Doctors and nurses on the front lines of the COVID-19 coronavirus crisis are spending many hours a day wearing face masks, and many members of the general public are doing the same. But although the devices offer invaluable protection, they can be the cause of significant skin damage through sweating and the rubbing of the masks against the nose.
Skincare experts at the University of Huddersfield are warning about the risks – and are suggesting remedies.
WHAT'S THE IMPACT?
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Professor Karen Ousey is the university's director of the Institute of Skin Integrity and Infection Prevention, and was part of a team that conducted detailed research into the pressure damage caused by a wide range of medical devices, including face masks. The findings and recommendations were published in February.
Now, the current emergency emphasizes the problems that can arise when healthcare professionals wear face masks for long periods.
After so many hours wearing this form of personal protective equipment, the wearers begin to sweat underneath their masks, causing friction. This leads to pressure damage on the nose and cheeks, and can result in tears to the skin – opening up the possibility of infection, one more health worry facing healthcare professionals as they continually expose themselves to infected patients.
What complicates the picture is that the masks healthcare professionals wear have to be fitted to the face. This means that adding dressings to the skin or under the mask increases the chance the mask will not fit correctly and adds to the likelihood of contracting COVID-19 from a patient.
Ousey suggests people wearing masks keep their skin clean, well-hydrated and moisturized, and apply barrier creams at least half an hour before they put masks on. The pressure from the masks should also be relieved about every two hours or so, preferably in a safe space away from patients.
THE LARGER TREND
More than one-third of healthcare workers were contaminated with multi-drug-resistant organisms, or MDRO, after caring for patients colonized or infected with such bacteria, according to a recent study in Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
The study found that 39% of workers made errors in removing PPE, including gowns and gloves, thus increasing the incidence of contamination.
The results suggest a need to reevaluate strategies for removing PPE, as well as the frequency with which staff are trained on those methods. A simple education-based intervention may help reduce contamination with MDRO.
Meanwhile, the simple act of acquiring PPE has become burdensome, and equipment shortages are one component of a toxic cycle of coronavirus-related challenges including insufficient tests, slow results and a dearth of ventilators for the highest-need patients.
These various challenges are playing off of each other and exacerbating the situation through a kind of domino effect, according to a report from the U.S. Department of Health and Human Services' Office of the Inspector General.