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Words on Wounds

A forum to discuss the latest news and ideas in skin and wound care.

Wednesday, August 12, 2020

Skin care for mask wearers

In the latest guideline released by the CDC the use of face coverings or masks in public areas is highly recommended where social distancing is difficult.  The purpose of having people wear masks is to prevent dispersal of droplets while talking, sneezing, and coughing and therefore reduce the risk of transmitting the coronavirus.  Healthcare workers wear medical-grade facial protection including surgical masks, N95 respirators, and face shields for prolonged durations.  Long‐time mask wearing during the coronavirus disease 2019 (COVID-19) pandemic can have a significant impact on skin health, especially in hot, humid, and poorly ventilated conditions.  International wound care communities have published timely best practices on how to prevent personal protective equipment-related pressure injury on the face.  Little attention has been paid to other skin conditions with acne being one of the most common concerns.

Under the mask, a tightly sealed environment promotes high humidity and heat accumulation.  Increased sebaceous production and poral occlusion can disrupt the skin barrier, leading to bacterial microflora imbalance and precipitating acne eruption.  Facial movement while talking, laughing, and other facial expressions can displace the mask, causing friction as the mask material rubs against skin.  These are some of the potential reasons why people experience flare of acne, rosacea, and other dermatitis.  People with these facial dermatoses including acne, atopic dermatitis, or seborrhoeic dermatitis are more likely to experience itching leading to frequent touching of the mask and face.

To minimize acne, here are some useful tips:

  1. Clean your face with mild, pH balanced soap before wearing a mask
  2. Avoid using makeup under mask
  3. Use water-based emollient on face
  4. Avoid using oily occlusive ingredients: e.g., petrolatum, silicone
  5. Avoid alcohol-based astringent on face; they are too drying promoting more irritation
  6. Use medicated cream with benzoyl peroxide for active acne lesions
  7. Use oil absorbing powder or lotion on the T-zone of the face, which tends to be more oily
  8. Avoid over-exfoliation that can irritate the skin
  9. Shave in the direction of hair growth; waxing is not recommended