How to Care for Your Skin If You Wear PPE at Work, According to Dermatologists
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April 29, 2020
At the end of what we can only imagine is a very long day, when medical professionals finally remove their masks, many of them are seeing breakouts, rashes, and skin irritation. Here's how to treat (and prevent) said side effects, according to dermatologists.
All around the country, Americans are learning what it feels like to wear a protective mask. The Center for Disease Control and Prevention (CDC)'s latest guidance advises Americans to wear cloth face coverings in public areas where social distancing is difficult, to reduce the risk of transmitting the novel coronavirus.
Nonessential workers are buying fabric masks and learning to sew, perhaps for the first time, but front line medical workers, including those highlighted in our "51 Faces of America" feature, have spent weeks or months wearing personal protective equipment (PPE) for hours every day. The constant use of gloves and masks is a preventive measure that's keeping medical workers safe. But at the end of what we can only imagine is a very long day, when doctors and nurses finally remove their masks, many of them are seeing breakouts, rashes, and skin irritation.
A study published in the Journal of the American Academy of Dermatology reports a striking 97 percent rate of skin damage enhanced by infection-prevention measures among front line medical workers in Hubei, China. Just over 70 percent of those workers cited dry skin; 56.8 percent faced tenderness; and 52.5 percent felt itchy skin. Over 60 percent noted desquamation (peeling skin); 49.4 percent experienced erythema (redness due to burst blood vessels); and 32.9 percent had papules (pimples). The nasal bridge, where a mask rests, was the most common area of irritation.
"N95 masks have a particularly high risk for injury due to requirements for a tight fit," says Bruce A. Brod, a board-certified dermatologist and fellow of the American Academy of Dermatology. "Injury can occur as a result of friction and the accumulation of moisture under the mask."
More importantly, N95 masks are "critical supplies that must continue to be reserved for health care workers and other medical first responders."
According to board-certified dermatologist Carrie Kovarik, problems associated with masks (including non-N95 masks) such as acne, which is "caused from the occlusion of the mask on the skin, whereby the hair follicles are blocked"; contact dermatitis caused by materials in the masks; irritant dermatitis on pressure points like the nose and ears; and moisture-related dermatitis around the mouth from breath or saliva.
Front line workers will most likely have to wear their PPE for weeks to come, but we spoke to dermatologists about how medical workers can best keep skin happy (or at least pain-free) during the crisis.
Before the mask goes on, you should...
"The most important thing you can do to prevent irritation and breakouts is to keep your skin clean and well moisturized," says Brod. "Wash your face gently but thoroughly using a pH-balanced cleanser before and after wearing a mask to remove oil, dirt, and bacteria, and apply moisturizer immediately after washing. Make sure both your cleanser and moisturizer are fragrance-free, noncomedogenic, and not known to irritate your skin."
Need help finding gentle skin-care options? Our guides to cleansers and moisturizers for sensitive skin can help.
Protect the moisture barrier.
The skin's moisture barrier is just what it sounds like: It helps the skin retain moisture.
Board-certified dermatologist Dhaval Bhanusali recommends using a product that can help protect the barrier, such as Desitin, which is better known as a diaper rash cream. "It has zinc, which is great for barrier protection," he says.
Cover any open wounds.
Health care workers should cover open wounds, breaks, cracks, or tears in the skin, says Brod, even if the area is completely covered by the mask: "Some facial skin conditions can lead to openings in the skin, and because of the need to protect any open areas, a skin covering for that respective area — as long as it does not impede the use and placement of the mask — would be highly encouraged."
Go makeup-free.
Brod suggests front line workers "consider skipping your makeup, such as foundations and concealers, as well as other skin-care items that could cause irritation." If makeup isn't noncomedogenic, it could clog pores and lead to breakouts or uncomfortable buildup. The same goes for skin care.
Unfortunately, now isn't the moment to experiment with that rich face cream or stronger-than-usual acid. As Brod points out, "the mask covers your face" anyway. If you're itching for the creative release of a beauty moment, play up the parts of your face that aren't covered by the mask — a fun eye look could be a way to help find joy in a long, stressful day. And the second you're off the clock, feel free to break out the makeup bag once again.
After the mask comes off, you should...
Apply serious moisture.
For fast-acting remedies that can provide immediate relief from irritation or breakouts once the mask is off, Bhanusali recommends "thick moisturizers." He suggests Aquaphor or Vaseline, both long-standing skin standbys, to layer on top of your face cream.
Look out for anti-inflammatory ingredients.
For workers dealing with acne or perioral dermatitis, which manifests as irritation or breakouts around the mouth, he recommends anti-inflammatory ingredients like niacinamide, turmeric, or azelaic acid. (We suggest The Inkey List Niacinamide Oil Control Serum and The Ordinary Azelaic Acid Suspension 10%.)
These temporary fixes are placeholders; crisis tactics that, we hope, won't be needed for much longer. If you are a front line worker (or even if you aren't), read up on how beauty brands are helping to provide relief — there may even be some free products in it for you.
