Skip to main content
Springer Nature - PMC COVID-19 Collection logoLink to Springer Nature - PMC COVID-19 Collection
. 2021 Aug 11;31(2):199–204. doi: 10.1684/ejd.2021.4007

“Face mask dermatitis” due to compulsory facial masks during the SARS-CoV-2 pandemic: data from 550 health care and non-health care workers in Germany

Anne-Charlotte Niesert 1,✉,#, Eva M Oppel 1,#, Tobias Nellessen 1, Surina Frey 1, Benjamin M Clanner-Engelshofen 1, Andreas Wollenberg 1, Lars E French 1, Markus Reinholz 1,
PMCID: PMC8356539  PMID: 33814358

Abstract

Background

During the COVID-19 pandemic, wearing face masks is mandatory not only for health care workers (HCWs) but also for the general population in many countries around the globe.

Objectives

The aim of the study was to investigate the onset of adverse facial skin reactions due to compulsory face masks during the COVID-19 pandemic in HCWs and non-HCWs, and draw awareness of this new dermatological condition and its preventive measures.

Materials & Methods

A questionnaire was distributed to 550 patients and HCWs from the Department of Dermatology and Allergy of the University Hospital Munich (LMU), Germany. Participants were surveyed regarding mask type, duration of usage and adverse facial skin reactions. Information on symptoms and the use of skin care products and topical drugs were retrieved.

Results

The duration of wearing masks showed a significant impact on the prevalence of symptoms (p < 0.001). Type IV hypersensitivity was significantly more likely in participants with symptoms compared to those without symptoms (p = 0.001), whereas no increase in symptoms was observed in participants with atopic diathesis. HCWs used facial skin care products significantly more often than non-HCWs (p = 0.001).

Conclusion

Preventive and therapeutic measures should be established in order to avoid “face mask dermatitis”, especially for people with underlying risk factors.

Key words: adverse skin reactions, COVID-19, face mask dermatitis, health care workers, SARS-CoV-2 pandemic

Footnotes

Disclosure

Financial support: none. Conflicts of interest: none.

These authors contributed equally

Contributor Information

Anne-Charlotte Niesert, Email: annecharlotte.niesert@med.uni-muenchen.de.

Markus Reinholz, Email: markus.reinholz@med.uni-muenchen.de.

References

  • 1.World Health Organization. Modes of transmission of virus causing COVID-19: Implications for IPC precaution recommendations: Scientific brief. Available at: https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations. Published 2020. Updated March 2020.
  • 2.Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020;382:970–1. doi: 10.1056/NEJMc2001468. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.MacIntyre CR, Chughtai AA. Facemasks for the prevention of infection in healthcare and community settings. BMJ. 2015;350:h694. doi: 10.1136/bmj.h694. [DOI] [PubMed] [Google Scholar]
  • 4.Centers of Disease Control and Prevention. Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission. Available at: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html. Published 2020. Accessed 28 May 2020.
  • 5.European Centre for Disease Prevention and Control. Using face masks in the community Reducing COVID-19 transmission from potentially asymptomatic or pre-symptomatic people through the use of face masks. 2020.
  • 6.Greenhalgh T, Schmid MB, Czypionka T, Bassler D, Gruer L. Face masks for the public during the covid-19 crisis. BMJ. 2020;369:m1435. doi: 10.1136/bmj.m1435. [DOI] [PubMed] [Google Scholar]
  • 7.Eikenberry SE, Mancuso M, Iboi E, et al. To mask or not to mask: modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic. Infect Dis Model. 2020;5:293–308. doi: 10.1016/j.idm.2020.04.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Söder DM. Leben mit Corona — Bayerns Fahrplan bis zum 3. Mai. In: Staatsregierung B. 2020.
  • 9.Robert-Koch-Insitut Mund-Nasen-Bedeckung im öffentlichen Raum als weitere Komponente zur Reduktion der Übertragung von COVID-19. Epidemiologisches Bulletin. 2020;19:3–5. [Google Scholar]
  • 10.Reinholz M, French LE. Medical education and care in dermatology during the SARS-CoV2 pandemia: challenges and chances. J Eur Acad Dermatol Venereol. 2020;34:e214–6. doi: 10.1111/jdv.16391. [DOI] [PubMed] [Google Scholar]
  • 11.Freeman EE, McMahon DE, Lipoff JB, et al. Pernio-like skin lesions associated with COVID-19: a case series of 318 patients from 8 countries. J Am Acad Dermatol. 2020;83:486–92. doi: 10.1016/j.jaad.2020.05.109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Foo CC, Goon AT, Leow YH, Goh CL. Adverse skin reactions to personal protective equipment against severe acute respiratory syndrome-a descriptive study in Singapore. Contact Dermatitis. 2006;55:291–4. doi: 10.1111/j.1600-0536.2006.00953.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Lin P, Zhu S, Huang Y, et al. Adverse skin reactions among healthcare workers during the coronavirus disease 2019 outbreak: a survey in Wuhan and its surrounding regions. Br J Dermatol. 2020;183:190–2. doi: 10.1111/bjd.19089. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Szepietowski JC, Matusiak L, Szepietowska M, Krajewski P, Bialynicki-Birula R. Face mask-induced itch: a self-questionnaire study of 2,315 responders during the COVID-19 pandemic. Acta Derm Venereol. 2020;100:adv00152. doi: 10.2340/00015555-3536. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Zuo Y, Hua W, Luo Y, Li L. Skin reactions of N95 masks and medial masks among health care personnel: a self-report questionnaire survey in China. Contact Dermatitis. 2020;83:145–7. doi: 10.1111/cod.13555. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Stoeva IL. Work-related skin symptoms among Bulgarian dentists. Contact Dermatitis. 2020;82:380–6. doi: 10.1111/cod.13523. [DOI] [PubMed] [Google Scholar]
  • 17.Navarro-Trivino FJ, Carolina MF, Teresa RH, Ruiz-Villaverde R. Allergic contact dermatitis caused by elastic bands from FFP2 mask. Contact Dermatitis. 2020;83:168–9. doi: 10.1111/cod.13600. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Hua W, Zuo Y, Wan R, et al. Short-term skin reactions following use of N95 respirators and medical masks. Contact Dermatitis. 2020;83:115–21. doi: 10.1111/cod.13601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Xie Z, Yang YX, Zhang H. Mask-induced contact dermatitis in handling COVID-19 outbreak. Contact Dermatitis. 2020;83:166–7. doi: 10.1111/cod.13599. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Aerts O, Dendooven E, Foubert K, Stappers S, Ulicki M, Lambert J. Surgical mask dermatitis caused by formaldehyde (releasers) during the COVID-19 pandemic. Contact Dermatitis. 2020;83:172–3. doi: 10.1111/cod.13626. [DOI] [PubMed] [Google Scholar]
  • 21.Donovan J, Skotnicki-Grant S. Allergic contact dermatitis from formaldehyde textile resins in surgical uniforms and nonwoven textile masks. Dermatitis. 2007;18:40–4. doi: 10.2310/6620.2007.05003. [DOI] [PubMed] [Google Scholar]
  • 22.Donovan J, Kudla I, Holness LD, Skotnicki-Grant S, Nethercott JR. Skin reactions following use of N95 facial masks. Dermatitis. 2007;18:104. doi: 10.1097/01206501-200706000-00013. [DOI] [Google Scholar]
  • 23.Wollenberg A, Flohr C, Simon D, et al. European Task Force on Atopic Dermatitis (ETFAD) statement on severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2)-infection and atopic dermatitis. J Eur Acad Dermatol Venereol. 2020;34:e241–2. doi: 10.1111/jdv.16411. [DOI] [PubMed] [Google Scholar]
  • 24.Yan Y, Chen H, Chen L, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther 2020: e13310. [DOI] [PMC free article] [PubMed]
  • 25.Reich A, Wilke A, Gediga G, et al. Health education decreases incidence of hand eczema in metal work apprentices: results of a controlled intervention study. Contact Dermatitis. 2020;82:350–60. doi: 10.1111/cod.13502. [DOI] [PubMed] [Google Scholar]
  • 26.Soltanipoor M, Kezic S, Sluiter JK, et al. Effectiveness of a skin care programme for the prevention of contact dermatitis in healthcare workers (the Healthy Hands Project): a single-centre, cluster randomized controlled trial. Contact Dermatitis. 2019;80:365–73. doi: 10.1111/cod.13214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Andrees V, John SM, Nienhaus A, et al. Economic evaluation of a tertiary prevention program for occupational skin diseases in Germany. Contact Dermatitis. 2020;82:361–9. doi: 10.1111/cod.13506. [DOI] [PubMed] [Google Scholar]
  • 28.Balato A, Ayala F, Bruze M, et al. European Task Force on Contact Dermatitis statement on coronavirus 19 disease (COVID-19) outbreak and the risk of adverse cutaneous reactions. J Eur Acad Dermatol Venereol. 2020;34:e353–4. doi: 10.1111/jdv.16557. [DOI] [PubMed] [Google Scholar]

Articles from European Journal of Dermatology are provided here courtesy of Nature Publishing Group

RESOURCES