Background: Due to the public health risk associated with SARS-CoV-2 (COVID-19) infection, universal use of face masks has been recommended to protect against viral spread. Adverse facial reactions from the utilization of masks in the general public are poorly characterized in literature.
Objective: We aimed to provide a systematic review of studies reporting adverse facial reactions associated with use of face masks during the COVID-19 pandemic.
Methods: PubMed and Cochrane databases were searched using the following search terms: "masks" AND "skin reactions, facial dermatosis, rash, acne, atopic dermatitis, rosacea, OR seborrheic dermatitis."
Methods: A total of 954 cases of dermatological adverse effects were reported. Over 17 different adverse facial reactions were found, including the top 10 in order: itch (370, 38.8%), indentation/ear pain (102, 10.7%), discomfort (90, 9.4%), erythema (72, 7.5%), dryness (62, 6.5%), rash (60, 6.3%), scarring (42, 4.4%), desquamation (22, 2.3%), pain (19, 2.0%), burning (19, 2.0%), and wheals (7, 0.7%). Face masks can increase acne (n=44), rosacea (n=14), and seborrheic dermatitis (n=9).
Limitations: Publication bias of articles, with limited studies available regarding this topic.
Conclusion: Wearing face masks to protect from COVID-19 can increase adverse facial dermatoses and exacerbate underlying dermatology conditions; however, several preventative measures may be taken.
Keywords: COVID-19; N95; acne; atopic dermatitis; facial dermatosis; rosacea; seborrheic dermatitis; viral infections.
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