Infectious Disease

Reusing disposable masks has no major impact on skin, upper respiratory microbiome

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The authors report no relevant financial disclosures.

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Key takeaways:

  • Reusing single-use surgical masks for up to a week had no major impact on skin or upper respiratory tract microbiomes.
  • There was a nearly 100-fold increase in the total bacteria on masks after 7 days of reuse.

Reusing single-use surgical masks for up to a week had no major impact on skin or upper respiratory tract microbiomes, according to data published in The Journal of Infectious Diseases.

“We all know that many people reuse masks meant to be single-use disposable — how long do you keep it in your pocket or purse to pull out when you want to wear one,” Ronald Collman, md, professor of medicine and professor of microbiology at the University of Pennsylvania, told Healio.

Box of surgical masks

Researchers found that reusing surgical masks for up to a week is not harmful to the wearer. Image: Adobe Stock.

“Others have studied whether they retain filtration capacity, and it seems they remain effective, but we wondered if it was bad for the wearer. Does it disrupt the normal complement of bacteria that live on the skin and in the throat?” Collman said.

To assess the consequences of long-term mask reuse, Collman and colleagues recruited 20 community members and trainees or employees of the University of Pennsylvania who were 18 years or older and routinely wore a mask for 6 or more hours each day for at least 5 days each week and who were instructed not to change their routine skin or oral care.

According to the study, the researchers sampled participants facial skin, upper respiratory tract and masks, and applied 16S rRNA gene sequencing to investigate the bacterial microbiome of participants randomly assigned to wear either a fresh surgical mask each day or to reuse their masks for 1 week .

Overall, the study showed that reuse was associated with increased number of taxa of the skin microbiome and a trend toward greater diversity but no difference in the oropharyngeal microbiome compared with daily fresh masks.

The authors wrote that this finding was “particularly interesting” with the numerous case reports of mask-associated acne, with some studies suggesting up to 25% of mask wearers experiencing new or worsening acne.

Ronald Collman

Additionally, the study showed that reused masks had either skin-dominant or upper respiratory tract-dominant bacterial sequences, as well as more than 100-fold higher bacterial content, although there was no change in composition compared with those used for 1 day.

The authors wrote that based on these results and other studies showing that masks have “considerable bacterial colonization” after just 4 hours of use, there may be hygiene concerns with prolonged reuse. However, reusing disposable masks can reduce supply issues and can lessen the impact on the environment by reducing microplastic pollution.

“Whether it’s okay to reuse masks meant to be single-use disposable hinges on several questions: Do the masks retain the ability to filter? Others have shown yes. Is it bad for the wearer? We show, basically, no, it’s not bad,” Collman said. “So, it probably is okay to reuse these surgical masks for COVID-19 protection.”

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