Mask‐induced dermatoses during the COVID‐19 pandemic: a questionnaire‐based study in 12 Korean hospitals

Abstract

Background During coronavirus disease 2019 (COVID‐19) pandemic, various adverse skin reactions to long‐term mask wearing have been reported. Objective We aimed to assess the clinical features of mask‐induced dermatoses and recommend prevention and treatment options. Methods From April to August 2020, questionnaires including preexisting skin disorders, patients’ reported mask‐related symptoms, their daily mask wearing duration and frequency, types of masks used, whether they are health care workers, and demographic information were distributed to patients of 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis, and recorded treatment modalities. Results Itchiness was the most frequent symptom, mostly affecting the cheeks. Most common skin disease was new‐onset contact dermatitis (33.94%), followed by new‐onset acne (16.97%) and aggravation of preexisting acne (16.97%). Daily wearing ( p =0.018) was significantly associated with new‐onset contact dermatitis. More than half of the patients with preexisting skin problems experienced aggravation while wearing masks. Longer duration (more than 6 hours/day, p =0.043) and cotton masks ( p <0.001) significantly increased acne flare‐up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical agents. Limitations Effect of seasonal characteristics and other risk factors were not assessed. The patients were visiting dermatologic clinics and had interest in their skin status. Thus, a selection bias may exist. Conclusion Mask‐induced/triggered dermatoses contribute to increase the dermatological burden during pandemic.

The Association Between Facial Dermatosis and Face-Mask Wearing During COVID-19 in Saudi Arabia

“…First, pimples and pustules were the most common skin changes associated with face-mask use in the general population [ 14 ]. In comparison to our findings, redness and itchiness were the most popular skin changes after wearing a face mask among health care workers [ 13 , 15 ]. Second, the cheek, chin, and around lips were the most severely impacted areas unlike nasal bridge in health care workers, suggesting that prevention efforts should be directed at these regions [ 10 , 16 ].…”

“…People who use cloth masks also washed their masks after a duration of use, leading to facial dermatosis in the long run. Wearing a mask for 2-5 hours a day indoors proved to be one of the contributory factors of facial dermatosis [ 13 , 14 ].…”

“…Second, the cheek, chin, and around lips were the most severely impacted areas unlike nasal bridge in health care workers, suggesting that prevention efforts should be directed at these regions [ 10 , 16 ]. These variations may be due to the fact that healthcare workers wear masks for a longer duration than others [ 13 ].…”

“…Data collection and statistical analysis: Data was collected using an online self-administered Google survey. The questionnaire was created using surveys from previous similar studies that contained questions related to demographic data, baseline skin conditions, type of masks, and mask-related skin conditions [ 12 , 13 ]. The survey was translated to Arabic, and pictures of different face mask types were attached as an option to be selected in the study.…”

I Congresso Nacional Acadêmico De Dermatologia

“…Os estudos analisados revelaram uma relação significativa entre o uso de máscaras e dermatoses relacionadas à face, principalmente nas regiões malar e nasal. Isso se explica pela possível relação com a oclusão provocada pela máscara, que gera alterações de temperatura, umidade e pH da pele, propiciando a proliferação bacteriana (CHANGXU HH, et al, 2020, CHOI SY, et al, 2021DAMIANI G, et al, 2021). Além disso, os sinais mais comuns apresentados pelos pacientes foram acne, caracterizada por cravos e pápulas na região malar e nariz, coceira, erupções cutâneas e piora de rosácea após o uso de (CHANGXU HH, et al, 2020, CHOI SY, et al, 2021.…”