Before COVID-19, as Yashu Dhamija describes it, when a patient presented with an itchy, painful allergic reason known as contact dermatitis, doctors had to “put on their detective hats” to identify the cause. Contact dermatitis can result from allergens in detergents, skin-care products, and more, and a doctor and patient often work together to find the irritating culprit. But mid-pandemic, when the rash appears in telltale areas of the face, it’s often clear where the blame lies: protective face coverings.
Dhamija, a physician in the department of immunology, allergy, and rheumatology at University of Cincinnati College of Medicine, is the lead author on a case report that details the story of one patient who developed contact dermatitis shortly after he began wearing a mask to prevent COVID-19. “Rash distribution correlated with the elastic-containing components of a non-surgical mask,” the report reads. The anonymous patient is just one of the many people — both front-line workers and not — who have suffered with skin concerns as a result of their face coverings. In extreme cases, contact dermatitis can become quite irritated and open.
“We wanted to send the message that providers may encounter a new wave of facial rashes due to face masks,” Dhamija tells me of publishing the case.
The “new wave” is cresting in allergists’ offices, dermatologist telemedicine visits, and texts to friends in medical school — and just because you haven’t had a reaction yet doesn’t mean that you never will. According to Dhamija, we can develop contact dermatitis at any time, even if the allergen hadn’t posed a problem in the past.
What is it about face masks?
“Contact dermatitis is a diagnosis where the body’s immune system has developed a hypersensitivity to an allergen,” Dhamija explains. (Think of the rash that pops up after exposure to poison ivy, for example.) Many face masks are made of synthetic materials, any of which could theoretically cause contact dermatitis upon wear.
According to New York City-based board-certified dermatologist Kavita Mariwalla, contact dermatitis is the most troublesome of all the newfound skin concerns (like maskne) caused by our new, masked-up reality. “The cause may be the material the mask is made of, what people are washing their masks with, the elastic straps, or even the metal nose clip,” she says. “Each reaction manifests differently.”
How to treat contact dermatitis
If you suspect your face mask is causing contact dermatitis, the easiest solution is to discontinue using it. Due to the ongoing pandemic, however, that isn’t entirely possible.