Face masks worn to reduce Wuhan coronavirus (COVID-19) transmission can trigger eczema flare-ups in people with sensitive skin and allergies. These are the findings of a recent case study presented at this year’s virtual scientific meeting of the American College of Allergy, Asthma and Immunology (ACAAI).

The case study involved a Black man aged 60 years with adult-onset eczema and contact dermatitis, as well as chronic nasal allergies. Lead author and ACAAI member Yashu Dhamija said he and his team treated the man after he showed up three times in their hospital emergency room. The man said he had an uncomfortable face rash.

The man also said he had his skin conditions under control up until April when he started wearing face masks more often due to the pandemic. Soon after, his symptoms began occurring in areas that healthcare providers were not yet accustomed to, said Dhamija.

Some allergens that trigger eczema can be found in face masks

The man was diagnosed with a case of contact dermatitis, a form of eczema triggered by contact with a certain substance. The physicians who first attended to him prescribed him prednisone to treat his rashes and reduce inflammation. However, it failed to improve his symptoms.

Further investigation revealed that the man began to experience flare-ups from his skin conditions as early as April, which coincided with the pandemic and the man’s use of face masks.

Co-author and fellow ACAAI member Kristin Schmidlin said they realized that the man’s face rashes occurred where the elastic parts of a mask would rest. Instead of putting the man on more prednisone, they advised him to use a topical steroid and immunosuppressant until his rash improved.

Schmidlin said they also told the man to use cotton-based, dye-free masks without elastics. One week after his last visit, the man phoned them to report that his rash was improving.

The authors note that the man might have experienced rashes from wearing masks because common allergens that trigger contact dermatitis are found in the components of face masks, including the cloth and elastic band.

Even in people without skin conditions but have sensitive skin, materials used to make face masks might cause damage due to friction, as well as mild to moderate discomfort.

Overall, the findings show that wearing face masks with elastic bands can trigger eczema flare-ups, particularly in people with skin allergies.

Other disadvantages of face masks

Besides eczema flare-ups, wearing face masks for long periods is also associated with other side effects, as well as some disadvantages. These include:

1. Creates a false sense of security – While face masks help lessen the risk of transmission to a certain extent, frequent handwashing is the most important step that the public can take to minimize the spread of the coronavirus, according to the World Health Organization (WHO).
2. May restrict breathing – According to Antonio Lazzarino, an epidemiologist from University College London, wearing a face mask makes breathing more difficult. For this reason, face masks are particularly intolerable to wear for people with chronic respiratory diseases that heavily affect lung capacity.
3. Causes discomfort – Face masks can cause discomfort for some people because of either the fit or the material used. Experts agree that cotton allows better ventilation and traps less moisture from breathing and sweating under the mask. The mask should also fit the face snugly to prevent droplets from escaping but not so tightly that it hurts.
4. Irritates the skin – Outside of sensitive skin and allergies, prolonged face mask use could still result in a higher incidence of acne, rashes and other adverse skin reactions. Side effects like these are particularly prevalent among frontline healthcare workers who have to wear face masks for several hours.
5. Irritates the eyes – Wearing a face mask also makes the exhaled air go into the eyes, said Lazzarino. This can make the eyes feel sore, dry and irritated as a result. If not careful, an individual could be tempted to touch his or her eyes because of this. The WHO strongly advises against touching the eyes, nose and mouth to minimize the risk of contracting COVID-19.
6. Can spread disease – The coronavirus can survive for long periods on the surfaces of different objects and materials, including face masks. If not disposed of properly, a dirty face mask could become a source of contamination.
7. Clouds eyeglass lens – Face masks can get in the way of eyeglasses for people who need to wear them. As exhaled air dissipates, it clouds the eyeglass lenses, making it difficult for the wearer to see.
8. May hurt young children – According to the Centers for Disease Control and Prevention, face masks should not be placed on children under two years. Children in this age range cannot reliably adjust or remove their face mask if it starts to cause breathing difficulties.