A few adjustments may be all it takes to help you keep your mask on and your COVID guard up.
We all have to wear face masks these days to help reduce the spread of COVID-19. But wearing a mask can be uncomfortable. The fix may just be a matter of trying a different type of mask (see "What to look for in a cloth mask").
Here are some common mask complaints and ways to resolve them.
What to look for in a cloth face mask
Cloth masks come in many styles and fabrics. One of the most comfortable types is a neck gaiter, a fabric tube placed around your neck that you can pull up and down. But gaiters perform very poorly on tests to block viral particles.
The most effective cloth masks are about the size of your hand and have straps that tie behind your head or loop around your ears.
Some of these masks have a curved vertical seam in the center, to make the mask bow out and give you room to breathe. Others have multiple horizontal folds that enable you to adjust the fit up or down easily. The construction you choose can affect your comfort; that preference will be specific to each individual.
What should be the same for all cloth masks, according to the World Health Organiza-tion, is that they have three layers. The first layer (closest to your mouth and nose) should be made of cotton or another moisture-wicking fabric to absorb droplets from your exhaled breath. The middle layer should be made of polypropylene fabric (a nonwoven material, the kind used in surgical masks) or a removable polypropylene filter. The outer layer should be made of a fabric that will repel moisture, such as polyester or a polyester-cotton blend.
If you overheat easily in a mask, look for inner and outer layers of tightly woven, lightweight, high-tech fabrics that can help keep you cool. Some sporting goods companies are selling these types of masks. Some mask makers claim their fabrics have anti-microbial properties, but there's no evidence they can protect you against COVID-19. Above all, make sure a mask covers your mouth and nose, with no gaps on the sides.
It makes breathing seem harder
Wearing a mask sometimes causes a sensation of uncomfortable breathing or shortness of breath, called dyspnea, especially during exercise. "Pulling air through the mask — which has some resistance to air flow — can require a small increase in the effort it takes to breathe, and you may notice it," explains Dr. Richard Schwartzstein, a dyspnea specialist and chief of the Pulmonary, Critical Care and Sleep Medicine Division at Harvard-affiliated Beth Israel Deaconess Medical Center.
What you can do. "The best strategy is to breathe at a slower rate to decrease the resistance against the mask. Try exhaling with pursed lips. Or if you're walking, decrease the pace to lower the demand on your lungs," advises Dr. Bartolome Celli, a pulmonologist with Harvard-affiliated Brigham and -Women's Hospital.
What about ditching the mask and wearing a face shield instead? "Shields are not replacements for cloth masks worn in the community. If you're infected, a cloth mask may help stop the spread of infection from you to others. Cloth masks may also protect against exposure to virus in respiratory secretions, but more studies are needed given the variety of cloth masks in use," explains Dr. Erica Shenoy, associate chief of the Infection Control Unit at Harvard-affiliated Massachusetts General Hospital. "But if you're unable to wear a mask, talk to your doctor before switching to a face shield. If it's your only option, the CDC recommends wearing a shield that wraps around the sides of your face and below the chin, and that you stay physically distanced from others."
It makes you feel claustrophobic
Having a snug mask on top of your face may make you feel anxious and even trigger claustrophobia (a fear of being in confined spaces). "Sometimes when we are anxious, we breathe more rapidly to get more oxygen into the blood, and our heart beats more rapidly. It's merely our body's alarm system performing its evolutionary job," points out Abby Altman, an associate psychologist at Brigham and Women's Hospital.
What you can do. First, know that you're not in danger. "There is no evidence that wearing a fabric face covering will change the oxygen or carbon dioxide levels in your blood or harm your lungs," Dr. Schwartzstein says.
Next, focus on breathing: take slow, deep breaths, which can help relieve anxiety. "And practice wearing your mask as much as you can," Altman suggests. "Anxiety can be significantly reduced by facing your fear and staying with the discomfort until you grow more comfortable." Many health professionals have needed to wear masks all the time they are at work, for the first time in their lives, but have grown used to it.
It irritates the skin
"Facial rashes or breakouts from mask wearing are common," says Dr. Jason Frangos, a dermatologist at Brigham and Women's Hospital.
He points to several potential causes. "Masks can trap oils, irritants, and allergens against the skin and block hair follicles and glands, causing pimples. In other cases, some people have a form of dandruff that affects the face called seborrheic dermatitis. This is a red, scaly rash that may be worsened by heat and humidity that builds up beneath the mask."
What you can do. Wash cloth masks regularly. "You should also wash your face regularly and consider an over-the-counter acne wash that contains salicylic acid to help unclog pores. For seborrheic dermatitis, wash your hair daily with an anti-dandruff shampoo and keep oil off the face with a gentle cleanser," Dr. Frangos suggests.
The straps hurt your ears
A mask's ear loops can make your ears sore. Elastic straps pull on your ears and put pressure on your skin, which can become irritated.
What you can do. "For irritated skin, a steroid cream and moisturizer can help," Dr. Frangos says.
There are also gadgets that can relieve pressure on your ears. One is an "ear saver," a strap or clip that attaches to the ear loops and is worn behind the head. Make your own version by threading shoelace through the ear loops and tying it behind your head. You can also find headbands and ball caps with large buttons placed so you can hook the mask ear loops onto them.
Other options are masks with fabric ear loops, which may cut down on irritation, and masks with fabric straps that you tie behind your head instead of loops you place around your ears.
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