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• W4384664191 abstract "Skin damage in relation with mask wearing, especially but not solely among healthcare workers, is considered a “pandemic within a pandemic.”1 The China Dermatologist Association has initiated a “national residents' scientific skincare habits survey in post-COVID-19 era” (1) to investigate the impact of lifestyle changes caused by the pandemic in terms of facial skin problems, that is, cutaneous signs and symptoms, due to mask wearing for a long time, and (2) to analyze Chinese residents' facial cleansing and moisturizing habits. The survey, conducted in 34 provinces in China through the Internet, used a questionnaire including 28 questions pertaining to previous and current skin condition, types of masks and daily continuous wearing habits, impacts of mask wearing, and facial cleansing/moisturizing habits. A total of 9258 participants responded, and 6641 were validated. These respondents were mostly aged 18–40 years (82.8%), the majority were females (82%). A vast majority (92.3%) used to wear surgical masks. Average mask wearing durations per day of 2, 2–4, 4–8, 8, and >8 h were reported by 47.9%, 25.6%, 17.5%, 4.8%, and 4.2% respondents, respectively. Mask replacement frequency was essentially (56.5%) once/day. Pre-epidemic skin disorders included sensitive skin, acne, seborrheic dermatitis, and allergy. A total of 26.6% respondents considered that their skin status had worsened compared to the pre-epidemic period, for example, aggravation of signs and symptoms such as erythema/edema/itching in subjects with sensitive skin, of acne pustules/drying/desquamation/indentation/oily skin in subjects with non-sensitive skin. Information is not available regarding skin care habits before and after the pandemics. The relationship between mask type and facial skin problems was explored. Compared with cotton masks, after adjusting for confounding factors, surgical and sponge masks were associated with a 2.40-times and a 3.06-times increase in odds of facial skin problems, respectively. Taking either surgical masks or N-95 masks as a reference, the effect size of the other on facial skin problems was not significant (see Data S1). The Cochran-Armitage test for trend showed a positive correlation between increased mask wearing duration and the advent of facial skin problems including acne/comedones, redness/telangiectasis, itching/pain, and dryness/xerosis (Figure 1): Taking 2 h of daily wear as reference and after adjusting for age, gender, region, hours of sleep, face-washing method, and face-washing frequency, mask wearing over 8 h/day was associated with a 1.51-times increase in odds of worse skin condition. Whereas local tolerance symptoms associated with mask wearing were described predominantly for facial skin, Figure 2 shows that there were also reports of nasal and respiratory and of ocular symptoms, all being positively correlated with mask wearing duration: There was no relationship between frequency of mask replacement and severity of facial skin problems or sensitive symptoms. The analysis of facial cleansing/moisturizing habits revealed that increasing the cleansing frequency (>once/day) is associated with worsening of skin condition. Applying a moisturizing product has a beneficial effect, a cream being more effective than a lotion or spray water. It may be inferred that improving the skin status with a suitable moisturizer may also be of potential help in the treatment of associated skin disorders. In conclusion, signs and symptoms reported in this survey are in line with those described in the literature, which include dryness/tightness and desquamation,1-4 burning sensation,4 or erythema,2 their prevalence being higher in subjects with chronic skin disease.5 Most commonly affected areas are the hands, cheeks, and nasal bridge.1-3 Both hospital surveys and literature reviews confirm that duration of protective equipment's wearing is the most common risk factor.1, 3 The present survey also shows that mask wearing duration is positively correlated with skin, ocular and respiratory problems. Of note, the new term MASKNE indicates a form of mechanical acne resulting from continuous textile–skin adherence and friction, modifying skin microbiota and sebum production.6 Overall, this survey shows that mask wearing duration and increased facial cleaning can lead to skin deterioration, thus raising the need for a specific description of the corresponding preventive or countermeasures (see Data S1). Xuan Wang: Conceptualization – Investigation; Lijun Liu: Formal analysis; Huan Yang: Investigation; Delphine Kerob: Supervision; Xianghua Zhang: Supervision; Zhongxing Zhang: Supervision; Zhenfeng Liu: Supervision; Bin Yang: Conceptualization - Supervision. We thank La Roche-Posay Pharmaceutical Laboratories for their support in this study. The data that support the findings of this study are available from the corresponding author upon reasonable request. Data S1: Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article." @default.
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• W4384664191 date "2023-07-19" @default.
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• W4384664191 title "A survey of the impact of the <scp>COVID</scp>‐19 epidemic on the skin condition and skin care habits of Chinese residents" @default.
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• W4384664191 doi "https://doi.org/10.1111/jocd.15807" @default.
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