FAQs: Non-Medical Masks and Face Coverings
Health officials recommend that people ≥2 years old wear a non-medical mask when in public or when around people who do not live with them, especially when social distancing is not possible (staying six feet [2 meters] apart).1,2 Masks, ideally with at least two layers of fabric, should be worn primarily to protect others, in case the wearer is infected with COVID-19, but doesn’t have any symptoms.1,5
Question |
Answers/Pertinent Information/Talking Points |
Which types of face coverings are best to use? |
Appropriately sized masks to cover the nose, mouth, and chin, with at least two layers of fabric (e.g., cotton) are preferred.2 For example, children’s masks may need to be smaller than adult masks, depending on the age of the child. More data are needed before special materials (e.g., silver nanoparticles) can be recommended over other materials or coatings. Discourage use of face coverings that have a valve for easy exhaling; are made of mesh; or with openings, holes, or vents. These are NOT considered sufficient as they may allow droplets to be released from the mask.16,23 Neck tubes, scarves, bandanas, buffs, or gaiters are not ideal, but these may be better than no coverage at all.22 However, note that when speaking through fleece material larger droplets may be dispersed into smaller droplets. Smaller droplets can remain airborne longer, so it may be best to avoid fleece.24 Face shields may be worn in addition to masks for possible added eye protection to the wearer (since it is thought that SARS-CoV-2 may also be contracted through the eyes). Face shields are NOT recommended as a substitute for masks. Face shields are also not appropriate for newborns or infants.6
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Who may be exempt from wearing a mask? |
Masks are not appropriate for everyone. People who are considered exempt from wearing a mask include:1,5
Prescribers may decide that other people are also exempt from wearing masks, such as those with:19,25,28
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How should masks be put on and taken off? |
Wash hands with soap and water or use hand sanitizer BEFORE putting on a mask.1,5 Use ear loops or ties to put on and remove masks.5 Masks should fit under the chin, over the nose and mouth, and snugly against the sides of the face without gaps.1,2,5 Avoid pulling masks down around the neck, up on to the forehead, or leaving masks hanging from one ear. These positions make it easy for people to inadvertently contaminate their hands by touching the outside of the mask. Instead, completely remove masks using the ear loops or ties. Masks should be removed prior to eating or drinking. Avoid placing masks directly on surfaces like tables, counters, etc. Once off the face, fold the mask in half, placing the outside edges together, keeping the inside layer inside.5 Then place in a clean paper bag or outer-side down on a napkin or paper towel.5 Avoid placing masks in pockets for future use.26 After storing the mask, wash hands with soap and water or use hand sanitizer. Avoid touching your eyes, nose, or mouth until after you have washed your hands.5 |
How should masks be cleaned? |
Use a new mask whenever it becomes damp or dirty.4,5 Disposable masks should be thrown away once soiled or damaged.27 Wash reusable masks, either in the laundry or by hand.4,5
Dry masks completely, either in the dryer (highest heat setting) or lay it flat to dry, in direct sunlight if possible.4,5 |
How can mask tolerability be improved? |
Give preference to cotton or linen over synthetic materials (e.g., polyester). Cotton may keep you a little cooler and polyester can trap moisture, making masks become damp more quickly.2,20 Ensure masks are snug, but not too tight.20 Use the type of mask that is most comfortable for you. For example, some people may prefer ear straps and some people may prefer ties around the head. Note that masks that tie may allow for more flexibility in securing a snug fit.21 See our chart, PPE-Related Skin Irritation: Prevention and Treatment, for ways to reduce or treat mask-related skin problems. |
What can be done to reduce anxiety about wearing a mask? |
Here are some tips to decrease anxiety associated with wearing a mask:10
Set a good example, let kids see you wearing a mask. For kids, a few other tactics may be helpful:11,18
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What can be done to keep glasses from fogging up when wearing a mask? |
Be sure masks fit well. Masks that allow warm air to escape can lead to glasses fogging.3 Masks with a nose bridge (moldable around the bridge of the nose) may fit more snugly than masks without this feature.9 Medical or sports tape can also be used to create a better seal between the mask and the nose/cheek bones. If patients have sensitive skin, recommend testing a small piece of tape to make sure it doesn’t irritate the skin.3,9 Push glasses slightly forward on the nose to allow more room for air to circulate or pull masks up higher and allow glasses to rest on top of the mask to block air from escaping out of the top of the mask.3,9 Consider washing the lenses with soap and water or applying antifog products or home remedies (e.g., toothpaste or shaving cream) apply a thin layer to lenses, then rinse with water before wearing them.3 Doing any of these can leave a thin film on the lens that may prevent fogging.9 Before using these strategies, ask patients to check with their optician to make sure it won’t damage any special coatings their glasses may have.9 |
What can be done to reduce headaches from wearing a mask? |
Patients may experience headaches while wearing a mask. Reassure patients that wearing a cloth mask will not lead to hypercapnia (the buildup of carbon dioxide [CO2]in the blood stream).12 Possible reasons for headaches may include:
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Project Leader in preparation of this clinical resource (360901): Beth Bryant, Pharm.D., BCPS, Assistant Editor
References
- CDC. Coronavirus Disease 2019. (COVID-19). How to wear masks. August 7, 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-wear-cloth-face-coverings.html. (Accessed August 20, 2020).
- Government of Canada. Coronavirus disease (COVID-19). Non-medical masks and face coverings. July 24, 2020. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/about-non-medical-masks-face-coverings.html. (Accessed August 5, 2020).
- Hazanchuk V. How to wear a face mask without fogging your glasses. May 21, 2020. https://www.aao.org/eye-health/tips-prevention/face-mask-foggy-glasses-coronavirus-covid. (Accessed August 5, 2020).
- CDC. Coronavirus Disease 2019. (COVID-19). How to wash masks. May 22, 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-wash-cloth-face-coverings.html. (Accessed August 5, 2020).
- Government of Canada. Coronavirus disease (COVID-19). COVID-19: how to safely use a non-medical mask or face covering. July 20, 2020. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/covid-19-safely-use-non-medical-mask-face-covering.html. (Accessed August 5, 2020).
- CDC. Coronavirus Disease 2019. (COVID-19). Considerations for wearing masks. August 7, 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html. (Accessed August 20, 2020).
- Ong JJ, Bharatendu C, Goh Y, et al. Headaches associated with personal protective equipment – a cross-sectional study among frontline healthcare workers during COVID-19. Headache 2020;60:864-77.
- World Health Organization. Advice on the use of masks in the context of COVID-19. June 5, 2020. https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak. (Accessed August 5, 2020).
- Cleveland Clinic. Health essentials: how to keep your glasses from fogging up while wearing a mask. May 12, 2020. https://health.clevelandclinic.org/how-to-keep-your-glasses-fog-free-while-wearing-a-mask/. (Accessed August 6, 2020).
- Anxiety and Depression Association of America. Getting comfortable with PPE. April 2020. https://adaa.org/sites/default/files/Tips%20for%20Getting%20Comfortable%20in%20Your%20Mask%20and%20with%20PPE_UChicago%20Medicine%2C%20NYU%2C%20Emory%20.pdf. (Accessed August 6, 2020).
- Demarco C. Kids and masks during the COVID-19 pandemic: 7 questions answered. June 1, 2020. https://www.mdanderson.org/cancerwise/how-to-get-kids-to-wear-masks-during-the-coronavirus-covid-19-pandemic.h00-159382734.html. (Accessed August 6, 2020).
- Hartford Healthcare. Killer COVID-19 masks? The truth about trapped carbon dioxide. June 22, 2020. https://hartfordhealthcare.org/about-us/news-press/news-detail?articleid=26712&publicId=395. (Accessed August 6, 2020).
- Cove. How to avoid migraine triggers while wearing your mask. https://www.withcove.com/learn/migraine-triggers-mask. (Accessed August 6, 2020).
- Premier Health. A face mask surprise: your bad breath. May 26, 2020. https://www.premierhealth.com/your-health/articles/healthnow/a-face-mask-surprise-your-bad-breath. (Accessed August 6, 2020).
- American Academy of Dermatology. 9 ways to prevent face-mask skin problems. https://www.aad.org/public/everyday-care/skin-care-secrets/face/prevent-face-mask-skin-problems. (Accessed August 6, 2020).
- Minnesota Department of Health. Frequently asked questions about the requirement to wear face coverings. Updated August 19, 2020. https://www.health.state.mn.us/diseases/coronavirus/facecoverfaq.html. (Accessed August 21, 2020).
- Cleveland Clinic. Will a face shield protect you from the coronavirus? July 28, 2020. https://health.clevelandclinic.org/will-a-face-shield-protect-you-from-the-coronavirus/. (Accessed August 7, 2020).
- The Summit Center. Teaching your child to tolerate wearing a mask: tips and guidelines. https://www.thesummitcenter.org/app/uploads/2020/04/Desensitizing-to-Wearing-Face-Mask-Parent-Resource.pdf. (Accessed August 11, 2020).
- Dorfman D, Raz M. Mask exemptions during the COVID pandemic – a new frontier for clinicians. July 10, 2020. https://jamanetwork.com/channels/health-forum/fullarticle/2768376. (Accessed August 11, 2020).
- Rossen J. How to make wearing a face mask more comfortable during the warm, sweaty, summer months. June 4, 2020. https://www.mentalfloss.com/article/625141/how-make-face-masks-comfortable-warm-summer-months. (Accessed August 11, 2020).
- Conner K. Face mask feeling uncomfortable? Here’s what you can do for ear and head relief. August 9, 2020. https://www.cnet.com/health/face-mask-feeling-uncomfortable-heres-what-you-can-do-for-ear-and-head-relief/. (Accessed August 11, 2020).
- Callaghan A. Neck tubes and scarves are not ideal face masks. Updated August 7, 2020. https://www.outsideonline.com/2411426/buff-bandana-face-mask-effectiveness. (Accessed August 11, 2020).
- CDC. Coronavirus Disease 2019 (COVID-19): about masks. Updated August 6, 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html. (Accessed August 11, 2020).
- Fischer EP, Fischer MC, Grass D, et al. Low-cost measurement of facemask efficacy for filtering expelled droplets during speech. August 7, 2020. https://advances.sciencemag.org/content/early/2020/08/07/sciadv.abd3083. (Accessed August 11, 2020).
- Southeast American Disabilities Act Center. The ADA and face mask policies. Updated August 10, 2020. https://www.adasoutheast.org/ada/publications/legal/ada-and-face-mask-policies.php. (Accessed August 17, 2020).
- Balzer D. Tips on how to wear and care for your cloth mask. May 8, 2020. https://newsnetwork.mayoclinic.org/discussion/tips-on-how-to-wear-and-care-for-your-cloth-mask/. (Accessed August 17, 2020).
- Johns Hopkins Medicine. Coronavirus: how to care for your face mask. Updated July 2, 2020. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-how-to-care-for-your-face-mask. (Accessed August 17, 2020).
- Cardinal Innovations Healthcare. Anxiety coping strategies when wearing a face mask. July 1, 2020. https://www.cardinalinnovations.org/Resources/Blog/Anxiety-Coping-Strategies-When-Wearing-a-Face-Mask. (Accessed August 17, 2020).
Cite this document as follows: Clinical Resource, FAQs: Non-Medical Masks and Face Coverings. Pharmacist’s Letter/Prescriber’s Letter. September 2020.