What to do if the mask leaves marks on the face and causes skin irritation

Last Updated on March 30, 2021

CPAP therapy involves sleeping with a mask on a regular basis. It is not always easy to get used to a foreign object on the face. But some patients face additional problems: in the places where the contour of the mask and its fixation straps fit, in the morning the skin looks “wrinkled”, there are irritation, redness and inflammation.

Looking for a Solution

Skin redness and traces from the mask are not uncommon problems for patients during the adaptation period to CPAP therapy. However, after a couple of weeks of using the device the skin gets used to the new external irritant, the normalization of breathing during sleep leads to the disappearance of morning face swelling and everything passes by itself. Unfortunately, not everyone is that lucky, and the owners of problematic, sensitive skin have a hard time. Let’s understand what factors can provoke this side effect and what to do if you face this problem.

The mask is not suitable for the type of

Everyone’s face shape is different. Therefore, it is not always possible to make the mask fit all over equally tightly, not letting air in, but at the same time not squeezing the skin unnecessarily. The smaller the surface area of the product, the easier to adjust the fixation straps and the lower the possibility of red marks in the morning.

To improve the tightness of the mask and at the same time to reduce pressure on the skin helps, for example, special pads on the nose bridge.

A nose bridge for CPAP therapy

You can also experiment with different types of masks. If even slight pressure is enough for your skin to form traces and dents, if you are regularly bothered by skin reaction in the area of nasolabial triangle, try switching to nasal cannulas. Note that nasal earmolds can cause discomfort with high therapeutic airflow pressure.

The mask is not the right size

Any mask has several sizes. And if the product is large for you, it is much more difficult to adjust it so as to achieve the necessary tightness. As a result, the contour of the mask puts more pressure on the skin and friction on the face, provoking irritation. Trying to decrease the tension on the straps in this case immediately breaks the seal, causing air leakage and decreasing the overall effectiveness of the treatment.

The size of the mask is a relative concept. This means that the size grid may differ depending on the manufacturer and the specific model. And if you have always used size L, but decided to try a model of another brand, it is important not only to double-check all sizes, but also if possible try on a new product.

It is best to go to the office of a specialized company where a consultant will help you decide on the necessary size. If you do buy a mask online, then do it only on the official sites of reliable certified suppliers of equipment who professionally advise how to make the necessary measurements and advise on which option you should stay.

The mask is incorrectly adjusted

If the adjustment straps are tight, the silicone contour will dig into the skin, leaving marks and causing irritation. If, on the contrary, the tension is loose, the mask will wiggle, rub the skin and still let air in.

In some cases the contour of the mask is too tight due to the need for very high therapeutic air pressure. Then, if the straps are loosened, even a properly fitting mask will pull away from the face under the pressure of the air. In this case, it is worth discussing this situation again with your physician and he may suggest switching to a two-level ventilation system (BIPAP).

Silicone allergy

Leading manufacturers of CPAP equipment produce masks made of high-quality, hypoallergenic materials. However, in rare cases medical silicone can cause contact dermatitis. If you suspect that you are allergic to silicone, you should try a gel mask, which in most cases solves the problem.

Wear of the mask or its parts

Over time, micro-cracks appear on the silicone part of the mask, which act on the skin as an abrasive, i.e. traumatize it and lead to chafing.

  • The mask should be changed according to the manufacturer’s recommendations. Usually it is once in six months or a year. Unscheduled changes are necessary in the following cases:
  • Appearance of visible signs of wear. This may include significant clouding or discoloration of the silicone part, cracking or hardening of the material, stretching and wear of the straps.
    The mask has always fit well on your face, but recently it has begun to leak or irritate your face.

Contamination of the mask

Both the silicone part of the mask and the straps are prone to contamination. Dust, skin grease, keratinized skin cells, etc. are deposited on them. All this creates a breeding ground for bacteria. This can cause irritation and even inflammation when in contact with the skin. Therefore it is important to keep the mask clean. Wash it regularly with water and neutral soap, rinse and dry it thoroughly. Also wash the straps periodically as they get dirty. After washing, disinfect the mask and hose using CPAP Sanitizer.

Inadequate Facial Cleansing

If you have a tendency to oily skin, a kind of greasy film will form on the face, leading to slippage of the mask. The product will rub the skin and traumatize it, in microscopic wounds can penetrate bacteria. The result is obvious – irritation, rashes and inflammation. To avoid this, cleanse your skin thoroughly before going to bed. Also, avoid greasy creams and lotions in the evening. Only moisturizers with a light texture should be used.

Water condensation in the mask

Due to the difference in temperature between the breathing circuit and the bedroom, condensation can form inside the air hose. Drops of water get into the mask and then onto your face. This can also cause some skin problems. There are different ways to fix this problem:

  • Adjust humidification parameters by reducing the supply air temperature.
  • Use a hose with a heated circuit;
  • Position the CPAP machine below head level;
  • Sew a special thermal cover for the hose if it is not heated.

Red marks on the face, rashes and irritation from the mask are uncomfortable and may reduce adherence to CPAP therapy. However, this should not be a reason to refuse treatment.

It should not be forgotten that untreated sleep apnea itself exacerbates skin problems. Lack of sleep provokes increased production of stress hormone, the body fights inflammatory processes worse, acne, eczema and dermatitis appear. Lack of important sleep phases reduces the synthesis of collagen and elastane, which means premature aging. And that’s not to mention the fact that sleep apnea can lead to far more dangerous and serious illnesses, including diabetes, heart attack or stroke. And skin irritation problems are usually temporary and quite correctable.

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