Covid, Mask Reactions, and Skin Care

May 3, 2020

Featured Physician: Leyda Bowes, MD

Featured Section: MyDoqter Covid-19

Dr. Bowes is a board certified dermatologist with over 20 years of clinical experience in medical and cosmetic skin treatments. She has published widely in the medical literature and shares her insights on mask use and skin protection given the risk of skin injury and irritation from mask utilization seen in healthcare workers. CDC guidelines on masks can be viewed here. 

Covid Masks and Skincare

Are face masks good or bad and do masks prevent the spread of covid-19?

The Centers for Disease Control (CDC) has issued specific guidelines for the use of face masks in the present Covid-19 pandemic. Masks can help a person who is infected with Covid to prevent the spread of the virus to other people. But the opposite is not true. Masks do not prevent a person from catching covid from another person who has the virus. Often times covid does not present with noticeable symptoms from the beginning, and so the CDC has ordered every person to wear a face mask when outside their house, even if they do not have symptoms.

As a result, we have seen millions of Americans wearing surgical masks and homemade masks all over the country. But doctors and healthcare workers need to use special protective masks that have been shown to cause significant skin reactions.

Mask Reactions: Skin Redness And Irritation

Our doctors, nurses, and all first responders have been seriously affected by the use of face masks. Rigorous schedules and high risk of exposure have forced them to wear the special protection masks called KN95 and N95 masks for long hours, even days at a time. These disposable N95 masks are made of a material that can cause allergic reactions on the skin. Also, the constant wearing and the friction that they cause on the skin, is made worse by trapped sweat and saliva, as well as by mask breathing itself.

Signs of Mask Reactions

As a result of prolonged mask use, myriad skin rashes have been seen, including:

  • redness of the face,
  • inflammation,
  • desquamation or peeling (almost as in a burn),
  • crusting, and
  • pigment changes (dark skin patches).
photo credit: The Daily Examiner

Treating Covid Mask Skin Reactions

It is very important to address the redness and inflammation that can develop from the use of KN95, N95 masks and other medical masks as soon as possible. Dermatologists and primary care doctors dealing with these rashes recommend the following:

  • A low potency hydrocortisone cream should be used, in order to bring down the redness, inflammation and swelling of the face.
  • An antibiotic skin ointment should also be applied if there are any open skin areas or abrasions.
  • Avoidance of direct sun exposure once these skin rashes from face masks have happened; otherwise, there will be pigment changes and dark patches developing later on. These can be treated with creams prescribed by your dermatologist if they occur.

How Do We Protect And Prevent Mask Reactions?

The right skin care is very important for everyone in the times of covid-19, but it is particularly important when mask use among the general population will be commonplace. It is even more important for all health care workers who will be exposed to prolonged mask use during the day.

The skin of the face should be kept in perfect balance and health, so that it can withstand the irritation that can result from wearing KN95 and N95 masks. Many in the general population will be using home made cloth masks that may cause less irritation, especially with proper fabric selection.

Top Tips for Preventing Mask Reactions

The following skin care tips can help prevent skin rashes from face masks in the Covid era for the general population and health care workers:

  • Apply face creams that contain ceramides and/or hyaluronic, once or twice daily, in order to maintain the skin hydrated and plump. This allows the skin to preserve water and, most importantly, the ceramides help restore and strengthen the natural skin barrier.
  • Use a gentle cleanser to clean the face. Never use a soap or other wash that may be harsh or contain glycolic or an exfoliating agent.
  • Avoid Retinoid creams or creams with glycolic acid, or other exfoliating or peeling agents.
  • Do not use a toner or astringent.
  • Do not use a skin scrubber or face roller. This will make your skin very sensitive and more prone to irritation for medical face masks.


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