Facial dermatoses due to increased use of masks in medical students during COVID-19 pandemic: A cross sectional study from JSMU

ABSTRACT

Objective To determine the frequency of skin manifestations associated with prolonged mask wearing during the course of ongoing COVID-19 pandemic. Methods A cross-sectional study was conducted at Jinnah Sindh Medical University (JSMU), Karachi. A total of 138 medical students, who gave history of wearing masks were enrolled. The demographic data including age, gender, and their year of education was collected. A total of 20 questions were asked related to the type of mask, duration of wearing mask, associated and underlying skin disorders, etc. All information was carefully recorded on Google forms. Results This study included 138 participants, 124 (89.9%) females and 14 (10.1%) males. The type of masks used by the medical students varied, however 84.8% used surgical masks. The average duration of mask wear was 4 hours for 72.4% of the participants. There was no significant relation between skin changes and the type and duration of mask wear. The common skin manifestations reported in this study were itching (24.6 %), redness (27.5%), rash (10.1%), burning sensation (12.3%), acne (24.6%), pimples (37.7%), pigmentation (8.7), cracked skin (1.4%), scaling of skin (2.9%), and 29.7% reported no changes. The most frequently affected locations were cheeks (41.3%), followed by chin (13.8%), nasal bridge (10.1%) and perioral area (8%). Participants with history of atopic dermatitis were affected slightly more by itching, redness, rash, burning sensation, acne than those without a history of atopic dermatitis however these manifestations had no significant relation (p>0.05). Pressure bruises were reported in 23.9% of the participants and there was no significant relation with the skin manifestations. About 33% of the females who use makeup under the mask found it inconvenient due to pimples and itching. (p<0.05). Relationship between different skin types and use of cleansers for maintaining skin hygiene generally (p=0.006) and after taking mask off is significant (p=0.034). Significant relation exists between people experiencing pimples after taking off masks and using oral/systemic drugs (p=0.003), and other products (ice cubes, day cream, steroids, skincare regime) for management (p=0.012). Significant relation exists between acne after taking off mask and use of topical drugs (p=0.034). Conclusion The increase in skin manifestations is associated with the increased use of face masks during the COVID 19 pandemic among medical students. As mask wearing can't be compromised due to the nature of the working environment, certain guidelines need to be established to prevent or reduce the occurrence of such manifestations.