Annette Matthews shares some insider tips on how to survive mask-wearing whilst maintaining a healthy, flawless appearance

Since the outbreak of COVID-19 pandemic, clinical staff all over the world have had to employ extra protective measures while providing care to patients.

The use of personal protective equipment (PPE) provides healthcare workers (HCWs) a level of safety by limiting the contact between clinical staff and patients. However, the prolonged application of PPE during clinical shifts can affect skin health. Indeed, in order to provide protection against airborne particle transmission, devices such as respiratory protective equipment (RPE) are tightly fastened to the face to create an airtight seal.

However, these masks are typically designed to a standard involving an average white male face shape, providing a limited range of size and geometry.

When the PPE devices are applied, it will create pressure, shear and friction at the skin interface, which can be sustained over an entire working shift. In addition, due to the mental and physical stress on clinical staff who are managing COVID-19 patients, the skin can be further compromised by moisture, originating from excess sweating.

A recent study, entitled Personal protective equipment related skin reactions in healthcare professionals during COVID-191, revealed that there have been increasing reports of adverse reactions associated with the average daily time spent in PPE – and the duration of PPE use without relief.

Trends in skin adverse reactions were also associated with the number of consecutive days of PPE usage, as well as the type and model of RPE. The research suggested: ‘There is a compelling need to improve the guidelines for PPE use and the design/materials of which the protective equipment are manufactured in order to minimise the risk of skin damage to valuable healthcare workers.’

Dental nurses know only too well of the challenges of day-to-day wear, with many reporting compromised skin integrity, skin damage and bruising after PPE during long shifts. Whilst there has not yet been a survey of dental professionals, a Royal College of Nursing study2 reveals that 93% of nursing staff had experienced some form of skin condition, including dryness, redness, cracking, itching and pain, in the previous year.

As a fellow dental PPE wearer, I salute you all! I would also like to help you with some top tips during the current climate and discuss the stresses we are putting our skin health through at this time by answering some common concerns. The reason we run into skin complications is usually down to one of or a combination of two things – intrinsic forces, such as illness, hormones, stress, biological age and genetics. And extrinsic forces, such as environmental changes, friction, UV damage, chemicals and extremes of temperature to name a few. Throughout the pandemic, we are putting our skin through just a few of the above and in combination and this can and will be making our skin health deteriorate. Just a few small changes can help you.

Think lipid barrier. The main reason our skin begins to lose function is down to a breach in this protective, moisture retentive barrier. A lot of cases I am seeing now will have disrupted this from poor skin habits or the introduction of more heavy duty PPE on a daily basis, not to mention the cold winter weather and extremes of temperatures felt from cosy, heated houses to fresh outdoor walks.

‘But everything I put on my skin makes it worse!’ If you are saying this to me in your head, I hear you! However, we are at a point of this getting a little worse before it gets better.

A history of poor skin health habits. The upheaval we all have in our lives will have affected the pH level (amongst other things) of our skin. Give new products time to adapt and avoid mixing and matching and continual change.

SPF is your daily BFF. With those holidays in the sun still a distance away, SPF (sun protection factor) actually helps our skin from the other extrinsic aspects just mentioned. It's not just for when we throw down the beach towel – SPF is a great barrier under masks to prevent frictional acne and skin issues, too.

Drying effects. From central heating to frictional issues caused by masks and PPE, the adaptation of our pH can all be improved by introducing just this little adjunct into out morning routine. Look for one with dermal corrective properties, too.

Antioxidants. Not only should we try to ingest these for optimum health as we know it, but application of these topically will help aid something called ‘reactive oxidative stress’ and the damage to skin from the aforementioned guilty parties.

Replace your masks regularly. If using the stealth type masks, ensure the cleaning agent is thoroughly removed. For the disposables, be mindful of how long you have worn this if out and about.

Don’t forget hand care. Excessive washing and alcohol gels can wreak havoc on the skin’s lipid barrier. Ensure you thoroughly dry your hands afterwashing.

Avoid fabric masks (in your home PPE). Especially if you are an acne sufferer or have noted more breakouts.

Are you what you eat? Think about keeping a food diary and take note of the food and drink that you find affect your skin health.

DO NOT over exfoliate. This will not improve breakouts, blocked pores or skin cell turn over. In fact, it is more likely to deteriorate the health of your skin.

PS. Remember, self-care is not selfish. Take care of yourself so you can continue to take care of others.

References available on request.

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