Changes in skin characteristics after using respiratory protective equipment (medical masks and respirators) in the COVID‐19 pandemic among healthcare workers

Abstract

BackgroundThe coronavirus disease‐2019 (COVID‐19) outbreak has presented unique dermatologic challenges due to respiratory protective equipment (RPE)–related skin conditions.ObjectiveTo objectively evaluate the effects of RPE including medical masks and respirators on the skin barrier by measuring various physiological properties of the skin.MethodsA cross‐sectional study was designed. Twenty healthy healthcare workers were included in this study. Skin parameters including skin hydration, transepidermal water loss (TEWL), erythema, sebum secretion, pH, and skin temperature were measured in the RPE‐covered and RPE‐uncovered areas of the face 4 and 8 hours after wearing RPE and 14 hours after not wearing RPE.ResultsSkin hydration, TEWL, erythema, pH, and skin temperature increased in the RPE‐covered areas after wearing RPE for 4 and 8 hours. By contrast, in the RPE‐uncovered areas, skin hydration decreased and TEWL, erythema, and pH showed minimal changes over time. Based on the repeated‐measure analysis, the changes in skin physiological properties over time were significantly different between RPE‐covered and RPE‐uncovered areas.ConclusionWe observed that skin physiological characteristics change with the prolonged use of RPE such as medical masks and respirators. These changes may lead to various adverse skin reactions after long‐term use.

P2/N95 respirators & surgical masks to prevent SARS-CoV-2 infection: Effectiveness & adverse effects

“…Most studies were observational, with only one being an RCT, and included adults with a mean age between 29 and 46 years. Most had a majority female representation (ranging from 39% in Niikura, Fujishiro ( 24 ) to 90% in Han, Shin ( 25 )). Most studies compared HCWs wearing surgical masks or N95 respirators (n=16), and the remaining studies compared HCWs wearing surgical masks compared to KF94 or KF95 (n=1), FFP2 (n=3) or various respirator types (n=1).…”

“…Studies were conducted in several different countries (although the USA was the most represented [n=8]) and ranged widely in participant number (e.g. 20 participants in Han, Shin ( 25 ) compared to 20,614 in Sims, Maine ( 26 )) ( Table 1 ).…”

“…Eight studies contributed data to the meta-analyses of AEs ( 25 , 30 , 32 , 34 , 36 , 39 , 41 , 42 ), with findings from Zuo, Hua ( 43 ) unable to be statistically combined. Healthcare workers wearing respirators reported more AEs than those wearing surgical masks, specifically: De novo headaches (respirator = 99/159 [62.3%], surgical mask = 156/314 [49.7%]); Respiratory distress or shortness of breath (respirator = 83/148 [56.1%], surgical mask = 52/217 [24.0%]); Facial itching or irritation (respirator = 66/256 [25.8%], surgical mask = 51/256 [19.9%]); Sweating (respirator = 1263/1485 [85.1%], surgical mask = 93/494 [18.8%]); Pressure-related injuries (respirator = 878/1523 [57.6%], surgical mask = 94/532 [17.7%]); and Attention deficit or disorders (respirator = 33/76 [43.4%], surgical mask = 40/145 [27.6%]).…”

Riehl's melanosis caused by occupational exposure to personal protective equipment

“…A warm and humid environment created from the continuous expiration into a confined space increases transepidermal water loss and skin pH, consequently altering the skin's susceptibility to allergens. 4 Furthermore, several allergens have been reported in each of the mask components (Table 1). 2,5 In our case, polyurethane/polyester sponge was the culprit.…”

Prävention und Therapie von Dermatosen, ausgelöst durch persönlichen Mund‐ und Nasenschutz (Medizinischer Mund‐Nasen‐Schutz, filtrierende Halbmasken (FFP1/FFP2/FFP3)

“…Okklusion Physikalische/chemische Irritation infolge gestörter Barrierefunktion [1, 3] durch Anstieg von ○ Temperatur (auch durch Ausatemluft) ○ Durchfeuchtung der Haut (auch durch Ausatemluft) ○ TEWL ○ Erythem ○Transientes Erythem (neurologisch mediiert durch Wärme/Druck) ○Persistierendes Erythem durch Inflammation ○ pH (folgend Dysbiose, Aktivierung von Serinproteasen und Ceramidase) ○ Sebumsekretion (auch außerhalb der von Masken bedeckten Zonen) Triggerung anlagebedingter subklinischer Gesichtsdermatosen …”