Ask the doctor: Is my reusable mask causing the red rash around my lips and are disposable ones the answer? – Independent.ie

Q: Im a woman in my late 50s and I keep getting a red rash around my lips that is sore, a little itchy and unsightly. Every couple of days it appears to start getting better, but then gets worse again. Someone suggested that it might be something to do with wearing a mask and recommended that I start using disposable masks rather than the cotton masks which I generally wear. I started doing this but it still hasnt gone away. Are there any creams I could use?

Dr Grant replies: Rash is always difficult to describe and diagnose without actually seeing it. I bet your doctor would have a good idea what type of rash you are suffering from just by looking at it and asking a few simple questions. You could be suffering from perioral dermatitis (POD) which is described as a symmetrical rash with multiple small (1 to 2 mm) lesions, in clusters of slightly red raised papules that may, or may not have some fluid, pus, or mild scales.

Burning or stinging sensation is common and there is a notable absence of acne. Occasionally there is a mild eczema in the underlying skin. It can occur in all age groups but is most commonly seen in women between 16 and 45. The reason why it develops is unknown although there are many potential contributing factors such as topical corticosteroids use, skin moisturisers and cosmetic products, fluctuations in normal skin flora and hormones, and oral contraceptive use. POD is benign and can even resolve spontaneously in some people.

You said your rash is a little itchy and this makes me think of allergic contact dermatitis. This rash may look similar to POD (red and scales) but with a prominent yellow scale and is usually accompanied by an intense itch. Common allergens include latex materials, protective equipment, soap, cleansers, resins, acrylics, metals (especially nickel), fragrances and topical antibiotics.

Lastly, there is a small possibility of a bacterial or fungal skin infection as the cause for your rash. Bacterial skin infections tend to have erosions, small water or pus filled vesicles, and often a superficial yellow crusting. Initial management of POD is called zero therapy and means you need to stop using all topical skin care products and cosmetics. You may wash your face with a soap substitute like aqueous cream.

If you have been using any mild topical corticosteroids on the rash you are best advised to stop. It is unclear what role topical corticosteroids play as they are capable of inducing POD or they may exacerbate pre-existing POD.

You need to keep wearing the disposable face masks to help reduce the transmission of Covid. Cotton masks are more breathable but disposable 3PLY face masks are preferred in the fight against Covid as they offer 98pc bacterial filtration efficiency. If after eight weeks there is little or no improvement then topical antibiotic therapy should be commenced and evaluated after another four to eight weeks.

Sometimes a topical medication called tacrolimus, which is used in the treatment of moderate to severe eczema, may be tried. The addition of oral antibiotic is generally the next phase of treatment. Once POD has fully cleared up, it is safe to re-introduce gentle skin cleansers and moisturisers. Be careful to start back using only one topical cosmetic product per week.

Dr Jennifer Grant is a GP with Beacon HealthCheck

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Ask the doctor: Is my reusable mask causing the red rash around my lips and are disposable ones the answer? - Independent.ie