Wearing facemasks during this pandemic has received several complaints such as fear of hypoxia or decreased levels of oxygen. One other concern is from those with skin allergies. The medical challenge of masks triggering contact dermatitis was recently presented in the American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting.
Allergist Yashu Dhamija from the University of Cincinnati presented the case study of a 60-year-old man with adult-onset eczema, contact dermatitis, and chronic nasal allergies. He arrived at the hospital's emergency room three times due to a face rash. After treatment, Dhamija's team determined that the rash was triggered after he began wearing face-masks in April.
The patient has initially prescribed prednisone, a corticosteroid to reduce inflammation, but his rashes persisted. Allergist Kristin Schmidlin said that the elastic or rubber part of the mask was where his rash appeared.
Dealing with Contact Dermatitis
The challenge shared by Dhamija is how to manage patients with skin allergies while protecting them from coronavirus. Wearing face masks and other safety measures are still a must, he said.
The patient was prescribed other medication and was advised to use cotton-based and dye-free masks without elastic parts or ones that "use the knot tie method around the back of the head to keep the masks up," said Dhamija. After a week, the patient reported that his rash improved.
Contact dermatitis is complex because the allergic reaction to a chemical substance could have a delayed reaction and appear days later. If the reactions are on and off, it becomes difficult to pinpoint if the allergen is from work, home, or elsewhere.
In a 2011 study, researchers determined that contact dermatitis cases rise during the summer and the top allergens include plants, antiseptics and topical drugs, and detergents or soaps. Meanwhile, several studies linked plastic chemicals to skin allergies and asthma.
Those will skin allergies can also contact face mask companies and ask what the product is made from in case the labels don't provide sufficient details, added Dhamija. While some cases may be mild, some immune reactions to allergens may be life-threatening.
People who may not be aware that they have contact dermatitis can take a patch test which will determine what allergens trigger a reaction after several days. Those with existing allergies can also ask doctors for other concerns.
Using Alternative Masks
Dermatologist Dr. Anna Chien from Johns Hopkins shared that she's seen an increase of patients with perioral dermatitis or a rash around the mouth and chin due to face masks. Masks made from polyester blends or cotton, "such as T-shirt or pillowcase fabrics, and these are fairly gentle on the skin," she said.
Aside from the plastic bands on the side of masks, people may be allergic to formaldehyde, a chemical substance that commercial masks are pre-treated with for disinfection. Others may be allergic to synthetic fabrics or detergents used on washable masks. She recommends that those with skin allergies should choose natural fiber-cloth masks and use unscented laundry detergent to prevent a rash breakout.
People who may not be aware that they have contact dermatitis can take a patch test which will determine what allergens trigger a reaction after several days. Those with existing allergies can also ask doctors for other concerns.
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