Written by Tim Newman on April 7, 2020 - Fact checked by Shikta Das, Ph.Dd for healthcare workers.

Preventing skin damage due to face masks

With many frontline healthcare workers wearing face masks for much of the day, some are experiencing uncomfortable skin damage. One of the authors of a recent article on the topic offers advice.

Face masks need to fit snuggly to the wearer’s face, and they must close tightly around the nose to ensure that they offer maximum protection.

However, in a fast paced, stressful, and sometimes hot environment, this can lead to discomfort and skin damage.

A recent study investigates this type of skin damage in detail. One of the authors of the paper, Prof. Karen Ousey from the University of Huddersfield in the United Kingdom, explains:

“The wearers are sweating underneath the masks, and this causes friction, leading to pressure damage on the nose and cheeks. There can be tears to the skin as a result, and these can lead to potential infection.”

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Usually, dressing a wound would help minimize further damage and prevent infection. However, in this situation, a dressing might prevent the mask from fitting correctly and, therefore, increase infection risk. The researchers published their article in the Journal of Wound Care in February.

The article covers a range of medical devices, including endotracheal and nasogastric tubes, oxygen tubing, urinary catheters, cervical collars, and casts. However, it is the increased use of face masks that has brought the study into the limelight.

The recent article is one of the first to offer advice on safely applying these medical devices. The authors advise both healthcare practitioners and the industry that creates and designs medical devices.

Device-related pressure ulcers

The paper focuses on pressure ulcers that develop due to medical devices, in particular. Pressure ulcers are injuries that result from pressure breaking down the skin and underlying tissue.

These ulcers can increase the risk of infections, such as sepsis, which might be life threatening. They also cause pain, leave scars, result in permanent hair loss, and increase the duration of hospital stays.

Prof. Ousey advises people who wear masks for long periods to keep their skin well-hydrated and moisturized. People should apply a barrier cream, she advises, at least 30 minutes before putting on the mask. It is also important to keep the skin under the mask clean.

“[W]e are suggesting that pressure from the mask is relieved every 2 hours. So you come away from the patient, relieve the pressure in a safe place, and clean the skin again.”

– Prof. Karen Ousey

Certain members of the public — for instance, people working in stores — might also wear these masks to reduce infection risk. Prof. Ousey suggests that if they feel their masks rubbing, they should “take them off as soon as they safely can.”

New COVID-19 guidance

The Centers for Disease Control and Prevention (CDC) have recently updated their guidelines for the use of face coverings. Symptoms of COVID-19 take up to 14 days to appear, and some people can have the infection without displaying symptoms.

For this reason, the CDC recommend that people who must leave the house wear a fabric face covering to protect others.

However, the CDC ask that people do not buy medical grade face masks, such as the N-95, because frontline healthcare workers need these, and they are already in short supply. Instead, they provide a guide to making your own.

As these masks fit less snuggly than clinical ones, the risk of pressure sores is lower. However, caring for the skin will further reduce the chances of pressure sores developing.

The CDC recommend that all people wear cloth face masks in public places where it is difficult to maintain a 6-foot distance from others. This will help slow the spread of the virus from asymptomatic people or people who do not know they have contracted the virus. Cloth face masks should be worn while continuing to practice social distancing. Instructions for making masks at home can be found here. Note: It is critical that surgical masks and N95 respirators are reserved for healthcare workers.

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