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Issue: Volume 18(2), June 2007, p 104
Copyright: (C)2007American Contact Dermatitis Society, All Right
Publication Type: [2007 ANNUAL ACDS MEETING ABSTRACTS: Oral
ISSN: 1710-3568
Accession: 01206501-200706000-00013
[2007 ANNUAL ACDS MEETING ABSTRACTS: Oral Presentations]
Skin Reactions Following Use of N95 Facial Masks
Donovan, Jeff; Kudla, Irena; Holness, Linn D.; Skotnicki-Grant,
Nethercott, James R.
Author Information
Occupational Health Clinic, University of Toronto
Background: The Severe Acute Respiratory Syndrome (SARS) epidemic in
2002 required prolonged use of N95 face masks by many health care
Objective: We reviewed all clinic referrals regarding possible N95
mask allergy
during and following the SARS epidemic. Results: The vast majority of
the 13
referrals worked in intensive care settings. The average number of
employed was 16.8, and no patient had experienced prior mask reaction.
facial eruption was described as urticarial in 3 patients, and
dermatitic in 5
patients. In 2 patients, mask use led to acute respiratory complaints
skin manifestations. Prick testing to the mask in 3 patients and patch
in 6 patients was negative. Patch testing using the North American
Dermatitis Series was performed in 8 patients. Two patients shared in
positive patch test reactions to quaternium-15 and ethylene urea
formaldehyde, one of whom also tested positive to formaldehyde. The
N95 mask
from the latter patient was analyzed for free formaldehyde and found
to be
Conclusion: Although majority of N95 mask reactions represented
irritant contact
dermatitis, 3 mask reactions fit clinically with contact urticaria and
reactions represented allergic contact dermatitis. The liberation of
formaldehyde during the manufacturing of non-woven polypropylene N95
masks may
contribute to allergic contact dermatitis in formaldehyde sensitive
... occupations and HCWs, but the association with previous skin diseases was not evaluated in prior reports. [1][2][3][5][6][7][8] Furthermore, we did not find sufficient data about these problems in Iranian HCWs during the recent pandemic, while they had to use this equipment in those difficult and stressful conditions. Hence, we evaluated dermatologic complications of PPE in HCWs and relation with some previous dermatosis in this cross-sectional study during the first peak of the pandemic in Iran. ...
... The face, hands, and scalp were more frequently involved compared to other sites and nasal bridge was the main site of involvement on the face similar to prior reports. [5][6][7] We found that dorsal hand dermatitis was more frequent than palmar dermatitis, especially in atopic participants, and in our cases, only palmar hand dermatitis was associated with frequent hand washing. ...
... The dorsal surface of the hands has a thinner skin compared to the palmar surface, so it is more sensitive to irritant or allergic agents. [6][7][8] Hand dermatitis could develop due to different etiologies such as using gloves, especially latex type, frequent hand washing with soap, or using other detergents. Furthermore, wearing gloves for a long time hyperhydrates the horny layer and disturbs cutaneous barrier of the skin which by itself could potentially increase the risk of contact dermatitis. ...
Background: The safety of health-care workers (HCWs) during the COVID-19 pandemic is a major concern worldwide. Dermatological problems due to personal protective equipment are annoying issues. We aimed to evaluate dermatological adverse events following the use of these protections in HCWs managing COVID-19 patients. Materials and methods: One hundred and fifty-six workers managing COVID-19 patients were enrolled in this cross-sectional study. We conducted face-to-face interviews to collect the data and focused mainly on protection type and mucocutaneous symptoms with new onset or exaggeration after this equipment. Results: Dermatological problems following protective equipment usage occurred mainly during the 1st week (65.4%). The most common site of skin involvement was the nose (82.7%) and the most frequent visible complaints were the pressure effect and erythema on the nose in 80.8% and 57.7% of cases, respectively. There was a significant association between mask type and facial skin problems (P < 0.001). The main symptoms were itching (21.8% scalp, 39.1% face and body) and burning sensation (14.1% scalp, 23.7% face and body). Skin desquamation (37.2%) and dorsal hand dermatitis (41.66%) were significantly more frequent in atopic participants (P = 0.02 and P = 0.01, respectively). Hand involvement was significantly associated with frequency of hand washing (odds ratio = 1.97, 95% confidence interval = 1.04-3.74, P = 0.03). Conclusion: We found that skin problems related to protective equipment were common and frequently located on the face mainly due to facial masks. These complications should be prevented by proper use of this equipment.
... Skin lesions observed due to prolonged contact with PPE and excessive PH are listed in Table 1 [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. ...
... Friction, warmth, and moisture from respiration may enhance these symptoms. Skin barrier dysfunction and skin microbiota disorder make patients more vulnerable to mask side effects [16,27,28]. ...
... Pressure urticaria is rarely observed [10,27,29]. Antihistamines such as cetirizine and loratadine are preferred for treating pressure urticaria, and antileukotriene agents may be added if needed [10]. ...
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Background/aim: Sars-CoV-2 virus infection (COVID-19) was observed in China in the last months of 2019. In the period following, this infection spread all over the world. In March 2020 the World Health Organization announced the existence of a pandemic. The aim of this manuscript is to investigate skin diseases associated with COVID-19 under three main headings: skin problems related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections, and skin findings due to COVID-19 treatment agents. Materials and methods: In PubMed, Google Scholar databases, skin lesions related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections and skin findings due to COVID-19 treatment agents subjects are searched in detail. Results: Pressure injury, contact dermatitis, itching, pressure urticaria, exacerbation of preexisting skin diseases, and new skin lesion occurrence/new skin disease occurrence may be due to personal protective equipment. Skin problems related to personal hygiene measures could include itching, dryness, and contact dermatitis. Skin findings may also be observed in SARS-CoV-2 virus infections. The incidence of skin lesions due to COVID-19 was reported to be between 0.2% and 29%. Many skin lesions including maculopapular, urticarial, vesicular, chilblain-like, thrombotic/ischemic, etc. are observed in COVID-19 patients. Some authors have stated that there is an absence of SARS-CoV-2 virus infection-specific skin findings. However, in asymptomatic or presymptomatic COVID-19 patients in particular, skin lesions can lead to the diagnosis of COVID-19. In addition, skin lesions may occur due to COVID-19 treatment agents. Conclusion: Many skin lesions may appear as a result of COVID-19. Even in the absence of a COVID-19 diagnosis, skin findings should be evaluated carefully in this pandemic period.
... Many studies have reported where COVID-19 infection has caused various dermatological symptoms such as rashes, itching, urticaria and other dermatitis-related infections that affect the body, hands, and faces (Darlenski & Tsankov, 2020 (Gheisari et al., 2020). In another study, Donovan et al., 2007 reported that N95 masks caused reactions during the time of the SARS epidemic in Toronto (Donovan et al., 2007). Urticarial facial eruptions were reported in 3 patients, dermatitis in 5 patients, and acute respiratory symptoms without skin lesions in 2 patients were observed (Sharma & Malviya, 2020). ...
... Many studies have reported where COVID-19 infection has caused various dermatological symptoms such as rashes, itching, urticaria and other dermatitis-related infections that affect the body, hands, and faces (Darlenski & Tsankov, 2020 (Gheisari et al., 2020). In another study, Donovan et al., 2007 reported that N95 masks caused reactions during the time of the SARS epidemic in Toronto (Donovan et al., 2007). Urticarial facial eruptions were reported in 3 patients, dermatitis in 5 patients, and acute respiratory symptoms without skin lesions in 2 patients were observed (Sharma & Malviya, 2020). ...
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Nutraceuticals have emerged as potential compounds to attenuate the COVID‐19 complications. Precisely, these food additives strengthen the overall COVID treatment and enhance the immunity of a person. Such compounds have been used at a large scale, in almost every household due to their better affordability and easy access. Therefore, current research is focused on developing newer advanced formulations from potential drug candidates including nutraceuticals with desirable properties viz, affordability, ease of availability, ease of administration, stability under room temperature, and potentially longer shelf‐lives. As such, various nutraceutical‐based products such as compounds could be promising agents for effectively managing COVID‐19 symptoms and complications. Most importantly, regular consumption of such nutraceuticals has been shown to boost the immune system and prevent viral infections. Nutraceuticals such as vitamins, amino acids, flavonoids like curcumin, and probiotics have been studied for their role in the prevention of COVID‐19 symptoms such as fever, pain, malaise, and dry cough. In this review, we have critically reviewed the potential of various nutraceutical‐based therapeutics for the management of COVID‐19. We searched the information relevant to our topic from search engines such as PubMed and Scopus using COVID‐19, nutraceuticals, probiotics, and vitamins as a keyword. Any scientific literature published in a language other than English was excluded. Practical applications Nutraceuticals possess both nutritional values and medicinal properties. They can aid in the prevention and treatment of diseases, as well as promote physical health and the immune system, normalizing body functions, and improving longevity. Recently, nutraceuticals such as probiotics, vitamins, polyunsaturated fatty acids, trace minerals, and medicinal plants have attracted considerable attention and are widely regarded as potential alternatives to current therapeutic options for the effective management of various diseases, including COVID‐19.
... • avoiding comedogenic or occlusive makeup; mineralbased makeup may be preferable. In severe cases, prescription products may be needed, such as topical retinoids or topical/oral antibiotics (9,11,12). ...
... Skin conditions such as rosacea, seborrheic dermatitis and atopic eczema can be aggravated by the heat and sweating which occur when wearing a mask. Previous studies have revealed that hand eczema is quite common in health care workers and the risk factors include frequent hand hygiene and wearing gloves for a long time (12). The generalised hand-cleaning and prolonged wearing of PPE have exponentially increased the problem of adverse skin events, which was already common in health care workers, but became particularly relevant during the previous SARS outbreak. ...
Full-text available
Severe acute respiratory distress syndrome (SARS)-CoV-2, the cause of Coronavirus disease 2019 (COVID-19), has caused a global pandemic with worldwide morbidity, mortality and disruptions to society. Undoubtedly, the global spread of the COVID-19 pandemic had warranted universal precautions to slow the rate of infection. Hand hygiene, social distancing, regular disinfection of surfaces and avoidance of touching one’s face are some of the measures which have been used in an attempt to decrease exponential disease spread. The epidemiology of SARS-CoV-2 had indicated that most infections were spread by respiratory droplets, through exposure to an infected individual at close range. For this reason, healthcare professionals are mandated to wear personal protective equipment (PPE) for a prolonged period of time when caring for COVID-19 patients. On the other hand, the COVID-19 pandemic has led to an increased use of face protection such as surgical masks and eye protection not only amongst healthcare workers but also now the general public. Prolonged use of N95 and surgical masks by healthcare professionals during COVID-19 has caused adverse effects such as headaches, rash, acne, skin breakdown and impaired cognition. This review delves into various adverse effects of prolonged mask use and provides recommendations to ease the burden on healthcare professionals. The magnitude of this condition is clinically significant and might worsen if the current outbreak further continues to spread widely and stays for a longer time, affecting the work performance of healthcare workers. Perhaps better strategies are needed for designing various PPE and reducing the duration for which healthcare workers are required to use them.
... Other studies reported similar finding in addition to other dermatologic side effects like pressure injury, urticaria, dryness of the skin, allergic contact dermatitis, and aggravation of underlying dermatosis. In all of these conditions, occlusion and friction were the main contributing factors [31][32][33][34]. These results were more commonly found among healthcare workers, who wear protective gear for prolonged times [16]. ...
Full-text available
Background: In COVID-19 pandemic increasing the frequency of hand washing and disinfection is the most important preventive measure of this disease which is causing in deleterious impact on skin among general population. So the aim of the study was to evaluate whether these measures are associated with development of skin damage. Methods: This was a descriptive type of cross-sectional, observational study conducted over a period of six months from April 2021 to September 2021 including 1166 patients coming to some private clinics in Gazipur with skin manifestations. Skin diseases were diagnosed by dermatologist on basis of clinical morphology with appropriate investigations. Data were collected by structured questionnaire and analyzed using SPSS. Results: Out of 1166 patients, 35.68% reported skin changes or symptoms over hands (ScH), and 13.98% reported skin changes on their face (ScF). Around 87.39% and 86.53% of the participants reported a change in hand washing habits and sanitizer using habits during the COVID-19 pandemic. There were significantly higher percentage (57.21%) of skin conditions in females (ScH: 45.28% vs ScF:17.30%), 43.82% individuals were working in environments requiring frequent hand washing (ScH: 41.88% vs. ScF: 18.59%), 39.88% working in facilities where they have to interact with people during the pandemic (ScH: 42.58% vs. ScF: 19.57%), 5.75% those encountering COVID-19 patients (ScH: 49.25% vs. ScF: 25.64%), 15.78% those exposed to chemicals (ScH: 52.72% vs ScF: 25.82%), and 9.17% healthcare workers (ScH: 57.00% vs ScF: 31.77%). Almost 35.22% reported skin dryness, 9.44% reported changes in the texture, 13.42% reported scaling, 16.52% reported itchiness, 4.46% reported changes in skin color, 14.52% reported redness, and 4.62% reported pain/ burning, while 1.80% reported skin ulcers. Conclusion: Our study suggests that the general population’s skin was negatively affected by COVID-19 precautions where increased frequency of hand washing and the use of alcohol-based sanitizers, overuse of soaps were contributing factors for skin disorders.
... They improved after acne treatment with systemic antimicrobials and topical retinoid. [7] Proposed approach for reusing surgical masks in COVID-19 pandemic Furthermore, the existence of an asymptomatic carrier phase decreases the effectiveness of prevention strategies that rely on symptoms. There is a strong rationale for a universal mask policy. ...
... Among various PPE complications, pressure and contact urticaria need to be mentioned [34]. In the first case, the immediate or delayed appearance of wheals is possible on sites of pressure. ...
Full-text available
Maskne, a newly coined term deriving from the contraction of mask-related acne, is a form of mechanical acne resulting from continuous textile–skin adherence and friction. Prolonged mask use heats up the face environment, thus modifying skin microbiota and sebum production. Although effective prevalence is unknown, since the pandemic began and the prolonged use of masks was extended to the general population, maskne has been a frequent topic of consultation among dermatologists. This term has been successfully introduced into common language, with more than 200,000 hashtags on social media, where it is also possible to find “home remedies” that can worsen this dermatosis. The aim of this paper is to discuss the pathogenesis, address clinicians on the correct differential diagnoses among facial dermatoses, and move towards the correct therapy.
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Occupational skin-related problems include dermatoses caused by agents in the working environment. For health care workers, these occupational dermatoses could be due to usage of personal protective equipment (PPE), such as gloves, masks, goggles, and other protective equipment. These PPE contribute to both allergic and irritant contact dermatitis. This review summarized the skin damage after PPE usage and hand hygiene protocol. Recommendations should be established to prevent these occupational dermatoses from PPE usage.
Since the COVID-19 pandemic, the unprecedented use of facemasks has been requiring for filtering exhaled and inhaled air in daily life. By wearing facemask, human exhaled breath aerosols and inhaled environmental exposures can be efficiently filtered and thus can be resided in facemask. Therefore, facemask could be a simple, wearable, in vivo, onsite and noninvasive sampler for collecting exhaled and inhaled compositions, and gain new insights into human health and environmental exposure. In this review, the recent advances in developments and applications of in vivo facemask sampling of human exhaled bacteria, viruses, proteins, and metabolites, and inhalable chemical contaminants and air pollutants of facemask are reviewed. New features of facemask sampling are highlighted. The perspectives and challenges on further development and potential applications of facemask devices are also discussed.
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