While it’s not a term that most of us would frequently hear of or read about, contact dermatitis has been a constant battle that both doctors and patients have to fight together even before the onset of the pandemic.
The reason? Identifying the irritating culprit of the itchy – and often painful – skin allergy have proven to be difficult, as contact dermatitis can be triggered by various factors, including allergens in detergents, skincare products, and so on.
But when the rash began to appear in telltale areas of the face, doctors around the world had very quickly come to realise the main cause: protective face masks.
We’re all too familiar with mask acne (a.k.a maskne) that’s caused by protective face coverings. But, what about this newfound skin condition – and can we keep it under control?
We speak to various experts, including medical doctors, to get the 411 on mask-related contact dermatitis.
What is contact dermatitis?
Prior to the pandemic, it’s not uncommon for doctors to take a longer time to pinpoint the source of contact dermatitis. That’s because they had to put on their detective hats to correctly identify the cause of the skin condition by running skin tests and sitting down with their patients to go through their medical history or past events that may have led to it.
As Dr. YX Lum, medical doctor at IDS Clinic, puts it simply, contact dermatitis is a condition in which the skin becomes irritated or inflamed when it comes into contact with a substance that it is allergic to. “It’s like a hypersensitive reaction to allergens found in detergents, skincare products, fragrances, and metal jewelry, for example,” she shares.
Dr. Kelly Tang, renowned Taiwanese dermatologist, further adds that the red, itchy rash can be caused by soaps and even plants, before letting on that irritant contact dermatitis is the most common type faced by many.
“This non-allergic skin reaction occurs when a substance damages your skin’s outer protective layer. Some people react to strong irritants after a single exposure. Others may develop signs and symptoms after repeated exposure to even mild irritants. Mask wear-induced contact dermatitis falls under the latter,” she explains.
So, what is it about our protective face coverings that’s causing contact dermatitis?
This new wave of facial rashes due to face masks is made known to the public by Yashu Dhamija, a physician in the department of immunology, allergy, and rheumatology at University of Cincinnati College of Medicine.
In a case report that details the story of one anonymous patient who developed contact dermatitis shortly after he began wearing a mask to prevent COVID-19, Dhamija (who is the lead author of the report) notes that “rash distribution correlated with the elastic-containing components of a non-surgical mask.”
Since most face masks are made of synthetic materials, this means that any kind of face coverings could theoretically trigger contact dermatitis in our new, masked-up reality.
What makes things worse is that it’s not just the mask material that you need to worry about: this troublesome skin concern can also be brought on by what you use to wash your masks with, the mask dye, the elastic straps, or even the metal nose clip, depending on our skin’s immunity. And, you’re like to have the less-common allergic contact dermatitis if your skin has reacted to any of the above.
Unfortunately, the anonymous patient mentioned above is just one of the many people – both frontline workers and not – who are suffering from skin flare-ups as a result of wearing their face coverings for an extended period of time.
According to Dr. Angeline Yong, MOH-accredited dermatologist and founder of Angeline Yong Dermatology in Singapore, she sees an average of two to three patients in her office per week in relation to contact dermatitis caused by mask wear.
Meanwhile, accredited dermatologist and medical director of TWL Specialist Skin & Laser Centre Dr. Teo Wan Lin contends that irritant contact dermatitis may also arise if you’re using skincare products for acne under your mask.
“Be mindful when using products such as acne creams that contain astringent ingredients such as retinoic acid, tea tree oil, salicylic acid, and even alpha hydroxy acids (AHAs),” she tells Daily Vanity.
“When such a product is applied onto the skin under occlusion, the absorption of these active ingredients is increased. This means that the irritation potential is then greater,” shares Dr. Teo. The affected area will usually be the part of your face that’s covered by your protective face covering, she adds.
Oh, and if you think that you are spared from contact dermatitis just because you haven’t had a reaction yet, think again. Dr. Gladys Teo, head of R&D at ést.lab, tells us, “It is possible that your skin’s immune system becomes weak, which may seem to have ‘suddenly’ caused your skin to experience dermatitis.”
Dr. Joyce Lim, accredited dermatologist and founder of Joyce Lim Skin & Laser Clinic, adds that those with an underlying sensitive skin are especially susceptible to developing this reaction after prolonged used of protective face coverings. Those who are taking medication for acne also face a higher risk of developing contact dermatitis at any time, even if the allergen hadn’t posed a problem in the past.
How to treat contact dermatitis caused by mask wear
In a different time, the easiest solution to this problem would be to discontinue using your face mask if you suspect that it’s the main culprit behind your newfound skin concern. Of course, that solution is practically impossible since the global pandemic is still ongoing and we’re still observing safe distancing rules in Singapore.
Dr. Tang, Dr. Yong, and Dr. Lim suggest sticking to cotton-based, dye-free masks if you’re dealing with irritant contact dermatitis.
Both Dr. Yong and Dr. Lim also recommend using a gentle hypoallergenic laundry detergent that’s fragrance-free to wash your reusable cloth mask. Additionally, Dr. Lim recommends to change out your mask if it has become damp with sweat and saliva.
If it’s not possible for you to wear a reusable mask, then it’s best to make sure that you’re prepping your skin the best way possible before putting on a synthetic mask. Dr. Lum, Dr. Yong, and Dr. Lim recommend using lightweight, soothing moisturisers that contain ingredients like ceramides to form a protective layer while restoring skin’s barrier and keeping the skin supple.
We like the ėst.lab ActivCalm Anti-Stress Hydra Cream (S$118), Derma Lab Hydraceutic Cera-Repair Cream (S$39.90), or the classic workhorse of a moisturiser – CeraVe Daily Moisturizing Lotion (S$24.18).
Additionally, Dr. Yong advises to skip products that may be drying or over-exfoliating if you have contact dermatitis. Dr. Lim also suggests going for masks that you can wrap around your head instead of those with elastic ear loops if you’ve noticed irritation around the ears.
If you still can’t seem to stem the rash, all the trusted experts we spoke to agree that you’d be wise to make an appointment with a dermatologist or doctor to properly determine the cause of your skin irritation.