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SURGICAL, N95 & CLOTH MASKS: Allergen or Not An Allergen?

Allergen

Surgical & Protective Masks

This is a slightly complicated answer. These masks have materials and substances that are top contact allergens. It is interesting that, while most protective masks contain several allergens, and although many healthcare workers experience contact dermatitis, there are very few case reports on contact dermatitis due to surgical masks. Because of the presence of multiple allergens, we are classifying these masks as allergens. Because these masks are so important for doctors and health workers (and certain patients) to protect themselves and others from infection, they should be used. For the purposes of this post, we will not be discussing the various protection levels of each type of mask and will focus on the contact allergenicity of their materials.

Masks have garters and sometimes foam or sponges, all of which contain rubber, a top allergen, and latex (which makes up the large majority of natural rubber). Some of these materials are also dyed different colors.

Typical disposable surgical masks (also called dental or medical procedure masks) can sometimes cause irritations due to bleaches, dyes, or antiseptics in the lining coming into contact with the lips or nose. If the allergens are in the outer lining, heat or perspiration may enable them to cross over and come into contact with the skin. Surgical masks and N95 masks may also contain formaldehyde (of the few case reports of mask contact dermatitis, some were to the formaldehyde present in certain N95 masks) and dibromodicyanobutane, a known contact allergen.

Cloth masks, while less protective, could be safer for skin if they’re pure, white or untreated cotton. Most, however, have been bleached or preserved. Colored cloth masks have also probably been dyed. And many use elasticized fabrics which could contain rubber

If your patch test shows that you are allergic to these materials but you need to use a protective mask, try putting a barrier like an untreated cotton cloth between the mask and your skin.

If you have a history of sensitive skin, don’t guess: random trial and error can cause more damage. Ask your dermatologist about a patch test.

To shop our selection of hypoallergenic products, visit vmvhypoallergenics.com. Need help? Ask us in the comments section below, or for more privacy (such as when asking us to customize recommendations for you based on your patch test results) contact us by email, or drop us a private message on Facebook.

For more:

On the prevalence of skin allergies, see Skin Allergies Are More Common Than Ever and One In Four Is Allergic to Common Skin Care And Cosmetic Ingredients.

To learn more about the VH-Rating System and hypoallergenicity, click here.

Main References: 

Regularly published reports on the most common allergens by the North American Contact Dermatitis Group and European Surveillance System on Contact Allergies (based on over 28,000 patch test results, combined), plus other studies. Remember, we are all individuals — just because an ingredient is not on the most common allergen lists does not mean you cannot be sensitive to it, or that it will not become an allergen. These references, being based on so many patch test results, are a good basis but it is always best to get a patch test yourself.

1. Warshaw, E.M., Maibach, H.I., Taylor, J.S., et al. North American contact dermatitis group patch test results: 2011-2012. Dermatitis. 2015; 26: 49-59

2. W Uter et al. The European Baseline Series in 10 European Countries, 2005/2006–Results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis 61 (1), 31-38.7 2009

3. Wetter, DA et al. Results of patch testing to personal care product allergens in a standard series and a supplemental cosmetic series: An analysis of 945 patients from the Mayo Clinic Contact Dermatitis Group, 2000-2007. J Am Acad Dermatol. 2010 Nov;63(5):789-98.

4. Verallo-Rowell VM. The validated hypoallergenic cosmetics rating system: its 30-year evolution and effect on the prevalence of cosmetic reactions. Dermatitis 2011 Apr; 22(2):80-97

5. Ruby Pawankar et al. World Health Organization. White Book on Allergy 2011-2012 Executive Summary.

6. Misery L et al. Sensitive skin in the American population: prevalence, clinical data, and role of the dermatologist. Int J Dermatol. 2011 Aug;50(8):961-7.

7. Warshaw EM1, Maibach HI, Taylor JS, Sasseville D, DeKoven JG, Zirwas MJ, Fransway AF, Mathias CG, Zug KA, DeLeo VA, Fowler JF Jr, Marks JG, Pratt MD, Storrs FJ, Belsito DV. North American contact dermatitis group patch test results: 2011-2012.Dermatitis. 2015 Jan-Feb;26(1):49-59.

8. Warshaw, E et al. Allergic patch test reactions associated with cosmetics: Retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2004. J AmAcadDermatol 2009;60:23-38. 

9. Foliaki S et al. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. J Allergy Clin Immunol. 2009 Nov;124(5):982-9.

10. Kei EF et al. Role of the gut microbiota in defining human health. Expert Rev Anti Infect Ther. 2010 Apr; 8(4): 435–454.

11. Thavagnanam S et al. A meta-analysis of the association between Caesarean section and childhood asthma. Clin Exp Allergy. 2008;38(4):629–633.

12. Marks JG, Belsito DV, DeLeo VA, et al. North American Contact Dermatitis Group patch-test results, 1998 to 2000. Am J Contact Dermat. 2003;14(2):59-62.

13. Warshaw EM, Belsito DV, Taylor JS, et al. North American Contact Dermatitis Group patch test results: 2009 to 2010. Dermatitis. 2013;24(2):50-99.

14. Al Badri, Faisal. (2017). Surgical mask contact dermatitis and epidemiology of contact dermatitis in healthcare workers. Current Allergy and Clinical Immunology. 30. 183-188. 

Want more great information on contact dermatitis? Check out the American Contact Dermatitis SocietyDermnet New Zealand, and your country’s contact dermatitis association.


DrVR LVB 8rDF Bertotto8106e 5May2014 20191023Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’s founding dermatologist-dermatopathologist. She has two children, Madison and Gavin, and works at VMV with her sister CC and husband Juan Pablo (Madison and Gavin frequently volunteer their “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)

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