Moisturizers and Cleansers in the Management of Skin Conditions Caused by Personal Protective Equipment and Frequent Handwashing

Sara Mirali, PhD; Patrick Fleming, MD, MSc, FRCPC, FCDA; Charles W. Lynde, MD, FRCPC, DABD


Skin Therapy Letter. 2021;26(4):9-13. 

In This Article

PPE-related Dermatitis

Atopic dermatitis (AD) and irritant contact dermatitis (ICD) are common types of eczema that are characterized by pruritus, eczematous lesions, xerosis, and lichenification. AD is a chronic relapsing inflammatory skin condition that often develops at a young age, while ICD is caused by direct contact of the skin with environmental, chemical, or physical agents that disrupt the epidermal barrier.[5,6] AD and ICD can be exacerbated or caused by wearing PPE for long periods of time.[2,3]

Prolonged usage of PPE can also exacerbate or cause acne vulgaris.[7,8] The tight seal and humid environment created by masks, particularly N95s, aggravates acne (also known colloquially as maskne). This is likely because pressure on the skin can rupture comedones and block pilosebaceous ducts. Moreover, the humid microclimate within the mask is ideal for bacterial growth and prevents filaggrin (FLG) breakdown, which contributes to skin barrier disruption.[8,9] In addition to AD and acne, masks can exacerbate other inflammatory skin disorders, such as rosacea and perioral dermatitis.[7,8]