Intended for healthcare professionals

Letters Skin damage from FFP3 masks

British Society for Cutaneous Allergy advice on skin damage from FFP3 masks

BMJ 2020; 369 doi: (Published 09 June 2020) Cite this as: BMJ 2020;369:m2268
  1. Deirdre Buckley, president,
  2. Natalie Stone, secretary
  3. on behalf of the British Society for Cutaneous Allergy Committee
  1. British Society for Cutaneous Allergy, London W1T 5HQ, UK
  1. drdabuckley{at}

Payne writes of the cutaneous lesions arising in healthcare workers wearing FFP3 masks, including erosions of the nasal bridge and cheeks.1 A recent survey of 542 frontline medical staff treating patients with covid-19 in Hubei Province, China, identified identical mask related symptoms of the face or hand dermatitis in 97%.2

The British Society for Cutaneous Allergy is carrying out a multicentre audit of personal protective equipment (PPE) related skin problems in the UK, which confirms nasal erythema and erosions to be frequent in workers wearing FFP3 masks.

Pressure effects seem to be the main cause of facial lesions, with length of time wearing the mask the strongest risk factor identified so far. Published guidance recommends limiting the time wearing FFP3 type masks to two hours. Our preliminary data indicate that staff on average wear the masks for much longer.

Payne suggests using a strip of hydrocolloid dressing on the nasal bridge under the mask. We agree that this might help reduce cutaneous pressure effects but warn of potential impairment of the mask seal. Re-fit testing is recommended if hydrocolloid dressings are used. The strip should also be applied at the identical site each time, and any emollients should be applied at least 30 minutes before donning PPE.

Both NHS England 3 and the British Society for Cutaneous Allergy4 have produced guidance for clinical staff affected by these issues.


  • Competing interests: None declared

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