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Skin irritations caused by face masks - what can be done?


Respiratory protective masks - either of synthetic origin or home-made of cotton - are not very comfortable to wear and can cause discomfort on mouth and nose depending on the daily wearing time. 

Also dry and tense skin conditions after removing the masks have been reported. In individual cases this can even lead to insidious contact eczema.

What happens under the mask and after removing it?

Depending on the specific type of protective mask, they are designed to impede the spreading of saliva aerosols and droplet infections and also filter the inhaled air (FFP2- and FFP3 masks).

Similar to the impact of tightly fitting clothes in the genital area, the skin will be degreased and the skin barrier becomes disordered due to the continued rubbing of the mask on the skin surface. That is why the transepidermal water loss (TEWL) after removing the mask is higher than before. That implies that the skin feels dryer and can become tense.

Due to the degreasing effect and the almost 100% air humidity building up under the mask, conditions are ideal for microorganisms to grow - similar to the conditions either in the genital area when wearing non-breathing textiles, or with feet in tight-fitted shoes or also hands covered by disposable gloves made of impermeable plastics. In the case of high sensitivity and intensified by the rubbing effect this can lead to inflammatory skin irritations.

Wearing protective masks often makes people feel that they have to clean their skin particularly well which already has been widely recommended for the hands to protect from infections. A fact, that leads to an increased removal of natural barrier components of the skin. The skin can react with swelling if on top of that inappropriate cosmetic preparations with occlusive effects are applied.

What can be done?

Three essentials should be considered:

  • effective skin protection
  • adapted facial cleansing
  • effective regeneration of the skin in times without mask

Preparations with physiological composition are compatible with the skin and provide protection and regeneration, in other words, the focus is on preparations that can both impede and help regenerate a disordered skin barrier. In particular lamellar base creams without the potential allergenic preservatives listed in the German Cosmetic Directive (Kosmetikverordnung - KVO) are suitable for this purpose but should be sparsely applied.

Such base creams also are free of emulsifiers and the involved washout effects and advantageous in so far as they are modular preparations that can be individually adapted to obtain the optimal results for the skin.

Depending on the individual needs, a variety of different components can be added as for instance astringent components such as witch hazel- (hamamelis) or green tea extract, anti-inflammatory boswellic acids, essential fatty acids (evening primrose-, kiwi seed-, linseed oil), aloe vera, CM-glucan, D-panthenol or azelaic acid-containing liposomes that are effective against anaerobes.

In contrast to the recommendations for hand cleansings, the face should preferably be washed with plain warm water without any cosmetic additives. An alternative are sparsely used cleansing preparations with skin barrier protective tensides. Another option is applying lamellar, tenside-free cleansing milk which can also be used to remove the make-up.

Dr Hans Lautenschläger

Please note: The contribution is based on the state of the art at the revision date.

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Revision: 27.05.2021