Impact of Prolonged Use of Face Masks on Nasal and Skin Microbiota among Healthcare Workers and Related Populations: A Systematic Review and Exploratory Meta-Analysis

Sowmya Nasimuddin; Giyo Selvaraj Vasanthakumari; Fahad Affan Tajir; Shaikh Mohammad Haroon al Waseem; Kiran Madhusudhan

doi:10.11910/j.issn.2791-2043.2025.4.04

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Impact of Prolonged Use of Face Masks on Nasal and Skin Microbiota among Healthcare Workers and Related Populations: A Systematic Review and Exploratory Meta-Analysis

REVIEW ARTICLES | Updated：2026-04-21

- Impact of Prolonged Use of Face Masks on Nasal and Skin Microbiota among Healthcare Workers and Related Populations: A Systematic Review and Exploratory Meta-Analysis
- Sterile Supply Vol. 4, Issue 4, (2025)
- Affiliations：
  
  Sri Muthukumaran Medical College Hospital and Research Institute
- Author bio：
  
  Sowmya Nasimuddin
- Funds：
- DOI：10.11910/j.issn.2791-2043.2025.4.04
  CLC：
- Published：15 December 2025
- Accepted：
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Nasimuddin Sowmya,Vasanthakumari Giyo Selvaraj,Tajir Fahad Affan,et al.Impact of Prolonged Use of Face Masks on Nasal and Skin Microbiota among Healthcare Workers and Related Populations: A Systematic Review and Exploratory Meta-Analysis[J].Sterile Supply,2025,04(04):259-265.
DOI：

Nasimuddin Sowmya,Vasanthakumari Giyo Selvaraj,Tajir Fahad Affan,et al.Impact of Prolonged Use of Face Masks on Nasal and Skin Microbiota among Healthcare Workers and Related Populations: A Systematic Review and Exploratory Meta-Analysis[J].Sterile Supply,2025,04(04):259-265. DOI： 10.11910/j.issn.2791-2043.2025.4.04.

摘要

Abstract

Background

Prolonged face mask use is an essential occupational safety measure for healthcare workers (HCWs)

especially during the COVID-19 pandemic. While mask wearing effectively reduces exposure to respiratory pathogens

extended use creates a warm

humid

and occlusive microclimate that may disrupt the nasal and facial skin microbiota

potentially affecting comfort

barrier function

and occupational well-being. This systematic review aimed to synthesize primary research evidence on the impact of prolonged face mask use on the nasal and facial skin microbiota among HCWs and related population.

Methods

A systematic review with an exploratory meta-analysis was conducted following the PRISMA 2020 statement. Searches were performed in PubMed

Scopus

and Web of Science for studies published between January 2000 and December 2025. Inclusion criteria were observational and interventional studies involving HCWs or related populations exposed to at least four hours of mask use per day

with nasal or facial skin microbiota as an outcome. Due to heterogeneity in study methods

findings were narratively synthesized.

Results

A total of eleven primary studies met the inclusion criteria: four examined nasal microbiota

and eight examined facial skin microbiota. Consistent evidence indicated that prolonged mask use (4 to 12 hours per day) was associated with reduced microbial diversity. Nasal microbiota analyses revealed increased relative abundance of

Staphylococcus and Corynebacterium

species and decreased commensal

species. On facial skin

reduced microbial diversity and dominance of

Cutibacterium

species were observed

particularly among individuals with mask-related dermatological symptoms. An exploratory meta-analysis of four studies showed no significant decrease in microbial diversity

with high heterogeneity (

70%).

Conclusion

This synthesis of eleven studies indicates that prolonged mask wearing is associated with localized alterations in the microbiota

primarily affecting facial skin and nasal microbial communities. These changes likely represent ecological adaptations to humidity and occlusion rather than clinically harmful dysbiosis.

关键词

Keywords

references

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