Case study: Allergens that cause common skin condition found in masks

  • A 60-year-old US patient experienced several skin allergies, which caused him to end up in the ER
  • Doctors found that his face masks, with elastic bands, were triggering his skin issues
  • After switching to cotton-based, dye-free masks, without elastic, his condition improved


Cloth face masks have been used as a key tool in the fight against SARS-CoV-2, the virus that causes Covid-19. However, one 60-year-old man ended up in the emergency room (ER) because of his mask. 

At this year’s virtual American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting, doctors delivered a report on the case.

"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," allergist Yashu Dhamija, MD, ACAAI member and lead author of the paper, said.

 "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."

Their report was published in the journal Annals of Allergy, Asthma & Immunology.

Skin allergies coincided with pandemic and mask-wearing

Contact dermatitis, Health24 explains, is an acute or chronic inflammation caused by skin contact with certain substances.

According to the report, the ER doctors who first saw the patient prescribed prednisone (a corticosteroid) for the rash.

When his symptoms didn't fade, he underwent a follow-up telehealth visit with the hospital's allergy clinic.

Doctors then discovered that his skin allergies had begun to flare up in April 2020, coinciding with the pandemic and his mask-wearing.

"We realised 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.”

Common allergens found in masks

Doctors also told the patient to use cotton-based, dye-free masks without elastic.

The patient had a follow-up telephone visit a week later, and his rash was reported to have improved.

The authors note common allergens that can affect contact dermatitis are found in masks, elastic bands, and other components of face masks.

They advise people with existing skin allergies to consult their allergist.

“Your board-certified allergist can perform patch testing to help identify specific components in masks which may be triggering symptoms,” they wrote.

READ | Researchers develop special cotton face mask that can be disinfected by the sun

READ | Face masks, yes, but don't forget hand-washing too

WATCH | Skip the 'maskne,' not the mask

Image: Getty/Kseniya Ovchinnikova

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