Mask induced dermatoses during COVID‐19 pandemic: A questionnaire‐based study in 12 hospitals of Korea

Choi, S.Y.; Hong, J.Y.; Kim, H.J.; Lee, G.‐Y.; Hyun, C.S.; Jung, H.J.; Bang, C.H.; Lee, D.H.; Jue, M.‐S.; Kim, H.O.; Park, E.J.; Ko, J.Y.; Son, S.W.

BACKGROUND: During coronavirus disease 2019 (COVID‐19) pandemic, various adverse skin reactions to long‐term mask wearing have been reported. OBJECTIVE: We aimed to assess the clinical features of mask‐induced dermatoses and recommend prevention and treatment options. METHODS: From April to August 2020, questionnaires including preexisting skin disorders, patients’ reported mask‐related symptoms, their daily mask wearing duration and frequency, types of masks used, whether they are health care workers, and demographic information were distributed to patients of 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis, and recorded treatment modalities. RESULTS: Itchiness was the most frequent symptom, mostly affecting the cheeks. Most common skin disease was new‐onset contact dermatitis (33.94%), followed by new‐onset acne (16.97%) and aggravation of preexisting acne (16.97%). Daily wearing (p=0.018) was significantly associated with new‐onset contact dermatitis. More than half of the patients with preexisting skin problems experienced aggravation while wearing masks. Longer duration (more than 6 hours/day, p=0.043) and cotton masks (p<0.001) significantly increased acne flare‐up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical agents. LIMITATIONS: Effect of seasonal characteristics and other risk factors were not assessed. The patients were visiting dermatologic clinics and had interest in their skin status. Thus, a selection bias may exist. CONCLUSION: Mask‐induced/triggered dermatoses contribute to increase the dermatological burden during pandemic.