To determine the incidence and site of any adverse effects of wearing face masks via an online questionnaire.

Healthcare workers in a dental hospital who wear Respiratory Protective Equipment (RPE) with various frequencies were invited to participate. An online questionnaire was used to identify adverse effects as a result of wearing face masks and possible remedies.

Red marks (72.1%) and indentations (66.7%) were the most frequently reported with increased use of the RPE. The bridge of the nose and cheeks were the most frequently reported sites of facial skin problems, such as blanching (54.1% and 42.2%. respectively) and pressure damage (42.3% and 24.3%, respectively). Overall perceived facial skin health deteriorated strongly and significantly (P < 0.001) following the use of RPE, where the mean skin health score (0 = best possible skin health and 10 = worst possible skin health) increased from 2.68 to 4.76. Broadly, there was increased discomfort with increased hours of use of RPE per day (P = 0.049). 71% of participants said that they generally felt safe or very safe using RPE.

The facial skin health of respondents deteriorated strongly after the use of RPE. Guidelines for using RPE should be made clearer. A greater range of face mask sizes or bespoke masks should be made available to improve the fit and wearability, as well as to reduce the frequency and incidence of surface skin problems.

This study has identified the factors influencing adverse skin reactions from face mask use, which can be used to inform face mask designers and manufacturers to improve the fit and wearability of face masks.