Short-term skin reactions following use of N95 respirators and medical masks

Contact Dermatitis. 2020 Aug;83(2):115-121. doi: 10.1111/cod.13601. Epub 2020 Jun 8.


Background: In the context of the COVID-19 pandemic, cases of adverse skin reactions related to the wearing of masks have been observed.

Objectives: To analyze the short-term effects of N95 respirators and medical masks, respectively, on skin physiological properties and to report adverse skin reactions caused by the protective equipment.

Methods: This study used a randomized crossover design with repeated measurements. Twenty healthy Chinese volunteers were recruited. Skin parameters were measured on areas covered by the respective masks and on uncovered skin 2 and 4 hours after donning, and 0.5 and 1 hour after removing the masks, including skin hydration, transepidermal water loss (TEWL), erythema, pH, and sebum secretion. Adverse reactions were clinically assessed, and perceived discomfort and non-compliance measured.

Results: Skin hydration, TEWL, and pH increased significantly with wearing the protective equipment. Erythema values increased from baseline. Sebum secretion increased both on the covered and uncovered skin with equipment-wearing. There was no significant difference in physiological values between the two types of equipment. More adverse reactions were reported following a N95 mask use than the use of a medical mask, with a higher score of discomfort and non-compliance.

Conclusions: This study demonstrates that skin biophysical characters change as a result of wearing a mask or respirator. N95 respirators were associated with more skin reactions than medical masks.

Keywords: adverse skin reaction, N95 respirator, medical mask, skin biophysical property.

MeSH terms

  • Adult
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections*
  • Erythema / etiology*
  • Facial Dermatoses / etiology*
  • Female
  • Healthy Volunteers
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Masks / adverse effects*
  • Middle Aged
  • Pain / etiology*
  • Pandemics*
  • Pneumonia, Viral*
  • Pruritus / etiology*
  • Respiratory Protective Devices / adverse effects*
  • SARS-CoV-2
  • Sebum
  • Skin*
  • Young Adult