How to Stop Skin Problems due to Wearing PPE

Getting breakouts or rashes from your masks and protective gear? How about dry, cracked hands or frizzy, dry hair from overwashing?

You’ve probably noticed that the recommendations on how to protect yourself from exposure to COVID-19 have been fluctuating for both healthcare workers and the general public over the past several weeks of this pandemic. Just breathing has become a potential occupational health hazard for those on the front lines.

It can be frustrating and confusing to figure out the “right” thing to do to protect ourselves, our loved ones, our neighbors, friends, colleagues, community, and our world.

It’s important to wear protective gear and take protective measures, but it isn’t doing our skin any favors. Many have experienced skin damage as a result of occupational safety. But I’m here to help you nurse your skin back to health.

Here’s what you need to know and what you need to do.

 

How can PPE harm your skin?

Your skin needs tender loving care sometimes. And in these crazy days, when you need to wear PPE for your community’s sake, your skin may be taking a beating from PPE.

PPE stands for personal protective equipment, used to prevent the spread of infectious diseases. This includes:

• Respirators
• Masks, face shields
• Gloves
• Goggles, or other eye protection
• etc.

This protective gear is known to trigger unwanted skin conditions, like:

• Pressure marks
• Chafing
• Pimples
• Papules
• Rashes
• Itchy skin
• Dry/cracked skin
• Abrasions
• etc.

Unfortunately, the use of PPE can also cause allergic reactions, such as contact dermatitis.

It is heartbreaking to see our first responders and medical providers dealing with work-related skin disease — showering Instagram with shots of their faces lined with red marks, blemishes, and indentations in their skin due to PPE.

It’s such a problem, the National Health Service in the UK issued guidelines to avoid skin damage while using PPE.

But never fear. There are simple solutions I want to share with you.

 

How to Treat and Prevent PPE Skin Problems

There are some easy methods to maintain skin health and treat PPE skin problems.

As a dermatologist, I wanted to share these recommendations on how we can keep our skin clear and healthy as we adjust to these new conditions.

NOTE: First things first — do what you can to protect yourself and others. Don’t skimp on your protection because of your skin reactions. We can work through those! 

And keep in mind, the common thread in all the recommendations is maintaining clean personal hygiene that protects the ways that viruses can enter our bodies. This includes:

• Keeping our hands clean by washing them more frequently
• Avoid touching our face, and protecting our nose, mouth and eyes by wearing masks and glasses, goggles, face masks etc
• Wearing caps to cover our hair and washing it when we come home
• Protecting our clothing and skin on our body by wearing protective gowns (for those in healthcare) and washing your clothes as soon as you return home and don’t forget to leave your shoes at the door. 
• And don’t forget to cover your nose and mouth when you are sneezing and coughing, even if you think it’s just your allergies and not COVID-19.
   

Face

The most common PPE skin problems are on the face — since that’s where we wear masks, respirators, etc. Facial skin irritation is a widespread problem right now among our medical professionals.

Here’s What Not To Do

Number one tip: don’t exfoliate. For now, at least.

Exfoliation is purposefully rough against your skin. Normally, exfoliation is great — it removes dead cells from your skin. But in these circumstances, it’s wise to avoid exfoliating because it can become an irritant in conjunction with uncomfortable PPE.

If you use retinoids, glycolics, or other exfoliating products, consider discontinuing them. You can always restart them later.

Avoid skin scrubs, as they are also exfoliating.

Consider putting down your electronic skin cleansing brushes (i.e., a Clarisonic brush) for the time being.

You also don’t want to rub or pick the flaky skin off — no matter how tempting it is! This prolongs the problem and can even cause new problems.

Here’s What To Do:

Wash your face with a gentle hydrating cleanser as soon as you take off your PPE.

Here are some great hydrating cleansers:

• CeraVe Hydrating Cleanser
• Aloe Herb Cleanser
• Mother Dirt Cleanser and Moisturizer 2-Pack

Pat dry, then apply a moisturizer. Depending on how irritated the skin is, you may need an emollient. If you are experiencing milder irritation, you can just use a lotion (made with water) or cream (made with oils).

REMINDER: An emollient is a thick moisturizer that softens your skin. It can be occlusive or greasy, but that’s alright for now.

Don’t know which moisturizer to choose? I have some favorites:

• Emollients:
  • Un-Petroleum Jelly
  • Organic Manuka Skin Soothing Creamy Balm
  • CeraVE Healing Ointment
  • Aquaphor Healing Ointment
• Lotions:
  • All Good Hand & Body Lotion
  • ACURE Moisture Lotion
  • Lipikar La Roche- Posay Body Lotion
• Creams:
  • TULA Probiotic Face Cream
  • Lipikar Balm AP+ La Roche-Posay Body Cream

Before putting on your PPE mask, you may want to apply moisturizer to the areas of your face where your mask typically rubs. Be careful this doesn’t loosen the mask’s seal to your skin. Ensuring that your mask fits properly to avoid leakages is key. So if you can’t pre-moisturize and maintain a seal, skip this step.

 

Hands

More people are washing their hands more often than probably ever before. With that comes some poor hand washing technique, which can lead to dry and/or cracked skin on your hands.

This is the proper way to wash your hands and maintain healthy skin (it looks a lot like the CDC recommendations, with an added skincare twist):

1. Wet your hands, then gently lather your hands with a high-quality soap.
2. Wash for 20 seconds with mild (not hot) soapy water. Don’t forget to get soapy water on your thumbs and under your fingernails!
3. Rinse well with extra focus between your fingers. Rinse the back of your hands as well. 
4. Pat your hands dry, then immediately apply moisturizer, even if you will be washing your hands again in a few minutes.

Get in the habit of always using a moisturizer after washing. You might be surprised how well it improves your hand skin. (The list of my favorite moisturizers is up just a few paragraphs.)

Consider using a thick emollient or cream before putting on gloves and before bed each night.

Finally, try to avoid or minimize the use of alcohol-based sanitizers/disinfectants unless you absolutely cannot wash your hands. These can dry out your hands and may interfere with the balance of good bacteria on your skin (called your skin microbiome).

 

Pimple Breakouts

You remember pimples, right? The annoying red raised bumps — sometimes with a white or yellow center. PPE can cause pimple breakouts underneath masks.

Here’s the skin-smart solution to PPE pimples:

First off, avoid touching or rubbing your acne or acne-prone skin. This has been shown to make things worse.

As soon as you can after you take off your mask, wash your face with a gentle foaming cleanser, such as these:

• CeraVe Foaming Cleanser
• Epionce Lytic Gel Cleanser

An acne wash may help, but be careful not to dry out your skin too much.

Pat dry and then apply a treatment formulated for acne prone skin. Here are some great over-the-counter options available on Amazon:

• La Roche-Posay Effaclar Duo
• ACURE Cleansing Stick
• Burt’s Bees Acne Solutions Cream
• Epionce Purifying Spot Gel

CBD oil is also known to treat acne, pimples, eczema, and psoriasis. CBD is anti-inflammatory and stops excess oil production that can lead to breakouts.

If you feel like you might need a prescription treatment, reach out to your local dermatologist for a telemedicine visit to see if they can prescribe a topical medication to help with breakouts. (Bonus points: Until the COVID-19 pandemic has subsided, HIPAA regulations on telehealth have been loosened. That means you can now schedule an online consultation with a dermatologist even if you’ve never been to one before!)

Moisturize with a non-comedogenic (which means “doesn’t block pores”) moisturizer after applying your treatment. Some examples of non-comedogenic moisturizers:

• CeraVe PM Face Moisturizing Lotion
• ACURE Mattifying Moisturizer
• TULA Oil-Free Gel Cream
• Epionce Renewal Lite Facial Lotion

Before you put your PPE mask on, put the acne-prone skin treatment on your nose, cheeks, and chin — where the mask will be covering your face.

You may want to pump the brakes on wearing moisturizers on areas covered by your mask. Wait until after you take the mask off.

 

Hair

We’re not just facing PPE skin problems. Our hair is suffering too. Whether it’s the caps we put over our hair or the tight hairdos we have to wear — it’s tempting to wash our hair out every night. But dry, tangled, frizzed out hair is a common result of overwashing.

Consider switching out your shampoo and conditioner for ones that are meant to moisturize. Temporarily avoid using dandruff shampoos.

Dry shampoo is usually okay once a week if you can wash it out later, but let’s also avoid dry shampoos under these circumstances since you probably want to wash your hair anyways.

Add a leave-in conditioner to your routine. Apply it after you get out of the shower. I suggest these leave-in conditioners:

• Innersense Sweet Spirit Leave-In Conditioner
• Sun Bum 3-in-1 Leave-In Conditioner

On your days at home, do a hair moisturizing treatment or a hair mask using argan oil, coconut oil, or even Innersense.

Minimize hair products that can dry out your hair, such as hairspray or gel.

Here are some clean hairsprays and gels that you may want to consider trying out if you feel like you still need to use them:

• Innersense Styling Gel
• Andalou Age Defying Hairspray
• Free & Clear Hair Styling Gel or Hairspray

You may also experience frontal scalp hair thinning from tight hairdos. The constant pull on your hair follicles from a tight hairdo loosens the anchoring components of your hair leading to hair loss. Many experts would suggest a child never wear a tight hairdo to prevent this process early on in life.

Over time, this hair loss can become permanent. So change your hairstyle now if you are starting to notice any thinning.

Get creative and employ looser updos to relieve that strain on your follicles. Use bobby pins, clips, or a light gel to hold loose hairs in place.

Avoid any updos (or, obviously, tight hairdos) while at home. As soon as you get home from work (or the grocery store), wash your hair then leave it loose.

 

Outlook

The coronavirus may stick around for another hot minute, but we don’t have to sacrifice our skin health while we employ protective measures.

With all of these PPE skin problems and hair issues, it may take several days or even weeks to see improvement. Be patient with yourself and your skin.

If you think you might need some prescription treatment or more individualized professional guidance, reach out to a dermatology professional and see if they are offering telemedicine office visit options (teledermatology).

For tips on how to make the most of your teledermatology visit, see my article here.

 

Sources

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