‘Commonly found’ allergens exist in some face masks
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Patients with skin allergies who wear certain types of face masks may experience adverse events, according to a presenter at this year’s virtual American College of Allergy, Asthma and Immunology Annual Scientific Meeting.
“There are multiple case reports and series that describe [allergic reactions in] patients with contact dermatitis due to formaldehyde and elastic components of masks such as carbamate and thiuram,” Yashu Dhamija, MD, an allergy and immunology fellow at the University of Cincinnati and an internal medicine resident at Akron General Hospital, told Healio Primary Care.
These materials are “commonly found in surgical and nonsurgical face masks,” he added.
Dhamija and colleagues presented a case report of a 60-year-old Black man with chronic allergic rhinitis and contact dermatitis stemming from textile dyes, carba and thiuram. The patient used emollient to control his adult-onset atopic dermatitis. In April, he presented to an Ohio ED three times with a rash and was prescribed prednisone. Subsequent telehealth visits with the staff at an allergy clinic indicated the patient’s rash persisted for 2 weeks and that the only allergens he had been exposed to came via the textile dyes, carba and thiuram within the nonsurgical mask he wore to protect against COVID-19.
According to Dhamija and colleagues, the allergy clinic staff provided the man with tapered prednisone to avoid rebound dermatitis, advised him to use topical steroid and topical tacrolimus until the rash resolved and instructed him to use cotton-based, dye-free masks that did not contain elastic. The researchers added that since the man switched to a mask that met this criteria his dermatitis symptoms have improved and he has not needed another allergy clinic appointment.
“Health care providers should know that contact dermatitis can occur due to sensitizations to many products such as body care products or chemicals that patients are exposed to at work,” Dhamija said. “Patients experiencing issues with face masks should be evaluated by an allergist or dermatologist. Patch testing is a clinical tool that can be used for diagnosing delayed hypersensitivities in these patients.”
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Cherie Zachary, MD
The connection between allergy and health disparities is a big issue, but one that is not as high on the radar as it should be. So, when I see research such as Dhamija and colleagues, I am hopeful it will shine more light to what has become a really important issue in the world of medicine.
I would hope that those who read Dhamija and colleagues’ report realize that the problem they describe affects a lot of different patients and therefore, we, as clinicians, need to have our antenna up with regard to quality-of-life issues for all patients with allergy, especially those who are members of socially disadvantaged groups.
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Stanley Fineman, MD, MBA, FACAAI
The findings of Dhamija and colleagues are probably more frequent than we think. I have seen several patients who have had the same complications in terms of contact dermatitis that stem from wearing a mask and we will continue to see cases like this.
The particular patient in this case report sounds like he already had patch testing and was documented to have a sensitivity to ingredients like rubber. A lot of people do not realize that there is rubber in elastic. Therefore, specialists may want to consider recommending cotton-based masks for their patients who are similar to the one in this case report.
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