Healthcare Workers Are Getting Scars From Their Face Masks

Photo: Getty Images.
The image went viral: a young woman, looking frankly at her phone as she takes a mirror selfie. She's wearing scrubs, and there are angry red bruises pressed into a half-moon below each eye, on the bridge of her nose, and on her forehead. The widely circulated caption is in Italian; it explains that the poster is a nurse, and her injuries were caused by the face mask she has to wear to protect her own health while she does her job during the coronavirus pandemic.
"I'm physically tired because the protective equipment hurts, the gown makes me sweat and once I'm dressed I can't go to the bathroom or drink for six hours," the caption reads. "I am psychologically tired, and so are all my colleagues who have been in the same condition as me for weeks, but this will not prevent us from doing our job as we have always done."
The N95 face masks that are worn by healthcare workers who are in close contact with COVID-19 patients are air-tight. They have to be, since the virus is easily transmittable, and travels in tiny respiratory droplets that can quickly make their way into your eyes, nose, and mouth and infect you with the virus. But the seal a mask creates can be painful, and lead to irritation and bruising, especially since doctors and nurses are wearing the masks for hours at a time.
"Generally, frictional forces caused by medical devices (or other objects in contact with skin) distort cells and tissues, resulting in sustained shear that leads to skin and subdermal tissue damage," according to an article in Wound Management & Prevention.
"The problem is pressure for duration. You have something on your face for your whole shift, and that can be anywhere from eight to 12 hours," says Shannon Sovndal, MD, an EMS medical director in Boulder, Colorado and the author of Fragile
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I broke down and cried today. I cried of exhaustion, of defeat. Because after 4 years of being an ER nurse, I suddenly feel like I know nothing. Because my face hurts after wearing an N95 for 13 fucking hours, which happens to be the same N95 I wore yesterday for 12.5 hours, and the same one from all last week. I don’t know how many times I’ve heard the statement “but this is what you signed up for”. Just, no. I signed up to take care of sick patients, yes. I did not sign up to be unprotected by their sickness (although my hospital is busting their asses to try to protect us). I did not sign up to be yelled at by angry patients because our government failed to be prepared. I did not sign up to risk mine and my family’s health and safety because people wanted to go on their vacations after they said NOT to. An ER nurse in New York died today of COVID-19. He was in his 40s and had very mild asthma. That’s it. This is not just a tall tale, this is the real risk. I have to go into every patient’s room and in the back of my mind I think “this could be the patient that gets me sick... that kills me”. “This could be the patient that gives me the virus I bring home to my children or asthmatic husband”. This is my new reality. But this is only the beginning. We haven’t even scratched the surface of the impact of what this illness is going to make on our country. And I’m scared.

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"Two months ago, I would put an N95 on for maybe five minutes at a time," Dr. Sovndal explains. "I would go into one patient's room and put on my N95, and then... I would just take it off. And if I had to go back into that room again, say 45 minutes later, I'd just grab a new mask."
Of course, this was before COVID-19 became a global pandemic, and healthcare facilities were facing life-threatening shortages of personal protective equipment (known as PPE). Now, workers are wearing masks for much longer.
"The problem here is that we have a limited supply, and we're assuming everyone has an infection when you're going into their room. Because of that, you just have to put it on and live with it," Dr. Sovndal says. "This is totally atypical from normal operating procedures... You're wearing a mask for eight hours a day. If you're wearing an N95 mask for an extended period of time it's going to be uncomfortable and you're going to get those spots," he says.
Healthcare workers across the world are sharing their own images of their bruised faces, along with pleas for people to follow hygiene and social distancing recommendations. Flattening the curve of COVID-19 is the best way to reduce the burden we're placing on local hospitals and protect our healthcare workers. You can also support hospitals and healthcare workers by pushing for more PPEs and donating any you have on hand. And if you know a doctor or nurse personally, they may welcome one of these gifts.

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