Why protective face masks can affect the skin (and how you can prevent it)

Besides getting rid of the skin concern itself, mask related skin concerns have a link with COVID 19 transmission!

• Damaged skin exposes the basal layer of the skin which have found to contain the receptor for Severe acute respiratory distress-related Coronavirus-2 (SARS-CoV-2)
• Irritated skin can be itchy which may promote frequent touching of the face as hence entry of the COVID-19 virus!
• Irritation may also induce the wearer to remove the mask, at a time or place where it should not be removed.

• Prolonged occlusion leads to a damp and warm micro-environment. There can also be increased sweating under the mask. This can exacerbate underlying skin conditions. It encourages the multiplication of germs like Pityrosporum yeast that act in seborrheic dermatitis and rosacea, bacteria that promote acne etc.
• If something rubs against your skin all day, it disrupts the protective skin barrier, allowing moisture to escape and irritants to enter.
• Medical masks may contain preservatives or disinfectants that may cause an irritant or allergic reaction.
• In situations where it isn’t possible to remove your mask for prolonged periods, restricted fluid intake may lead to a feeling of intense thirst and constant lip licking, causing dry lips.

Sites like nasal bridge, cheeks & chin, where the mask remains in contact, are more likely to be affected.

One could experience redness, itching, irritation, pus-filled bumps etc. These features could represent a wide spectrum of skin concerns:

• Flare up of pre-existing conditions like seborrheic dermatitis, rosacea
• Acne/breakouts
• Irritant contact dermatitis or allergic contact dermatitis- eczematous lesions on the face corresponding to areas that are in contact with the mask. This would improve during holidays and time off from work.
• Friction dermatitis
• Pressure urticaria
• Sores behind the ears or allergic dermatitis to the elastic ear strap
• Lip lick dermatitis

Gentle skin care can prevent skin problems and play a vital role in healing your skin.

• Gentle cleansing – Prior to putting on a mask, use a gentle (mild, fragrance-free) cleanser to remove oil and dead skin cells to avoid clogged pores.
• Daily Moisturizing – Moisturisers act as a protective layer that keep the skin barrier intact and therefore reducing the risk of irritation!
  • Apply a moisturizer immediately after washing your face and at least 30 min before a wearing mask.
  • If your skin is oily, or if you live in hot & humid weather, you can use a gel moisturiser!

• Gentle cleansing & moisturising should be done not only before wearing a mask but also after coming home and taking your mask off as well!

• Avoid harsh/irritating skin care products that you may be using otherwise like salicylic acid, retinoids, scrubs or aftershave.

Beneath a mask, makeup is more likely to clog pores and lead to breakouts or worsen mask-induced skin problems. If you have to wear makeup look for products labelled “oil-free”, “mineral-based” or “non-comedogenic” (non-pore blocking)

• A snug, comfortable fit prevents coronavirus transmission. It also reduces skin problems. If the mask feels too tight or slides around your face, the friction irritates your skin. You’re also more likely to touch your face to adjust a poorly fitting mask which should be avoided in Covid times!
• The fabric is also important. Invest in cloth masks (Of course, medical professionals may have to follow stricter guidelines!) But soft, natural, and breathable fabric, such as cotton is best for sensitive skin. Or at least ensure a lining of such fabric on the inside to be in contact with the skin. These materials would be gentler on your skin as opposed to disposable ones. Avoid synthetic fabrics, such as nylon, polyester, and rayon as these are more likely to irritate your skin.  Remember that while lighter fabrics are easier to breathe through, they may not filter the virus very well if loosely woven or in a single layer! Look for masks that are multi-layered or made of tight weave fabrics.

Many health care organizations now recommend washing cloth mask after each use to prevent the spread of germs. But this is good for the skin too since washing removes oils, dead skin cells & particle build-up that collect inside the mask.

1. Wash the masks in hot water, unless the instructions say otherwise.
2. Use a fragrance-free, hypoallergenic detergent.

This tip helps health-care workers on the frontline to save their skin. Of course, only remove your mask when it’s safe to do so (like inside your car, at home or away from crowds) and after washing your hands. This gives the skin an intermittent ‘breather’ break and an opportunity to wipe off the sweat.

Ensure your mask fits well. Find masks with different types of ties and ear loops and wear a different type each day.

If you develop dry skin and chapped lips prevent this by applying petroleum jelly to your lips after washing your face. To prevent breakouts, take care to apply the petroleum jelly only to your lips and avoid lip licking.

If already you have an underlying skin condition, such as acne or rosacea, it’s especially important to follow your treatment plan. This can help keep the condition under control.