Masks 101: How they work, design options, etiquette and skincare

BY CAITLIN HEANEY WEST AND GIA MAZUR

Most people probably thought that, by now, we wouldn’t need to wear masks anymore.

With the coronavirus pandemic not going away any time soon, though, a simple walk to work or trip to the grocery store continues to require this extra precaution. And as Halloween nears, trick-or-treaters likely won’t be the only ones masking up.

But just how well do you know how to wear that mask or why officials continue to recommend them to help stop the spread of COVID-19?

Welcome to Masks 101.

 

How they work

With COVID-19 able to infect people through respiratory droplets in the air, masks worn over the nose and mouth provide “source control,” according to the Centers for Disease Control and Prevention. Since the coronavirus mostly spreads among people in close contact with each other — that’s that 6 feet you keep hearing about — masks are particularly important to wear when social distancing isn’t always possible.

“Masks are recommended as a simple barrier to help prevent respiratory droplets from traveling into the air and onto other people when the person wearing the mask coughs, sneezes, talks or raises their voice,” the CDC explained on its website.

Face masks aren’t a substitute for social distancing, but using masks and other precautions together can help slow the coronavirus’ spread, according to Mayo Clinic News Network.

“Countries that required face masks, testing, isolation and social distancing early in the pandemic seem to have had some success slowing the disease’s spread,” the Mayo Clinic explained.

The CDC recommend the widespread use of cloth face coverings over the nose and mouth “to help prevent transmission of COVID-19 by people who have the virus but don’t know it.” People should wear them when in public around people they don’t live with and when social distancing is not easy. They should not put their masks around their neck or on their foreheads, the CDC noted.

Two infectious disease specialists recently proposed a theory showing that even if the virus does sneak through a mask — since the type of mask determines its filtering capacity, and certain ones may not block every droplet — people might get less sick than if they’d had no mask on at all, the Mercury News reported.

“Masks cut down the amount of viral particles flying around — so if you’re infected, you’ll get a lower dose and less severe symptoms,” said Dr. George Rutherford of UC San Francisco, whose paper with Dr. Monica Gandhi was recently published in the New England Journal of Medicine.

This reduced exposure to the coronavirus could affect how sick someone gets. If fewer infected droplets enter a person’s body, then the immune system has a smaller number of viral particles to fight before they start multiplying, the newspaper explained.

 

What’s the difference?

Cloth masks work well for the average person who doesn’t work in health care and are for sale at most retailers, can easily be homemade, and are washable and reusable. The CDC has posted directions for making no-sew masks from T-shirts and bandannas on its website. Cloth masks should have multiple layers of fabric to be effective, according to the Mayo Clinic.

Health care providers, meanwhile, use disposable surgical and N95 masks. A loose-fitting disposable mask, the surgical/medical mask filters large particles in the air and “protects the wearer’s nose and mouth from contact with droplets, splashes and sprays that may contain germs,” according to the Mayo Clinic. It also prevents saliva or other bodily fluids from the wearer from getting out.

N95 masks, meanwhile, are designed to stop 95% of very small particles, hence the name. They actually are a kind of respirator and offer more protection than surgical masks by filtering out large and small particles, according to the Mayo Clinic. Professor Manhar Dhanak of Florida Atlantic University noted that N95 masks don’t always fit snugly on some people, though, which can impact their effectiveness.

“How well it fits on your face is so important,” he told the Sun Sentinel. “They can leak from the sides or in gaps.”

For the best fit, the top of the mask should sit close to the bridge of your nose with the bottom under your chin, according to health care company Kaiser Permanente. Then, tighten the loops around your ears so the masks fits snugly with no gaps.

 

Other options

Of course, not everyone can wear a mask. The Mayo Clinic recommended not putting them on anyone under age 2 or who has trouble breathing, is unconscious or can’t remove the mask without help.

Those looking for other types of protection have turned to neck gaiters (a fabric tube that encircles the neck and can be pulled over the wearer’s face as a mask or pulled down like a scarf) or plastic face shields. However, two new studies from Florida Atlantic University showed that gaiters, shields and masks with valves were not so effective in slowing the spread of coronavirus particles, the Sun Sentinel reported.

The studies showed that bandannas, folded cotton handkerchiefs, two-layer cotton masks, a surgical-grade mask and an N95 mask reduced the distance droplets traveled from a person’s mouth by several feet.

“Plastic face shields stopped large droplets but allowed small particles to bolt from under the barrier and around its sides,” the newspaper reported. “Neck gaiters also were found not to be a good roadblock.”

While a recent Duke University study of fleece neck gaiters made from a polyester and spandex blend showed the covering was not effective in blocking coronavirus droplets, other types of gaiters were not tested. And the New York Times reported that “the study’s authors said their data had been misconstrued.”

“Our intent was not to say this mask doesn’t work, or never use neck gaiters,” said Martin Fischer, an associate research professor at Duke and a co-author of the study. “This was not the main part of the paper.”

The CDC does not recommend wearing masks with exhalation valves or vents because those allow the virus to escape from the person wearing the mask.

 

Designs vary

Over the last several months, crafters gobbled up fabric and elastic and took to their sewing machines — suddenly in short supply — to make their own masks, often donating them to people in need or selling them in their communities. Major retailers also sell reusable and disposable masks in a variety of sizes and styles, such as with favorite Disney characters, colors and sports teams.

Some masks go beyond just basic cloth, though. Masks featuring clear plastic over the mouth have come out to help people who need to read lips when communicating, and face masks with zippers let the wearer eat and drink without removing the entire mask.

Under Armour’s SportsMask, a face mask for athletes, sold out in less than an hour when it debuted in June. Additional SportsMasks in new colors are now available for pre-order and are expected to ship by Sept. 28, PennLive reported. The $30, water-resistant masks come in four sizes, have an adjustable nose bridge and offer 50+ UPF sun protection. They have three layers: a light spacer fabric with air pockets; an open-cell, breathable foam layer; and the stretchy “Iso-Chill,” which feels cool against the skin and ears and “has an anti-microbial treatment.”

 

Take care

Remember to take care of yourself and your masks. Try not to touch your mask while you have it on, but if you do, wash or sanitize your hands afterward. The Mayo Clinic recommends removing masks by untying them or lifting them by the ear loops so you don’t touch the front of the masks or your face. Once you have your mask off, immediately wash your hands.

Many businesses, schools and other spots require face masks, and those who haven’t complied have faced the consequences, from being barred from entering stores to losing their places in school. To prevent COVID’s spread, some colleges planned to monitor student behavior via social media, check security footage of students gathering in large groups and even kicked out students who violated policies. Penn State suspended fraternity Pi Kappa Alpha and its student leaders after the group held an event with 70 people last month.

KidsHealth.org recommends teaching children to move away from anyone not wearing a mask in public. If someone you know doesn’t want to wear a mask and confronts you about yours, the website offers several suggestions:

• Acknowledge what the person dislikes about masks and “use empathy to make a case for everyone ‘being in this together.’”
• Discuss how covering noses and mouths protects others, particularly people who are more at risk of getting sick.
• Keep the discussion friendly but firm, perhaps by suggesting to continue the conversation at a distance or over email.
• Keeping clean masks on hand to offer to give to others who don’t have any.
• If the person still refuses to wear a mask, tell him or her you hope to see each other again after the pandemic ends.

If you encounter a stranger who isn’t wearing a mask, KidsHealth.org suggests these tips:

• If in a store, find a security guard or employee to talk to the customers without masks. For employees without masks or who are wearing them improperly, ask them to correct the situation; share your concerns with a manager or owner if the worker does not comply.
• Do not threaten the people, shame them or bully them to try to get them to wear a face covering.
• Politely ask someone without a mask to stand back; leave the premises if he or she refuses or if you can’t stay 6 feet apart.
• Contact a manager or the business owner if store masking policies don’t seem strong.
• Be prepared to leave the property if you feel uncomfortable.
• Talk to your children after any confrontations, noting that “that this is new territory for everyone. Someone who reacts badly might be missing loved ones, have lost their job or be stressed about something that’s not related to wearing a mask. Reassure your kids that in most cases, these reactions aren’t personal.”

 

Protect your skin

Don’t ignore your skin under that mask, either. Kara Rempe, a certified physician assistant at Lackawanna Valley Dermatology, said the most common skin issues right now include everything from breakouts and irritation to bruising and abrasions thanks to wearing masks and face coverings.

To combat this, cleanse and moisturize before and after wearing a mask, using gentle products since harsh ingredients will only add to irritation and inflammation. For breakouts or “maskne,” Rempe recommended salicylic acid (a beta hydroxy acid that can be found in cleansers, wipes and pads, gels or lotions) as an effective yet gentle option. Products with gentle ingredients such as niacinamide and azelaic acid will help decrease inflammation, heal breakouts and also fade leftover discoloration. Also, skip face makeup under masks.

Beards aren’t much dirtier than clean-shaven skin, but men still should care for beards by cleansing and brushing them regularly. If you use an oil or wax to tame your beard, make sure to wash your fabric mask frequently to avoid buildup on it. This also is a good tip for anyone to keep skin clear.

Wash your mask regularly using soap and water in a washing machine. Yes, you can wash it with other laundry, but make sure to use fragrance-free laundry detergent and avoid fabric softener, which can cause skin irritation.

If you experience more intense skin care concerns from using personal protective equipment, apply barrier cream such as Desitin or CeraVe Healing Ointment twice a day after moisturizing and prior to wearing masks to combat chafing, bruising and lesions.

While you may skip lipstick for the time being, invest in a good lip balm or mask to keep your lips hydrated and healthy and to protect them from chapping or chafing under masks.