key: cord-0907039-7vfqqtrt
authors: Sinha, Anwita; Singh, Anchit Raj
title: An Unforeseen Hazard of Masks Being in Vogue
date: 2020-10-26
journal: Int J Occup Environ Med
DOI: 10.34172/ijoem.2020.2211
sha: 7c18d5742979c88fb2c7a56f3fcbd8e9b8b9e2ca
doc_id: 907039
cord_uid: 7vfqqtrt

nan

A cne mechanica in the COVID-19 pandemic, colloquially known as "maskne," is a variant of facial dermatosis seen in areas with friction from use of masks, respirators, and personal protective equipment (PPE). 1 Increased levels of interleukin-1a, produced by friction, are implicated in the pathogenesis of this disease. 2 Maskne is a broad umbrella term that may not be associated with acne per se; it also includes other facial lesions caused by using PPE. PPE are usually used by workers with specific occupations. However, with the COVID-19 pandemic spreading throughout the world, the use of PPE has now become prevalent. 3 This dermatological condition, although previously seen only in occupational health practice, has now become quite common so that it might be missed by the uninitiated. It may be seen as a flare of acne in patients who have a history of acne vulgaris, but can also present de novo as solitary lesions or other facial dermatoses. It is frequently seen in both health care workers and the general population, especially in areas that are atypical for acne vulgaris. Certain areas like lips can be particularly sensitive to the problem. Important differentials over lip include herpes simplex, traumatic folliculitis, cheilitis, and perioral dermatitis. Most cases are resolved by limiting exposure and friction; persistent or severe cases may be treated on the lines of acne vulgaris. 4 Apart from acne mechanica, other forms of PPE-related skin damage are also frequently reported. These include dryness, eczema, desquamation, and maceration. Nasal bridge, hands, cheeks, and forehead are common areas for PPE-related skin damage. 5 Risk factors include older age, prior skin disease, long hours of PPE usage, improper sizing, fitting or tighter PPE, and use of adhesive tapes. Avoiding continuous usage of masks for more than 6 hours is recommended; use of moisturizers and face wash both before and after wearing PPE are also beneficial. Use of protective dressings and alcohol-free liquid skin protectants can help reduce damage at pressure sites. 6 In our patient, the lesion was associated with friction over lips from prolonged use of a surgical mask, as evidenced by areas of wear on the mask (Fig 1) . The lesion was associated with inflammation of Fordyce spots over lip causing folliculitis. Even though the lesion does not classically fit under the description of acne, the frictional effects of PPE can explain the inflammation of Fordyce spot. The lesion was resolved with advice regarding switching to a different type of mask, changing masks when worn for prolonged periods and using a face wash twice a day.

None declared.

Occupational and environmental acne

Acne mechanica: probable role of IL-1α

Exacerbation or Eruption of Acne During the COVID-19 Pandemic

Skin damage among health care workers managing coronavirus disease-2019

Prevention and Treatment of Skin Damage Caused by Personal Protective Equipment : Experience of the First-Line Clinicians Treating 2019-nCoV Infection