The reason why your face breaks out in a rash after you wear a mask amid the coronavirus pandemic might be because of the elastic in your facial covering.
A University of Cincinnati immunologist is recommending people who have contact eczema refrain from using face masks with elastic or rubber so they can avoid possible allergic reactions and stay safe during the ongoing outbreak.
Dr. Yashu Dhamija, a first-year fellow in the University of Cincinnati Division of Immunology, Allergy, and Rheumatology, presented the findings at the virtual American College of Allergy, Asthma and Immunology (ACAAI) scientific Nov.13 while discussing a medically challenging case, according to a news release.
Dhamija treated a patient who had contact dermatitis, also called contact eczema, which is a rash caused by a reaction to an allergen or irritant that’s come into contact. Contact eczema does not have an immediate bodily response.
“What makes contact dermatitis tricky is that it can be delayed so you may expose your skin to something and a reaction may not occur until days later,” Dhamija said. “Intermittent reactions can be tricky because you don’t know what the patient is exposing themselves to and the allergen could be at work or home.”
Helping patients manage the condition is imperative amid the pandemic since not wearing a mask puts them at risk of contracting the disease caused by the coronavirus, COVID-19.
“We definitely want our patients to use masks and apply social distancing," Dhamija said. "That’s a must. But they can avoid elastic components and use face masks that use the knot tie method around the back of the head to keep the masks up.”
In the case of Dhamija’s patient, he visited a hospital emergency room three times in the spring complaining of a facial rash and eyelid swelling. The patient was sent home with prednisone, a drug to treat skin diseases and severe allergies. One to two weeks later, he was seen via a telehealth appointment during where he said he’d had the rash for two weeks.
Dr. Kristin Schmidlin, an assistant professor in the UC Division of Immunology, Allergy, and Rheumatology and co-author of the abstract at ACAAI, said doctors noticed the rash happened on the areas where the elastic portions of the face mask rested.
In addition to using a steroid that aids in lessening inflammation and is commonly used in treating mouth sores, doctors reduced the amount of prednisone and advised the patient to use an elestic-free, dye-free cotton-based face mask, Schmidlin said. She said that after the patient used the cloth face mask, he reported his symptoms improved a week later.
“Instead of using elastics in a facial mask, I would modify it and use cotton-based knot ties around the back of the head to hold the mask in place,” Dhamija said. “We also advise patients to call companies that make facial masks to find out what’s in the product if labeling does not contain enough details.”
“There are immune reactions to allergens that can be life-threatening but when it comes to contact dermatitis, it doesn’t escalate that far," he continued. "We can quickly identify the allergen and stop the offending agent. But, some cases can be severe. Treatment usually means avoiding the agent or we can use a topical or oral steroid if needed. It depends on how severe the reaction is and how much of the body is affected. We also take into account how it is impacting the patient’s life or ability to work, for example.”
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