Intended for healthcare professionals

Letters Skin damage from FFP3 masks

Covid-19: virtual occupational skin health clinics for healthcare workers

BMJ 2020; 369 doi: (Published 18 June 2020) Cite this as: BMJ 2020;369:m2281
  1. Mahbub M Chowdhury, consultant dermatologist1,
  2. Nicola Bevan, head2,
  3. Karen Ryan, nurse team leader3
  1. 1Welsh Institute of Dermatology, University Hospital of Wales, Cardiff CF14 4XW, UK
  2. 2Employee Health and Wellbeing Services, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
  3. 3Occupational Health Department, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
  1. mmu.chowdhury{at}

Collaborative working is a key feature of remote team working during the covid-19 pandemic. Occupational health nurses and the dermatology team have worked together closely for many years in Cardiff. With corporate executive level support, we quickly set up a covid-19 occupational virtual skin clinic “seeing” up to 10 patients a week. This service has been advertised in the CEO’s daily updates, staff Connect apps, and covid-19 branded posters.

Occupational health nurses screen healthcare workers to advise self-care measures or refer persistent moderate to severe skin disease to dermatology for a virtual telephone consultation. A central administration email account can receive clinical photographs securely reviewed by the dermatologist.

The health board is supplying free emollients on wards for healthcare workers using a central ward based ordering system. Patient named prescriptions are being delivered by hand to healthcare workers on site or faxed directly to the pharmacy for dispensing. All prescriptions are free in Wales. Follow-up is either direct with dermatology, with occupational health, or proposed future skin allergy patch tests or skin prick testing for latex allergy.

To date, we have screened over 45 healthcare workers and enabled the majority to self-manage their skin problems related to FFP3 masks or other personal protective equipment with occupational health nursing or medical support. The full impact for redeployment of healthcare workers will be clearer in the next few months.

Most skin problems seen to date are pre-existing hand dermatitis exacerbations, facial rashes, nasal bridge erosions as described previously,1234 and odd eyelid swellings related to fluid resistant surgical masks possibly due to immediate latex allergy.

These prospective data are being fed into a multicentre data collection exercise with the British Society for Cutaneous Allergy and show the benefits of virtual occupational skin health clinics during the current pandemic.


  • Competing interests: None declared

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