Beauty Clinic: Solving an A&E doctor's mask-wearing challenges

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Q. I’m a hospital doctor [above*] working 13-hour shifts in A&E and for the last four months, I’ve been wearing facemasks and occasionally full face coverings. My skin is now spotty, congested and dry in places, plus it’s sore round the edges of the mask. I’ve had an infection near my nostrils where the mask sits, probably because I was sweating, the mask was chafing against my skin and there are lots of bugs hanging round in A&E. Antibiotics worked but I don't want to keep taking them. Any advice would be appreciated!

A. Firstly, we’d like to say that, like everyone UK-wide, we appreciate what you are doing. Secondly, your problem is a common one for health workers nowadays. Dr. Sophie Shotter, a qualified anaesthetist who now works as an expert in aesthetics, returned to the Red Zone in her old hospital when the pandemic was at its height. She says: ‘Be assured you’re not alone - these sorts of skin problems have been commonplace amongst healthcare workers over the last few months, and there are definitely some solutions.’ 

The first issue is, as you’ve experienced, the mask rubbing against the skin, which is particularly an issue with tighter-fitting masks. ‘This abrasion can cause sensitisation and even a condition called “acne mechanica” – breakouts in areas affected by friction,’ Dr. Shotter says. ‘The other main problem is that the area under the mask becomes a microclimate - you breathe out hot humid air, which is trapped against the skin. This can cause problems for the skin barrier and also creates a perfect breeding ground for bacteria,’ she explains.

Dr. Shotter’s advice is to ‘tread carefully – don't start using any overly aggressive products formulated for acne as they could very well cause a problem for skin with an already sensitised barrier’.

This gentle regime should help, she says:

• ‘Cleanse with a gentle product; I love the NeoStrata Restore Facial Cleanser/£31 for 200 ml. It’s very hydrating and skin barrier friendly, while being deeply effective. Cetaphil Gentle Skin Cleanser/£8.99 for 236 ml, is a good budget option.  

• ‘Spritz your face with Clinisept+ spray/£15.90 for 250 ml, from their Prep & Procedure range; this incredible product kills over 99.9% of bacteria, viruses, fungi and spores (down to an exclusive stabilised hypochlorous technology). It will decrease the microbial load on your skin and help to minimise breakouts. It’s also an excellent anti-inflammatory.

• 'Throughout the day, spritz your face with the Clinisept+ whenever you remove your PPE. When I returned to the NHS, this never left my pocket and I sprayed my face, neck and hands with it regularly. It will not only help your skin, but will also kill any stray Covid-19 particles.'

• ‘Use a hydrating serum with hyaluronic acid. Neostrata Tri-Therapy Lifting Serum/£74.99 for 30 ml, will hydrate and also very gently exfoliate your skin, which will help to minimise breakouts. Or try La Roche Posay Hyalu B5 Serum/£38 for 30 ml. (We would add in Garden of Wisdom Hyaluronic Acid Serum/£10 for 30ml.)

• ‘Wearing foundation under the hot moist mask forms the perfect breeding ground for bugs. Either skip it completely, or use Oxygenetix Acne Control Foundation SPF25/£45 for 15 ml; this anti-inflammatory treatment foundation contains salicylic acid and is clinically proven to treat acne; it is transfer resistant, water resistant  and comes in seven shades suitable for a range of skin types.

• ‘Use pimple patches at night; Zitsticka Killa Kit/£26.99, contains 8 soaked CLEANA swabs to prime the spot and eight microdart KILLA patches.  Tiny micro darts in the clear-coloured patches deliver active ingredients into the spot to help decrease inflammation overnight. They’re great when surrounding skin is sensitised or dry, as you’re targeting the ingredients at the problem area.’

*Dr Aneesa Hussain, Northwick Park Hospital