Lehigh County Health & Medicine Fall/Winter 2020 - 14

FEATURE

Prevention
and treatment
of skin
conditions
related to personal protective
equipment in the era of COVID-19

By CYNTHIA BARTUS, M.D., Advanced Dermatology Associates and Lehigh Valley Health Network,
CHELSEA KESTY, M.D., Advanced Dermatology Associates and Lehigh Valley Health Network,
OLIVIA DAHLGREN, Lehigh University

D

ue to the emergence of the coronavirus disease
2019 (COVID-19) pandemic, personal
protective equipment (PPE) has been used
beyond its normal measures to prevent the
spread of disease. Healthcare and other frontline
workers wear multiple layers of PPE including
gloves, masks, gowns, and face shields/goggles. The
extended use of the variety of PPE has accompanied
a re-emergence of dermatologic conditions including
mask-related acne ( " maskne " ), contact/irritant dermatitis, pressure-related skin damage, and exacerbation
of existing dermatologic conditions.

Mask-related acne is a form of acne mechanica
arising from occlusion of pores and irritation from
prolonged wearing of masks and tight-fitting goggles
or face-shields. Moisture and other irritants can
accumulate on the inner surface of the PPE and
contaminate the covered area of skin. With the
increased moisture and friction, the natural skin barrier
is susceptible to breakdown and secondary infiltration
with inflammation-causing bacteria leading to acne
breakouts. Treatment strategies include traditional acne
therapy comprising of regular use of over-the-counter
(OTC) benzoyl peroxide or salicylic acid cleansers,
topical retinoid therapy (prescription or OTC), topical
antimicrobial therapy, and, in severe cases, systemic
therapy (antibiotics, retinoids, hormonal therapy).
Prevention strategies include use of 100% cotton
masks when possible, avoidance of makeup or other
comedogenic products when masks are worn, regular
cleansing or replacement of masks, and cleansing/
moisturizing skin using non-comedogenic cleansers
and emollients at least one hour prior to PPE use.
In addition, taking appropriate and safe breaks from
wearing PPE for 15 minutes after every 2 hours can
be helpful in preventing accumulation of moisture
and acne-inducing contaminants.
Contact and irritant dermatitis are also a potential
consequence of increased hand-cleansing and PPE use.
Hand dermatitis is characterized by redness, itching,
burning, and cracking of the hands and fingers. It is
caused by repetitive use of hand sanitizer, hand soaps,
hot water exposure, and certain types of gloves in
susceptible individuals. Prevention and treatment

14 Lehigh County Health & Medicine | FALL / WINTER 2020
Lehigh County Health & Medicine Fall/Winter 2020

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