Some allergens that cause contact dermatitis are found in masks that prevent COVID-19

Throughout the course of the COVID-19 pandemic, those able to wear a face mask have been encouraged to do so to prevent transmission of the virus. For some people with skin allergies, wearing a mask can cause further problems. A medically challenging case presented at this year's virtual American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting revealed that for a man with several skin allergies, mask-wearing triggered his contact dermatitis.

"We treated a 60-year-old Black man with adult-onset eczema, contact dermatitis and chronic nasal allergies in our clinic after he presented three times to our hospital emergency room (ER) because of an uncomfortable face rash," says allergist Yashu Dhamija, MD, ACAAI member and lead author of the paper. "Up until April 2020, his skin conditions had been under control, but with mask-wearing, his symptoms began occurring in areas that providers were not yet accustomed to."

The ER doctors who first saw the patient prescribed prednisone for the rash. When his symptoms were not relieved, the patient underwent a follow up telehealth visit with the hospital's allergy clinic. Further investigation revealed his skin allergies had begun to flare in April 2020, coinciding with the pandemic and his mask-wearing.

"We realized that his rash appeared right where the elastic parts of a mask would rest," said allergist Kristin Schmidlin, MD, ACAAI member and co-author of the paper. "We tapered down the prednisone and advised him to use a topical steroid and a topical immunosuppressant until the rash resolved. We also told him to use cotton-based, dye-free masks without elastic. At a follow up telephone visit one week later, the patient said his rash continued to improve."

The authors note common allergens that can affect contact dermatitis are found in masks, elastic bands, and other components of face masks. People with existing skin allergies should work with their allergist. Your board-certified allergist can perform patch testing to help identify specific components in masks which may be triggering symptoms.