PPE Skincare For Mask Wearers

As COVID-19 vaccinations roll out across the world, we all need to keep doing what we can to avoid picking up the virus that causes coronavirus disease (COVID-19) or passing it on.

For most of us, this means wearing a face mask, at least while out in public. We’re also washing our hands way more often. Unfortunately, masks and good hand hygiene come with their own problems, including face spots and sore, dry skin.

Here’s a bit about the common skin problems that come with personal protective equipment (PPE), and what you can do to help keep your skin clear and comfortable during the pandemic.

Maskne

Dampness from your breath collects under masks and respirators, and sweat and oil gets trapped on your skin. So it’s not surprising that masks can cause breakouts. This so-called 'maskne' (mask + acne) can cause spots, bumps and rashes on your nose, chin or cheeks. You’re more likely to get it if you’re already struggling with skin conditions like acne, eczema, or rosacea.

Dermatitis

Another common mask-related problem is contact dermatitis. There are two types. Irritant dermatitis is caused by the physical contact of the mask. Allergic dermatitis happens if you’re allergic to the material or anything in it. Both can make your skin sore, red, tight, dry, and itchy. Contact dermatitis most often affects the bridge of the nose, where the mask is tight. It’s particularly common among frontline healthcare workers who have to wear masks for long periods of time, as well as goggles and visors.

How to protect your face

Here are some PPE skincare tips to keep your complexion clear while protecting yourself and others from COVID-19:

• Soft is best - Facial skin is sensitive. If you’re just wearing your mask for trips to the store, rather than for professional reasons, pick a fabric that’s soft and smooth. This can help to reduce chafing and similar skin issues.
• Try cotton - 100% cotton face coverings are soft and breathable. Try ones with cloth loops rather than elastic, or ones that tie behind your head, to reduce irritation. Some research does support that thicker, medical grade masks offer the greatest protection, and double masking may further reduce transmission. However, much of this research also emphasizes that the fit of the mask is probably more important than the material. It should fit snugly over the mouth and nose, without ‘gaps’ that allow particles to enter and exit around the mask edges if you cough or sneeze, or someone does near you.
• Wash regularly - treat your mask like you do your underwear, a fresh one each day. Wash reusable masks daily in your washing machine as you do your other laundry. Make sure it's entirely dry before you wear it again.
• Easy skincare - take your daily pre-mask skincare routine back to basics, with just a gentle fragrance-free cleanser and moisturizer. Save products with active ingredients for nighttime, because masks can intensify their effects. This includes leave-on salicylic acid, retinol lotion, and aftershave.
• Personalize your skincare - different skin types have different skin issues. Look for face care products made for oily skin, dry skin, or normal skin based on your skin type.
• Let lotions sink in - it’s important to keep your skin well-moisturized because some masks can suck moisture from your skin. Try to apply face lotions at least half an hour before you put your mask on to let it sink in.
• Bare-faced is best - dermatologists recommend going make-up-free to reduce residue build-up under your mask and reduce the irritants that your skin has to deal with. Remove any makeup or sunscreen before bed.
• Check you’re not allergic - some masks are treated with antibacterial agents, which can cause a reaction. Or your skin may react to your laundry detergent. Try something different and see if things improve.
• Medicated cream, if you need it - medicated creams can help with contact dermatitis. So talk to a doctor if your skin is red, dry and itchy, and simple moisturizers don’t seem to be working.
• Stay hydrated - hydrating throughout the day helps combat dryness in your skin and prevents some skin irritation.
• Gentle exfoliation - skip the rough exfoliating; it can lead to more irritated skin. Gently exfoliate any areas with blemishes or breakouts.
• Create skin barriers - protective masks often have pressure points, like over the nose or on the cheekbones. Mask wearers can create a barrier with a barrier cream (like zinc oxide) or occlusive ointment (like Aquaphor) or with soft silicone tape or bandages. Just make sure you don't ruin your mask's seal.

Hand dermatitis

Hand hygiene is really important, but it takes its toll on your skin too. Doctors recommend regular handwashing with soap, for 20 seconds. And if this isn’t possible, use alcohol hand gel with at least 60% alcohol content.

Frequent exposure to water, soap, and alcohol gel, as well as prolonged glove-wearing, can cause dry skin and contact dermatitis. The skin on your hands may start to itch, and become sore and red. You may develop small blisters, painful cracks (fissures) and broken skin.

How to protect your hands

Here’s what you can do to reduce the damage to your hands:

• Wash gently - hot water doesn't offer any extra protection against germs (it's the friction and soap together which kill germs), so switch to cool or lukewarm water. Hot water can dry out your skin more than cooler water.
• Follow-up wash - experts recommend washing with soap and water, but these are very drying, so you can always follow with an emollient wash if you need to.
• Dry well - dry your hands fully after washing by patting them dry, not rubbing.
• Slather on hand lotion - moisturizers (emollients) help to repair damaged outer skin and lock in moisture, keeping skin soft and supple. Apply lotions (emollients) generously each time you wash your hands, and whenever your skin feels dry.
• Try overnight treatments - you might find an overnight moisturizing treatment helpful. Apply a generous layer of moisturizer before you go to bed, then put on a pair of clean cotton gloves and leave overnight. Trapping the lotion in with the cotton gloves will help it absorb and moisturize even better.
• Wear gloves when you can - wear gloves when your hands are going to come into contact with water or soap (other than hand washing), such as washing the dishes, household cleaning, or shampooing a child’s hair.
• Take glove breaks - if you have to wear gloves for work, take them off when you have a break. This is a good opportunity to apply moisturizer if you have half an hour to let it soak in. You can also try a cotton liner under your latex or nitrile gloves.

Steroid cream, if you need it - steroid creams can help with contact dermatitis. So talk to a dermatologist if the skin on your hands is dry, itchy and cracked, and simple moisturizers don’t seem to be working for your skin damage.

Sources

• Skin care tips during the COVID-19 (coronavirus) pandemic - Mayo Clinic
• Skin care complications from PPE: The DOs and DON’Ts - Skin Care Physicians
• How to Care for Your Skin If You Wear PPE at Work, According to Dermatologists - Allure
• 9 ways to prevent face mask skin problems - American Academy of Dermatology Association
• How to Store and Wash Masks - CDC