Thursday, 30 April 2020 10:32

The PPE Treatment Plan

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The COVID-19 pandemic has rapidly changed how  the world population lives, works, and learns. In hospitals around the world, doctors, nurses, and other healthcare workers are fighting an enemy that has already killed more than 100,000 people. Medical workers who are called upon to assist or treat those with COVID-19 experience physical strain of protective equipment such as dehydration, heat, and exhaustion, as well as physical isolation. Many individuals were absolutely distressed and heartbroken to see photos on social media of these everyday heroes with bruised faces after prolonged mask wear.


In those medical workers working around-the-clock with COVID-19 patients, face masks, eyewear, facial hoods, and other personal protective equipment (PPE)  have resulted in red, sore, irritated skin,  bruising and abrasions, and even irritant contact dermatitis. Kinesiology tape manufacturers have stepped up quickly to bring a new form of protective tape to the market. This type of tape is designed to adhere like a “second skin” that is comfortable, breathable, and provides an excellent barrier between the user’s skin and their mask, eyewear, and other personal protective equipment. While the tape can be placed just about anywhere on the skin to protect against  irritation, the most common application uses three strips shaped in a triangle, one across the nose and the other two at either end running down towards the chin to protect from face mask pressure. The gel-like, acrylic adhesive on the strip maintains a seal on the skin without irritation and can be removed painlessly.


The nasal bridge is a problem area, as the mask and the eyewear both sit on it. Mask wearers have been most likely to develop acne followed by itch, rash, post-inflammatory hyperpigmentation and scarring at the bridge of the nose. The type of acne that forms under masks is a special type of acne - acne mechanica. The biggest difference between acne mechanica and acne vulgaris is the cause,  while common acne has hormonal roots, the cause of acne mechanica is completely physical and it boils down to one word –  friction. Anything that traps heat against the body for a prolonged period, rubs or puts pressure on the skin (such as an N95 mask and eyewear) can trigger acne mechanica. Personal protective equipment traps and holds heat and sweat against the skin, causing the pores to become blocked. With continued rubbing, the pores become irritated and those tiny blemishes morph into larger, red pimples. Occlusion of the hair follicles and a warm sweaty environment predisposes to acne flares – this same scenario may also occur under the protective suits as back acne.


To treat acne, it is recommended to wash the face as soon as possible or at the end of the shift with a slightly drying, glycolic acid cleanser. A salicylic acid wash should be used in the areas affected by acne and a topical salicylic-based spot treatment applied only on the blemishes before bedtime. After this nighttime routine, a non-comedogenic, peptide-based moisturizer should be applied to protect the skin and promote healing.


For those healthcare workers that have developed bruising and abrasions, there are several ways to restore and mend the skin. Skin lesions with cuts and bruises require a corneotherapy centric approach – repairing, nourishing the barrier, restoring the skin’s homeostasis, and regenerating the tissues. After removing all personal protective equipment, at the end of the shift, it is recommended to cleanse the face with a gentle cleanser and then layer peptide products from thinnest consistency to thickest – think water-based peptide serum followed by a light, fragrance-free peptide cream. Those with bruising or abrasions from personal protective equipment need to completely avoid any harsh exfoliation, salicylates, or retinoids because their skin is already sensitive. For bruising, the recommendation is to use creams and gels with arnica and vitamin K ingredients, both of which reduce bruising and inflammation.


One of the best ways to treat bruises, pain, and inflammation is with multi-wave LED technology. The correct type of equipment to treat inflammation is a device with a wavelength falling within 630 nanometers red to 660 nanometers red and 850 nanometers infrared, to 940 nanometers. These wavelengths have been proven to help diminish bruising and subdue localized pain. It is recommended to use a handheld LED for three to five minutes per area, or a whole face panel for 20 minutes at a one to two inch distance from the face.

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