Don’t worry about the “dangerous skin” caused by masks, there is a magic formula for “rejuvenating skin”

This is the 4116th article of Da Yi Xiao Hu

Three years have passed, and the mask remains unchanged, but its color is ever-changing. Burning, flushing, and itching, when will we say goodbye to "mask color"? ! Since December 2019, the new coronavirus pneumonia epidemic has recurred. Wearing a mask can effectively prevent respiratory infectious diseases such as the new coronavirus, but because of long-term wearing of masks, not only medical staff fighting the epidemic on the front line, but also ordinary people have more or less skin discomfort, and even cause various skin problems. So how can we wear masks scientifically to protect our respiratory tract without bringing extra burden to the skin?

What is "mask dermatitis"?

Masks cover most of the face. When worn for a long time, the moisture exhaled from the nasal cavity and the droplets flying out when talking will keep the skin surface in a hot and humid environment for a long time. The stratum corneum of the skin will absorb too much moisture, which will damage the skin barrier function, cause allergies or induce skin diseases such as blackheads, closed comedones or acne, rosacea, etc., commonly known as "mask rash" [1]. There are also people who choose masks improperly, such as wearing high-level N95 masks, chemical fiber masks, or wearing them with the nose clip too tight, which causes skin allergies or skin damage. These skin inflammatory diseases caused by wearing masks are collectively called "mask dermatitis."

How to classify skin inflammation under masks?

The causes of skin inflammation under masks are complex and are often related to contact allergens, immunity, environmental factors, skin barrier abnormalities, etc. They can be roughly divided into physical, allergic, infectious skin diseases, and other types of skin diseases [2].

1. Physical skin diseases mainly refer to the physical damage to the skin such as erythema, indentation, blisters, erosion and damage caused by the continuous pressure and friction of the mask on the skin. In addition, the mouth and nose are in a hot and humid environment for a long time, which may cause local skin softening, wrinkling, peeling and other skin maceration manifestations.

2. Allergic dermatitis is caused by allergies to one or more materials in the mask, such as the metal nose clip, which causes erythema, swelling, and even erosion and blisters at the contact site.

3. Infectious skin diseases are mainly caused by the moisture exhaled from the nasal cavity and the droplets when speaking, which form a humid and hot environment locally, leading to the over-breeding of local Propionibacterium acnes, Malassezia, mites, etc., thus aggravating local skin folliculitis and other related skin diseases. What some people call "mask acne" is actually the aggravation of acne caused by excessive oil secretion and over-breeding of local mites and bacteria due to the hot and humid environment under the mask.

4. Other types of skin diseases are mainly caused by the irritation and aggravation of existing facial diseases under the mask, resulting in local burning, flushing, itching, and even swelling. They are generally manifested as rosacea, sensitive facial skin, seborrheic dermatitis, etc.

How to avoid "mask dermatitis"?

Traditional Chinese medicine believes that this is because the patient is intolerant and the skin is not tight. When exposed to certain substances, the toxic evil invades the skin, accumulates and turns into heat, and the toxic heat fights with the qi and blood to cause illness. However, physical factors are the main factors for the onset of disease. The same substance will cause illness in people with intolerant constitutions, but not in people with strong constitutions. In a nutshell: clear internal heat and strengthen the constitution.

1. Wearing a mask correctly is the prerequisite for maintaining skin health

1) Wearing a mask should be comfortable . Choosing a mask of qualified quality, suitable model and appropriate protection level is a prerequisite. If it is not necessary, there is no need to wear an N95 mask with better sealing performance. Other ordinary medical masks are sufficient for protection and can also reduce local indentation on the face.

2) There are some tips for wearing a mask properly . After wearing a mask, make sure that the air does not enter or exit from the top edge of the mask when you breathe. Do not clamp your nose tightly to avoid abrasion of the skin from long-term wearing of the mask. You can also choose a mask with a sponge pad on the inside of the nose clip or buy a hydrocolloid dressing to stick on the bridge of the nose, behind the ears, etc. to protect the skin.

3) Keep it dry and change it frequently . Try to keep the inside of the mask dry. It is recommended to replace it after wearing it for 4 hours. If water vapor condenses inside the mask, it should be replaced in time.

2. Moisturize and cleanse thoroughly to maintain a strong skin barrier

1) Apply a moisturizer that contains skin barrier repair ingredients, such as hyaluronic acid, ceramide, etc. before wearing a mask.

2) While wearing a mask, it is recommended to choose mild cleansing products to avoid further aggravating skin dryness.

3) After removing the mask, immediately wash your face with a mild cleanser and apply an efficient moisturizing lotion.

3. Eat a healthy diet and improve your physical fitness.

Eat more nutritious foods such as meat, eggs and milk on weekdays. Avoid spicy, meaty and other stimulating foods during the onset of the disease, and strengthen exercise. Chinese medicine says that "when the positive energy is inside, the evil cannot enter." This is the reason.

What should I do if I get "mask dermatitis"?

1. For people with sensitive skin, the non-woven fabric material, adhesives, metal clips, rubber bands and other accessories of the mask may become allergens and induce skin inflammatory reactions.

1) First, understand the material of the mask before wearing it and avoid allergic ingredients. If an allergic reaction occurs, stop using the suspicious mask and replace it with a mask of other materials in time. You can put 2 layers of gauze in the mask to separate the skin from the mask to avoid repeated stimulation. After allergic symptoms appear, avoid contact with irritating substances such as hot water washing and alcohol wiping. Cold water can be used locally.

2) When the skin lesions are mild, strengthen local moisturizing care and avoid further irritation. Mild cases can improve on their own after 3 to 5 days without special treatment.

3) If the skin lesions are severe and itching is obvious, appropriate medication should be used under the guidance of a dermatologist. Short-term topical glucocorticoids, such as mometasone furoate cream, can be used in combination with topical moisturizing creams. Oral antiallergic drugs, such as cetirizine and Claritin, can be used when necessary.

4) If exudation occurs, wet compress treatment can be used. You can first use 3% boric acid solution for cold wet compress for 20 minutes to reduce exudation, and then apply protective ointments such as zinc oxide to wait for the skin to recover.

2. For patients with existing skin diseases. Wearing a mask for a long time will keep the skin in a hot and humid environment for a long time, which will aggravate the blockage of the hair follicle sebaceous gland duct. Some people with acne skin will feel that their acne has worsened. In addition, the hot and humid environment created by the mask and the friction and pressure on the local skin will make patients with rosacea more prone to skin redness, itching and other discomforts.

1) Do not wear a mask or shorten the time you wear a mask in a safe environment.

2) Before wearing, apply a moisturizer containing hyaluronic acid, ceramide and other skin barrier repair ingredients.

3) You can put two layers of gauze inside the mask to separate the skin from the mask.

4) After removing the mask, clean your skin with clean water and apply moisturizer immediately.

5) If the condition continues to worsen, you can use external treatments such as body acupuncture, ear acupuncture, cupping, and external application of Chinese medicine facial masks under the guidance of a dermatologist.

Don't worry about the "dangerous skin" of masks. In the current epidemic situation, masks must still be worn, but face must not be lost. I hope the epidemic will pass soon, and we can take off the masks and smile as before.

References:

[1] Jia Yuanlong. “Prevention and treatment of mask rash” [J], Family Medicine (Part 1). 2020.06:30

[2] This journal’s reference room. “How to take care of your skin when wearing a mask frequently” [J], Xinjiang Workers’ Movement 2022.1:54

Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine

Author: Xu Qinying, Li Fulun