Types and prevalence of adverse skin reactions associated with prolonged N95 and simple mask usage during the COVID‐19 pandemic

Abstract

Background As the coronavirus 2019 (COVID‐19) pandemic persists on a global level, the chronic daily use of face masks within the healthcare system remains an important component of disease prevention and transmission. Increased use of personal protective equipment (PPE) may result in increased rates of occupational dermatoses and adverse skin reactions. Objectives The purpose of this study is to explore how chronic, prolonged use of N95 masks or simple surgical masks affects the prevalence of adverse skin reactions in Healthcare Workers (HCWs). Methods An optional, quantitative, web‐based survey was administered to patient‐facing HCWs across six network hospitals in a large metropolitan city. Data were analysed to assess the types and sites of adverse skin reactions, and to evaluate correlations between single mask use duration and adverse skin reactions. Results A total of 230 HCWs responded with 192 endorsing occupational dermatoses. Among the healthcare responders, ( n = 192, 83.5%) experienced at least one adverse skin reaction. The most common occupational adverse skin reactions were acne ( n = 133, 57.8%), dryness ( n = 108, 47.0%) and redness ( n = 105, 45.7%). Anatomical areas most commonly affected included the nasal bridge ( n = 92, 40.0%), cheeks ( n = 92, 40.0%) and chin ( n = 91, 39.6%). Acne ( P = 0.002), dryness/scaling ( P = 0.002), increased pore size (0.003), itch ( P = 0.003), nasal bridge scarring ( P < 0.001), redness ( P < 0.001), frictional erosions ( P = 0.001) and ulcerations ( P = 0.002) showed a positive correlation to duration of mask use. Conclusions Prolonged, daily usage of PPE is associated with numerous adverse skin reactions among HCWs with acne being the most commonly seen adverse reaction. Many adverse reactions are associated with prolonged use of single mask.

The Correlation Between Wearing Face Masks and Skin Damage in Adults During the COVID-19 Pandemic: A Cross-Sectional Study in Jeddah, Saudi Arabia

“…Among those who wore surgical face masks, acne was the most self-reported skin disorder, followed by rash and itching, erythema, and skin pigmentation. While these findings are consistent with similar studies in the literature [4,[15][16], other studies reported itching only when wearing the N95 as a common form of skin irritation around the area of the mask [17,18].…”

“…This present study included both healthcare workers as well as non-healthcare workers to understand the extent of the effect of face masks on a wider segment of the population [14]. Most previous studies with similar aims have been conducted exclusively among healthcare workers [12,13,[15][16][17][18][19].…”

The impact of masks on the condition of facial skin in the time of the COVID-19 pandemic

“…The study of Darnall et al reported an increase in the incidence of new skin lesions among healthcare workers [11]. Compared to the data from our study, the results are consistent and the frequency of these changes is at a similar level.…”

Efficacy of a moisturizing cream and facial mask for alleviating skin problems associated with medical mask use: A half‐face, randomized controlled study

“…Concurrently, prolonged mask usage prompts a trend toward reddening of the skin. 13,14 This is primarily due to the elevation in skin temperature, which stimulates the thermoregulatory mechanisms, causing skin blood vessels to dilate, and blood flow to increase. 15,16 Although these effects generally revert to normal post-mask removal, persistent erythema may ensue in cases of extended mask wear due to inflammatory responses.…”

“…This effect disrupts the skin's barrier function, potentially culminating in skin dryness, and desquamation. Concurrently, prolonged mask usage prompts a trend toward reddening of the skin 13,14 . This is primarily due to the elevation in skin temperature, which stimulates the thermoregulatory mechanisms, causing skin blood vessels to dilate, and blood flow to increase 15,16 .…”