Elastic-free face masks can help some with allergies stay safe during COVID-19

A University of Cincinnati immunologist recommends that people with contact dermatitis choose face masks made without elastic or rubber that allow them to stay safe amidst COVID-19 while avoiding possible allergic reactions.

Yashu Dhamija, MD, a first-year member of the UC Division of Immunology, Allergy, and Rheumatology, presented his findings in an abstract while discussing a clinically challenging case at the American College of Allergy, Asthma and Immunology (ACAAI) virtual science meeting held from 13 to 15 November.

“How do you help patients manage a condition that puts them at risk for something like COVID-19?” Dhamija asked. “We absolutely want our patients to use masks and apply social distancing. This is a must. But they can avoid elastic components and use face masks that use the knot method around the back of the head to keep the masks up.”

Dhamija treated a patient who was diagnosed with contact dermatitis, a reaction to allergens that touch or come into contact with the skin. It is different from allergies to things like dog or cat hair because with contact dermatitis the body’s response is not immediate. “

“What makes contact dermatitis difficult is that it can be delayed in order to expose the skin to something and a reaction may not occur until a few days later,” Dhamija said. “Intermittent reactions can be complicated because you don’t know what the patient is exposed to and the allergen could be at work or at home.”

Contact dermatitis can affect up to 6% of the US population.

The case report Dhamija discussed in front of the ACAAI involved a patient who visited a hospital emergency room three times during the spring with complaints of a rash on his face and swelling of the eyelids. The patient was sent home with prednisone and was seen a week or two later during a telemedicine appointment during which he reported that the rash had been going on for two weeks.

Doctors realized that the rash occurred where the elastic parts of her face mask would rest, explains Kristin Schmidlin, MD, assistant professor in the UC Division of Immunology, Allergy and Rheumatology and co-author of the abstract. at the ACAAI.

Schmidlin said doctors have reduced the amount of prednisone and recommended the use of topical triamcinolone, a steroid that helps reduce inflammation and is commonly used in the treatment of canker sores. He said the patient was also advised to use a cotton-based, dye-free mask with no elastic.

The patient was able to find a cloth mask and reported symptom improvement a week later, Schmidlin said.

The Centers for Disease Control and Prevention offer some guidelines for making masks at home and this is a starting point for people with contact dermatitis.

“Instead of using the rubber bands in a face mask, I would modify it and use cotton-based knots around the back of the head to hold the mask in place,” says Dhamija. “We also advise patients to call the companies that make face masks to find out what’s in the product if the labeling doesn’t contain enough detail.”

“There are immune reactions to allergens that can be life-threatening, but when it comes to contact dermatitis, it doesn’t escalate that far. We can quickly identify the allergen and stop the offending agent. But some cases can be serious.” , Dhamija said. “Treatment usually means avoiding the agent or we can use a topical or oral steroid if needed. It depends on how severe the reaction is and how much of the body is affected. We also take into account how it affects the patient’s life or ability to work , for example. “

“The patch test is a tool we use to detect contact dermatitis,” said Dhamija. “It’s good to talk to your primary care physician or ask for a referral to an allergist if in doubt. The patch test involves placing a compound that we suspect is a problem for your skin. Please come back a few days later and see if there is a reaction. “

Dhamija said that there is an abundant literature documenting patients with contact dermatitis due to allergens such as rubber bands in FFP2 masks, N95 respirators, neoprene rubber masks, and medical masks containing formaldehyde or rubber components that use carbamates or thiurams.

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