would recommend you apply 1% hydrocortisone cream to the irritated areas – this can be bought over the counter from your pharmacy.

If you have a darker skin tone, then these raw eroded areas could heal with post-inflammatory hyperpigmentation (PIH).

Recommendations

My recommendation is to cleanse your skin thoroughly but gently at least once a day with a gentle, slightly foaming cleansing. Remember it is the foam (surfactant) that kills the coronavirus and I would caution against using any toners or scrubs.

I would suggest that you do not wear any heavy, occlusive make-up as this would not only rub off on your mask but it could increase the likelihood of acne breakouts. Depending upon your skin type, I would apply a barrier cream to your face especially in the areas where there might be friction with your mask. However, this barrier cream should not be too greasy as it may make the acne breakouts worse.

Product Recommendation: La Roche-Posay Cicaplast Balm B5 SPF50+

Always let the barrier cream be completely absorbed into the skin before applying the mask. If your skin is feeling irritated by wearing the mask for long periods of time, it may be worthwhile cutting back on your active ingredients, for instance, your retinol at night time.

If you get acne breakouts you can use spot treatments which would include ingredients such as benzoyl peroxide, azelaic acid, and salicylic acid. If you have a flare-up of your rosacea you can use a thermal spring water spray as well as topical products formulated for rosacea.

If you are a healthcare worker and have been using say, for instance, a hard N95 respirator mask for many hours, I would recommend using a thicker barrier cream without preservatives to the more sensitive, irritated, or raw areas on your face at night time.

Product Recommendation: SBR Repair Cream

Remember, if you have a day off and it is a nice sunny day, then remember to use a high factor, broad-spectrum sunscreen to help prevent post-inflammatory hyperpigmentation on your face.

Product Recommendation: Shop skin type-specific sun care

Posted in LEARN / LATEST ARTICLES on May 14th, 2020.

Product Recommendations

SBR Repair Cream 30g

SBR
Repair Cream 30g

R165.00

SBR
Repair Cream 30g

Skin Identical Barrier Repair

Dry, Disrupted Skin

R165.00
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Heliocare Gel SPF 50 (Oil-Free)

Heliocare
Gel SPF 50 (Oil-Free)

R300.00

Heliocare
Gel SPF 50 (Oil-Free)

Advanced UV Protection

Normal, Combination or Oily Skin

R300.00
Add View
pHformula SPOT ON Blemish Active

pHformula
SPOT ON Blemish Active

R310.00
Active ingredient

pHformula
SPOT ON Blemish Active

Targeted Blemish Treatment

Acne-prone skins

R310.00
Add View

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