Lubrication to reduce tissue shear loading - effects on comfort perception and tissue damage when wearing a facemask

Patients with respiratory disease often require breathing support delivered via a nasal or facemask. The use of such a mask causes continued loading of the skin which can result in discomfort or skin injury, which may lead to low adherence to treatment. It is hypothesised that lubricating the mask-skin interface will reduce shear stress, thus reducing the load on the skin. The aim of this study was to determine whether the application of a novel lubricant to the mask improved discomfort and/or skin injury measured using three outcomes: subjective comfort, erythema, and the presence of epidermal interleukins. Ten healthy participants were randomised to wear a lubricated or unlubricated facemask for one hour. Each participant switched over after a one-hour washout period. Subjective comfort was measured using visual analogue scales. Erythema was quantified from facial photographs and interleukins were obtained using tape stripping and ELISA assay analysis. Results show that the subjective comfort significantly improved after one hour with the application of a novel lubricant, compared to no lubrication (p=0.015), however erythema and interleukins were not significantly different. As comfort perception may affect adherence, this novel lubricant may be beneficial in the clinical care of those needing to wear facemasks.