key: cord-0969375-8xxwccj5
authors: Resuello, Tina Elaine M.; Puyat, Maria Cristina A.
title: Mask-induced facial dermatoses during the COVID-19 pandemic: A cross-sectional study in a tertiary medical center in the Philippines
date: 2022-03-11
journal: JAAD Int
DOI: 10.1016/j.jdin.2022.03.002
sha: fc532f85e0d80e13fd8722a4321bfcb61bfc5cf1
doc_id: 969375
cord_uid: 8xxwccj5

nan

Medical Center • 161 (51.4%) participants who wore masks experienced symptoms of facial dermatoses • No significant correlation was found between type, duration and frequency of mask used and occurrence of symptoms • Symptoms are slightly more frequent in those using disposable masks than those who wore elastomeric/silicon masks • More subjects have reported symptoms when they use masks for 17 hours or more • More subjects describe symptoms when they use masks for 5 days a week • A significant difference was also observed among the different areas of assignment of employees

The type, frequency and duration of face mask usage does not significantly correlate in the development of symptoms of facial dermatosis in many subjects. However, the frequency of adverse events among HCWs due to face mask use is still substantial. Since the start of the COVID-19 pandemic, an increase in reports of mask-related skin 26 problems have emerged 1 . We did a cross-sectional study on the prevalence of the self-reported 27 new-onset and/or aggravations of previously diagnosed facial dermatoses among the medical 28 and non-medical staff of Rizal Medical Center, a tertiary hospital in Pasig, Philippines. 29

A total of 313 out of 319 participants completed the questionnaire, consisting of medical 30 and non-medical staff who have been using any type of face mask for at least 6 weeks prior to 31 the time of study. Out of these, 161 (51.4%) respondents have self-reported symptoms of facial 32 dermatoses, the common reported symptoms were itching (n=126) followed by dryness/tightness 33 of the skin on the area under the mask (n=66). Symptoms of facial dermatosis were only slightly 34 more frequently observed in those using cloth and disposable masks such as surgical masks, 35 N95 masks, KN95 masks than those who wore elastomeric/silicon masks. The type of mask use 36

is not associated with the occurrence of symptoms of facial dermatoses (p-value: 0.7079). 37

The mean frequency and duration of mask use among participants is 12.1 hours (s: +4.35) 38 and 6 days (s:+3.31), respectively. No significant correlation was also found among those who 39 use face masks for 8 hours or more, but more subjects have reported symptoms to occur when 40 they use masks for > 17 hours. This is consistent with a systematic review published by Barnawi 41 et al. which reported the occurrence of dermatological complications of wearing personal 42 protective equipment (PPE) more apparent among individuals wearing PPE for ≥ 4 hours a day 2 . 43

More subjects describe symptoms that appear when they use masks for 5 days a week. In our 44 study, we found no significant difference in frequency and duration of use of different types of 45 masks between respondents with and without symptoms which is not in concordance with the 46 result of the systematic review on the impact of PPE use on health care workers' physical health 47

showing that longer duration of shifts and increased consecutive days wearing PPE increases the 48 risk of symptom manifestation 3 . 49

3

The most common diagnosis of facial dermatoses were acne vulgaris/mechanica 50 (n=36/78, 46.2%) followed by irritant contact dermatitis (n=24/78, 30.8%). We found that 51 symptoms of facial dermatoses significantly differ at 5% level of significance among those in 52 medical than in the non-medical subgroup. A significant difference was also observed among the 53 different areas of assignment of employees which could mean that the working environment may 54 be a factor in the occurrence of symptoms. 55

Despite emerging reports of the increase in the prevalence of mask-induced facial 56 dermatoses, this study showed that the type, frequency and duration of face mask usage does 57 not significantly correlate in the development of symptoms of facial dermatosis in many subjects. 58

We recommend further related studies done with larger sample size or data collection conducted 59 simultaneously from different institutions and hospitals around the country. 60 Since the start of the COVID-19 pandemic, an increase in reports of mask-related skin 26 problems have emerged 1 . We did a cross-sectional study on the prevalence of the self-reported 27 new-onset and/or aggravations of previously diagnosed facial dermatoses among the medical 28 and non-medical staff of Rizal Medical Center, a tertiary hospital in Pasig, Philippines. 29

A total of 313 out of 319 participants completed the questionnaire, consisting of medical 30 and non-medical staff who have been using any type of face mask for at least 6 weeks prior to 31 the time of study. Out of these, 161 (51.4%) respondents have self-reported symptoms of facial 32 dermatoses, the common reported symptoms were itching (n=126) followed by dryness/tightness 33 of the skin on the area under the mask (n=66). Symptoms of facial dermatosis were only slightly 34 more frequently observed in those using cloth and disposable masks such as surgical masks, 35 N95 masks, KN95 masks than those who wore elastomeric/silicon masks. The type of mask use 36

is not associated with the occurrence of symptoms of facial dermatoses (p-value: 0.7079). 37

The mean frequency and duration of mask use among participants is 12.1 hours (s: +4.35) 38 and 6 days (s:+3.31), respectively. No significant correlation was also found among those who 39 use face masks for 8 hours or more, but more subjects have reported symptoms to occur when 40 they use masks for > 17 hours. This is consistent with a systematic review published by Barnawi More subjects describe symptoms that appear when they use masks for 5 days a week. In our 44 study, we found no significant difference in frequency and duration of use of different types of 45 masks between respondents with and without symptoms which is not in concordance with the 46 result of the systematic review on the impact of PPE use on health care workers' physical health 47

showing that longer duration of shifts and increased consecutive days wearing PPE increases the 48 risk of symptom manifestation 3 . 49 9

The most common diagnosis of facial dermatoses were acne vulgaris/mechanica 50 (n=36/78, 46.2%) followed by irritant contact dermatitis (n=24/78, 30.8%). We found that 51 symptoms of facial dermatoses significantly differ at 5% level of significance among those in 52 medical than in the non-medical subgroup. A significant difference was also observed among the 53 different areas of assignment of employees which could mean that the working environment may 54 be a factor in the occurrence of symptoms. 55

Despite emerging reports of the increase in the prevalence of mask-induced facial 56 dermatoses, this study showed that the type, frequency and duration of face mask usage does 57 not significantly correlate in the development of symptoms of facial dermatosis in many subjects. 58

We recommend further related studies done with larger sample size or data collection conducted 59 simultaneously from different institutions and hospitals around the country. 60 

Journal of the European Academy of Dermatology and Venereology

Does Wearing a Face Mask During the COVID-19 Pandemic Increase the 71 Incidence of Dermatological Conditions in Health Care Workers? Narrative Literature Review

The Association of the Prolonged Use of Personal 74 Protective Equipment and Face Mask During COVID-19 Pandemic With Various Dermatologic 75 Disease Manifestations: A Systematic Review

Impact of personal protective equipment 77 use on health care workers' physical health during the COVID-19 pandemic: a systematic 78 review and meta-analysis

Personal protective 80 equipment induced facial dermatoses in healthcare workers managing Coronavirus disease 81 2019

Acta dermato-venereologica