The risk for dermatoses increases with the length of time the mask is worn, according to a recently published systematic review and meta-analysis.
Around half the people who wear face masks may develop acne, facial dermatitis, itch, or pressure injuries.
Skin conditions that cause inflammation of the skin, such as eczema, are known as dermatitis.
“This report finds the most statistically significant risk factor for developing a facial dermatosis under a face mask is how long one wears the mask. Specifically, wearing a mask for more than 4 to 6 hours correlated most strongly with the development of a facial skin problem,” Jami L. Miller, MD, associate professor of dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, told Medscape Medical News. Miller was not involved in the study. “The type of mask and the environment were of less significance,” she added.
Mask wearing for infection control has been common during the COVID-19 pandemic and will likely continue for some time, study coauthors Lim Yi Shen Justin, MBBS, and Yik Weng Yu, MBBS, MPH, PhD, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, wrote in an email to Medscape Medical News. And cross-sectional studies have suggested a link between mask wearing and various facial dermatoses.
To evaluate this link as well as potential risk factors for facial dermatoses, the researchers reviewed 37 studies published between 2004 and 2022 involving 29,557 adult participants self-reporting regular use of any face mask type, across 17 countries in Europe and Asia. (The mask types commonly studied in the papers they analyzed included surgical masks and respirators.)
Facial dermatoses were self-reported in 30 studies (81.1%), and were diagnosed by trained dermatologists in seven studies (18.9%).
Justin and Yu found that:
- Overall prevalence of facial dermatoses was 55%
- Individually, facial dermatitis, itch, acne, and pressure injuries were consistently reported as facial dermatoses, with pooled prevalence rates of 24%, 30%, 31%, and 31%, respectively
- The duration of mask wearing was the most significant risk factor for facial dermatoses (P < .001)
- Respirators, including N95 masks, were not more likely than surgical masks to be linked with facial dermatoses
“Understanding risk factors of mask wearing, including situation, duration, and type of mask, may allow for targeted interventions to mitigate problems,” Yu said.
Yu advised taking a break from mask wearing after 4 to 6 hours to improve outcomes.
“Patient factors were not investigated in most studies, therefore, we were not able to ascertain their contributory role in the development of facial dermatoses from mask wearing,” he said. “We were also unable to prove causation between risk factors and outcome.”
The findings were welcomed by four Dermatologists.