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The first thing that Julia Paris, MD, an emergency medicine physician in New York City, noticed were the breakouts around her mouth area. Then the chafing and irritation started to sprout up on the bridge of her nose, right at the tightest spot where the protective face mask nestles in. This isn’t isolated to her: Nurses and doctors all across the globe—who are relying on life-saving personal protective equipment to work on the frontlines of the COVID-19 pandemic—are experiencing skin irritation from the masks.
“The problem with surgical and N95 face masks [which most health care workers are wearing] is that they’re all made of a non-woven textile, and they’re made from a plastic-type of polymer… which right away isn’t nice for the skin,” says Sandy Skotnicki, MD, a Toronto-based dermatologist and skin allergy expert. “In the hospitals, you have to wear the masks at all times to avoid spreading the virus, but these masks aren’t really [designed] for that.” According to her, pre-pandemic, doctors would typically wear a mask for a couple of hours tops for surgery—but now, workers are wearing them for their entire 10 to 12-hour shift.
“In the hospitals, you have to wear the masks at all times to avoid spreading the virus, but these masks aren’t really meant for that.” —Sandy Skotnicki, MD
When Dr. Skotnicki studied skin reactions of healthcare workers, during the SARS epidemic in 2007, she found that skin irritation is often the most common reaction of extended contact with a surgical-grade face mask (and, in more serious but rare cases, there have been allergic reactions and rashes from the polymer material). “When you have a mask on for hours at a time, they’re going to get moist,” she says. “And with moisture, the mask rubs. When something is moist, it rubs more, and the more friction you have, the more it leads to irritation.”
It’s a lot like acne mechanica, or breakouts that come solely from friction of something against your skin. “If you look at people who wear helmets or chin straps, they’ll experience friction and rubbing and sweat, which exacerbates acne,” says Dr. Skotnicki, who adds that skin conditions like rosacea and dryness can be exacerbated, too. Basically, the face masks leave your skin vulnerable, inflamed, and angry—which is why it’s essential to protect it. This is what experts recommend for doing the job.
1. Wear a barrier cream: Dr. Skotnicki says that the most important thing for keeping skin protected from masks is to slather on a moisturizing cream that forms a barrier on the outermost layer of your skin. Her favorite are those made with cica, an incredibly soothing and healing ingredient, as well as dimethicone, which “sits on the surface of the skin to help decrease rubbing and irritation.” She prefers the La Roche-Posey Cicaplast B5 Balm ($15), Avene Cicalfate Restorative Skin Cream ($28), and Bioderma Cicabio Cream ($12). “Try to wear a barrier cream underneath your mask, and reapply it as often as you can,” she says.
2. Go light with makeup (or skip it altogether): While moisturizing is key, makeup is not your best bet. “Any potentially irritating or pore-clogging ingredients should be avoided under mask-covered skin at all costs,” says Erin Jensen, PA-C, aesthetic medicine expert and founder of The Treatment Skin Boutique. “With extra moisture under the mask, it could affect your skin and increase clogged pores and breakouts.”
3. Repair, repair, repair: Once your time wearing a face mask is over for the day, it’s important to work on repairing the skin. “Always make sure to wash your face with a gentle cleanser after you take off your mask,” says Jensen, who then recommends slathering on something soothing and calming to help with repairing the skin. Her pick is to use a healing ointment like Aquaphor ($14) to help rebuild the skin’s barrier.
Frontline healthcare workers can’t wear a different type of face mask—one that’s friendlier to the skin—because of health precautions. But for the general public, Dr. Skotnicki says that a double-layered cotton fabric will cause much less irritation. Otherwise, the best that you can do to save your complexion from experiencing irritation is to pay special attention to the products you’re using to protect it. “It’s definitely a love-hate relationship that we have with the masks,” says Dr. Paris. “We’re so happy that we’re getting them because they’re protective, but all you want to do after wearing it for 10 minutes is rip it off of your face. But, it’s hard to complain. We’re making the best of it.”
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