18 April,2021 08:22 AM IST | Mumbai | Anju Maskeri
Dr Diksha Batra says they have to wear respirator mask while treating patients. N95 mask with a 3-ply surgical mask is also used for added protection, since she spends long hours close to a patient’s oral cavity
In January this year, marketing professional Meghna Bajaj felt confident enough to start attending physical meetings and occasionally squeeze in a restaurant meal with friends when time permitted. Up until then, she had spent most of her time holed up indoors. "With cases on the wane, it felt good to be out and about. But within a few days, I started seeing spots pop up on my face. It [skin eruptions] had spouted around the mask lines. Initially, I presumed it to be dehydration so I started drinking more water and washing my face often with an anti-bacterial face wash. But it got worse with time."
Bajaj was battling an unfortunate side effect of daily mask-wearing that is now a must to slow the transmission of COVID-19: maskne or acne caused by wearing a mask.
A research letter published in the Journal of the American Academy of Dermatology in March 2020 reported that at least 83 per cent of healthcare workers in Hubei, China, suffered skin problems on the face. "The general prevalence rate of skin damage caused by enhanced infection-prevention measures was 97 per cent among first-line healthcare workers. The affected sites included the nasal bridge, hands, cheek, and forehead, with the nasal bridge the most commonly affected (83.1 per cent). Among a series of symptoms and signs, dryness/tightness and desquamation were the most common symptom," read the report. Bajaj, who experienced similar symptoms, is currently on antibiotics prescribed by a dermatologist. "The doctor said that while the spots looks exactly like acne, it's a much stronger infection. I have been told to use only disposable masks, which I had avoided, because I didn't want to add to the mounting bio wastage."
Dr Manasi Shirolikar, head dermatologist at Remedico, an online dermatology service that helps users consult India's doctors for skin or hair problems, says this form of facial irritation has seen a steady uptick since the Coronavirus outbreak. The portal saw its first case in April 2020. At the time, Shirolikar says they received a lot of queries from frontliners, whose job necessitated wearing the mask for long hours. "Maskne is an umbrella term to refer to a host of skin infections such as acne, rosacea (roe-zay-she-uh), a skin inflammatory condition that causes redness and pimples on your nose, cheeks, chin, and forehead; and contact dermatitis. It is a red, itchy rash caused by direct contact with a substance/synthetic fibres or an allergic reaction to it. Just the way babies get with diapers." The other skin condition that she says has seen an increase is folliculitis, a skin problem that occurs when you get bacteria or a blockage in a tiny pocket of your hair follicle. "It's more common among men and mimics the symptoms of acne," she adds.
Amar Patnaik, senior software consultant in Mumbai, says skin rashes led to cuts at the back of his ears. "There was a time when I had to wear the mask for 12 hours a day, five days a week. Application of an ointment prescribed by the dermatologist has helped."
According to Dr Rashmi Shetty, dermatologist and founder of Ra Skin and Aesthetics in Mumbai and Reva Health & Skin, Hyderabad, when the mask is worn right, it ends up being tightly closed from the ends with no air coming in or escaping out. "Exhaled air also has moisture in it, so that sits within. Also, it tends to be warm, so the temperature in that area goes high. We don't realise that skincare creams can actually mix with the moisture along with sweat and worsen the condition." Makeup, lotions and sunscreen are known to aggravate maskne because they mix with facial perspiration. "Most of us perspire from the upper lip and around the mouth and nose. So, it's best not to put any cream under your mask," she suggests. Dr Shirolikar says those who work as salespersons in malls and are involved in client-facing jobs have no option but to use full-face makeup. "We recommend that they take off the mask for 15 minutes as and when possible so that the pores can breathe."
Dr Diksha Batra, owner of the dental clinic, Smile Essentials in Bandra, says as dentists, they end up spending long hours around the patient's oral cavity, the hub of the COVID-19 virus. Hence, one of the first changes the pandemic brought for them was a switch from regular three-ply surgical masks to an N95. "Our work involves using aerosols which are generated from drilling and other pressure technology that we use. We wear a respirator mask for aerosol procedures, which is made out of silicon and covers more than half our face and has changeable filters on the outside. The additional N95 mask with a 3ply surgical mask gets disposed after treating every patient; it is mandatory for all other procedures, including a simple patient consult," she says.
Dentists typically wear a mask a minimum of eight to 12 hours barring breaks for drinking water or eating a meal. Dr Batra has resorted to improving and changing the fit and fabric of the mask. "Softer materials and adjustable straps made us more comfortable. We also ensured we changed our approach by hydrating more and using vitamins to maintain our own health," she says.
Despite the perils, Dr Shirolikar says they make sure that the importance of wearing masks is not lost on patients. "It is no fun to wear it, but it's the only powerful and lifesaving tool we have against COVID-19. And we remind every patient who consults us."
. Keep the mouth area and cheeks clean. Avoid using sunscreen or other skin products in areas touched by the mask
. Removing the mask every two to three hours makes a difference. "It's a good idea to also change the mask in the day so that the bacteria that has been forming
doesn't have the chance to grow and disrupt the skin," says Dr Shetty
. Don't overexfoliate. "People often think they need to dry out acne, but drying out your skin can actually lead to more breakouts," says Dr Shirolikar
. The minute you remove the mask, make sure you wash your face and it's clean
