Liječnički vjesnik (Feb 2022)
Skin changes caused by the use of personal protective equipment and disinfectants during the COVID-19 pandemic
Abstract
The use of personal protective equipment (PPE) and hand hygiene belong to essential preventive measures against the spread of the COVID-19 pandemic. Several professions, particularly health care workers, are exposed to prolonged contact with PPE, which may result in numerous skin changes, including new skin lesions and aggravations of the pre-existing skin diseases. Occlusive effects of protective masks, together with pressure and friction, may lead to the dryness of the facial skin and the appearance or flair-ups of preexisting acne (maskne). Frequent hand washing with soaps and detergents may result in both dryness of hands and irritant contact dermatitis since detergents and hot water represent the combination of mechanic and chemical irritants. Talcum powder in the gloves may have an additional irritative effect. Protective masks, goggles, and clothing impair the skin barrier due to their occlusive effect, leading to irritant contact dermatitis. Allergic contact dermatitis, which occurs less frequently than irritant contact dermatitis, is a delayed-type hypersensitivity reaction provoked by allergens present in PPE (particularly in masks and gloves) and disinfectants. Contact urticaria is a rare consequence of PPE, and the most common cause of contact urticaria is latex in protective gloves. Prolonged use of protective masks, goggles and face shields may also lead to mechanical injuries to the skin, which range from the mildest forms, such as skin redness and linear marks, to blisters, erosions and ulcerations. The results of up-todate studies concerning skin changes caused by PPE are presented in this review article.
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