Preventing Skin Irritation from Wearing PPE

Preventing Skin Irritation from Wearing PPE

One issue we may face in the COVID-19 era is the use of personal protective equipment (PPE) — masks, gloves, face shields, and gowns — often for several hours a day, for months or even years at a time.

This isn't a concern only for healthcare workers; anyone who needs to wear a mask or other PPE for several hours a day can experience growing impacts on their health, particularly on their skin.

A 2021 study of healthcare workers in Hubei, China found that 69% experienced injuries on the bridge of their nose from wearing N95 masks, and 28% experienced facial itching. It was also found that 56% experienced dry skin from wearing latex gloves, and wearing a full PPE gown caused 36% to experience dry skin and 34% to experience itching.

Another study in China by the Journal of the American Academy of Dermatology found that 97% of staff reported PPE-related skin damage. Incidents increased when PPE was worn continuously for more than six hours.

The US nursing education website Nurseslabs offers eight tips to help avoid PPE-related skin damage.

1. Keep the Skin Moisturized with Lotion

Wash the face and neck with soap and water after removing PPE. Pat dry with a towel and apply a lightweight, good-quality lotion.

Before wearing PPE, apply lotion and allow enough time for it to absorb into the skin first — about half an hour. For the hands, for example, dry them thoroughly after washing and apply lotion before putting on gloves. After removing gloves, wash hands with soap, then apply lotion again.

2. Make Sure the Mask Fits Properly

A mask that doesn't fit or isn't worn correctly is a common cause of skin problems. Make sure the mask sits comfortably on the face and isn't too tight or too loose.

If wearing a double mask, put each one on separately. And replace the mask as soon as it becomes very uncomfortable — for example, if it becomes wet, smelly, or dirty.

3. Release Pressure Points on the Skin as Often as Possible

Remove masks, glasses, or face shields at least once every four hours, and more often if possible, to relieve pressure points on the skin. Removing pressure from the skin for a few minutes allows for more normal blood flow to the area and helps prevent skin damage.

4. Use a Barrier Cream

If PPE will be worn for an extended period, apply a barrier cream. This is especially important if there is already some skin damage, such as bruising or prolonged redness.

Barrier cream contains long-lasting ingredients that protect the skin from friction. It can be applied to the areas of the face most exposed to PPE friction. After applying, allow the skin to dry for about one minute before putting on PPE.

5. Use Bandage Material if Needed

Moisture-absorbing bandage or gauze material can be used between the skin and areas that are under pressure or friction from PPE. Bandage or gauze can be cut to fit as needed to protect the face.

6. Protect the Ears

Mask straps hooked behind the ears can irritate the skin behind them. An alternative is to tie the mask straps to a hat or behind the head. However, make sure not to pull the mask too tight, which would increase pressure on the face. Masks tied behind the head generally offer the best solution for avoiding irritation.

7. Keep the Body Temperature from Getting Too Hot

"Intertriginous dermatitis" is a red, itchy rash that can be caused by wearing a PPE gown for extended periods, due to moisture trapped in skin folds. To prevent this condition, dry the skin carefully after bathing and avoid tight clothing. Use baby powder on sensitive body areas to help keep them dry.

8. Stay Hydrated

Because wearing PPE makes the body warmer, don't forget to drink plenty of water, especially while working, to prevent dehydration.

References

• Yuan, X.Q., et al. Online survey on healthcare skin reactions for wearing medical-grade protective equipment against COVID-19 in Hubei Province, China. PlosOne Journal. April 29, 2021. journals.plos.org
• Paton, F. 8 Tips to Avoid Skin Damage While Wearing PPE. Nurseslabs. August 20, 2021. nurseslabs.com

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