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What are some of the potential complications and/or side effects of mask wearing (skin irritations, foggy glasses, etc.)?
When it comes to skin conditions associated with wearing a mask, they fall into 3 main categories.
The first has to do with breakouts associated with rosacea or acne. Much of this has to do with the heat and humidity that build up between the skin and the mask as well as potential bacteria and yeast that overgrow in these areas. Often times this can be managed by considering the fact that the skin can get considerably irritated from friction and moisture. Taking measures to protect the skin with a good moisturizer or even products that contain niacinamide can help reduce inflammation locally in the skin. It may help to reduce the use of true acne products at this time as some of them can irritate the skin significantly and contribute to further skin irritation. Most true acne products work by exfoliation. With moisture buildup between in the skin and the mask, this can often feel a little bit more sensitive.
Another trigger for a mask irritation can be yeast buildup on the skin from moisture that changes the pH of the skin around the nose and the mouth. Our skin’s pH tends to be low in an attempt to keep the growth of bacteria and yeast in check in the skin environment. This delicate balance has been affected by the use of masks. I almost think of this as similar to a diaper rash. We find that the moisture as well as the yeast and bacteria that escape the nose and the mouth can be contributing to this. Much the same way that a diaper rash can be controlled with various barrier creams, considering the use of non-comedogenic moisturizers especially ones with ceramides to restore the skin barrier can be very effective to prevent this type of irritation. It may even help to consider the use of topicals that contain azaleic acid, sulfur, or even dandruff shampoos (containing zinc pyrithione) as facial cleansers on the face.
The next condition to consider is folliculitis. Post shaving followed by mask wearing can actually trigger bacteria to enter these pores and cause inflamed or infected hair follicles. The bacteria can essentially enter these pores and cause trouble. It can help to consider washing your face with an antibacterial soap or again, using an aftershave or moisturizer to protect those pores from any buildup of bacteria after shaving.
Another condition happening around the eyes that we’ve seen in excess at this time has been blepharitis, chalazion or styes, and meibominan gland dysfunction. We talk about foggy glasses which is truly a problem and one that I still struggle with. However the bacteria that escape through the mouth and nose if they land in and around the skin of the eyelashes and upper eyelid, this can actually trigger inflammation and potential swelling of the eyelids. Gently cleansing the eyelid skin in the shower with no more tears baby shampoos can help reduce the likelihood of these conditions developing.
Are there any dangers to wearing masks, i.e. can unwashed or reused masks increase the rate or spread of COVID-19?
It is not likely that an unwashed or reused mask can increase the rate of spread of COVID-19 unless there is something that has compromised the actual ability the mask to block spread a respiratory droplets. For example if there is a tear in the mask over repetitive use, this could be a problem. I actually worry that repetitive washing could stretch or wear the fabric in such a way that it could compromise the masks ability to do its job. My research is focused on repetitive washing and its ability to impact the ability of clothing to block UV effectively. We find that initially the fabric tightens and perhaps makes it slightly more effective but over time the wear on the fabric with fibers breaking down actually decrease its ability to block the sun. I suspect a similar issue can develop as a result of repetitive washing of the mask and it’s ability to block Covid. However, simply wearing the exact same mask over and over again will probably build up sweat, oil and other unpleasant debris in the mask, but not likely to contribute to the spread of Covid.
And finally, do the benefits outweigh the risks?
All of the above conditions can be treated or managed effectively. The benefits of wearing a mask absolutely outweigh the risks.