I’ve been sharing a lot of COVID related information on my Instagram lately, and my recent post on PPE skin protection was helpful for a lot of folk in medicine. I wanted to repost it here so you can share it with colleagues who are on the frontlines.
First of all, THANK YOU to all of the healthcare workers on the frontlines. This includes doctors, nurses, RTs, medical assistants, scribes, janitorial staff, front desk clerks, bed control, EVERYONE helping to keep the hospitals open and functioning in this time of absolute chaos. The world cannot thank you enough. My heart goes out to everyone, but especially those in NYC, where I trained. Please stay safe, to the best of your ability.
Now, onto the main topic of this post: how to protect your skin from Personal Protective Equipment (PPE).
I’ve seen a couple videos on social media, showing healthcare workers in China gearing up to care for covid patients. While I am struck by the PPE they have available, I also notice that all the staff have PPE skin protection on. I’ve been seeing a lot of photographs from the US featuring healthcare workers with bruising, irritation, cuts, and sores on their faces from masks. The very least I can do at this time is to help provide some tips on PPE skin protection.
According to a study out of Singapore during the SARS epidemic, mask wearers were most likely to develop acne followed by itch, rash, pigmentation, and scar at the nasal bridge.
Let’s tackle the top ones: acne and itch/rash.
Acne or “Mascne”
I’ve written about acne treatments before, but the type of acne you get under masks is a special type of acne. Acne mechanica, or “mascne” in this case, occurs in skin areas that are under occlusion. Commonly we see this in athletes who wear helmets and shoulder pads. Occlusion of the hair follicles and a warm sweaty environment predisposes to acne flares. .
To treat mascne: wash or wipe the sweat off your face as soon as you can or after your shift ends. Exfoliants are your friend. Use a benzoyl peroxide or salicylic acid wash in the areas affected by acne, and apply a topical retinoid like Differin or prescription Tretinoin to help exfoliate. Then apply a non comedogenic moisturizer to protect the skin such as Cetaphil or CeraVe.
Itch/Rash
For itch/rash from the masks: irritant contact dermatitis from long periods of mask wearing is likely causing these symptoms.
To counter this, you need some sort of barrier to protect the skin. You can use Duoderm or a gentle skin tape over the nasal bridge and cheeks where the mask rests. You can also use a barrier cream like zinc oxide. Wash your face with a gentle cleanser and then apply a thick emollient to encourage healing such as Aquaphor healing ointment or Vaseline. Avoid exfoliants or retinoids here because your skin is already sensitive.
If the rash persists, you can use over the counter hydrocortisone or prescription strength steroid cream to decrease inflammation.
If you develop any open cuts or sores from the mask, you can apply Vaseline or Aquaphor twice a day. I don’t recommend neosporin (can cause allergies).
Please help share with anyone who is wearing masks all day and can benefit from this info! I will try to cover hand dermatitis in another post.
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