1. Problems with masks common in critical care staff and are limiting working during #COVID19 epidemic. Skin problems affected about a third of staff in previous SARS epidemic in Asia. My thoughts on preventing and treating this... @NHSEngland @PHE_uk @HealthySkin4All

2. Mostly it seems be an irritant contact dermatitis secondary to repeated minor friction over 4 hours plus of mask use with associated sweating, skin masceration with probably bacterial suprainfection causing skin inflammation, itch, tenderness, exudation and erosions. +bruising

3. Occurs over nasal bridge and overlying infraorbital maxilla. Suggestions: FIRST Apply thin layer of paraffin-based emollient to these areas prior to mask and at mask change which should be airtight, lubricating and protect barrier (eg Doublebase or Doublebase Dayleve gel).

4. SECOND After shift wash face with antimicrobial moosturiser e.g. Dermol cream then apply further as leave on antimicrobial emollient

5. THIRD For persistent sore/ red weeping areas apply steroid antimicrobial combination e.g. Trimovate cream (moderate corticosteroid, nystatin, neomycin thinly once a day) before bed.

5. For significantly sore areas of broken or weeping skin use Fucibet in place of Trimovate twice daily for no more than 48 hours. NB vital to check appropriate mask fit following test emollient application. (Pictures are from news sources)