Allergy to CPAP Mask?

[MLT]

I recently got a CPAP machine, and I am using the ResMed Swift LT for Her mask. I am getting a rash on my face, blotchy, extremely dry skin, in certain places where the mask materials touch my face. The problem is not due to air flow - I use the humidifier, and no excess air blows on the rash locations. I believe it is due to the mask materials of construction. I am allergic to latex and have very sensitive skin, prone to skin allergies and rashes. Has anyone else experienced a rash from the mask? What did you learn about the cause(s) and solution(s)?

[Dory]

I also have been using a ResMed Swift mask for about 2 months. A week ago, I went to bed and awoke with a very painful forehead. I had oozing sores that were burning like a chemical burn on my forehead. Today it is hard crusty and feels like plastic. My cheeks had been looking like I was getting Rosacea but I thought it was from where they sanded my face for the sleep study. I'm a little worried about the material used in the mask. I've heard of a nasty infection from flip-flops imported from China.

[MLT]

I contacted the manufacturer of the Swift LT for Her, ResMed, from a phone number that I found on their website, and asked for information on the materials of construction. The following is what I received from them:

Component
Material

Frame
Silicone Elastomer

Cushion (Pillows)
Silicone Elastomer

Headgear Assembly
Headgear Straps: Foam Layer: Open cell Polyurethane Fabric: Nylon/Spandex

Buckles: Thermoplastic Polyester Elastomer (TPE)

Yokes: Nylon

Elbow
Polypropylene

Inlet Tube
Thermoplastic Polyester Elastomer (TPE)

Swivel Assembly
Polycarbonate/ Polypropylene

Plastic Tube Retainer
Thermoplastic Polyester Elastomer (TPE)

Soft Wraps
Polyester

I received this information from Susie Justice, Clinical Support Specialist, [e-mail]. I recommend that you take it to your dermatologist to find out what is going on. That is also what I plan to do because I have a spot on my lip that is like a dry spot, where the thing that the pillows connects to touches my lips. I don't know what that part is called.

I would like to hear from other people about these parts and allergies, still. I wonder if there is a pattern here.

[Tanya]

Hi, I am writing from Australia. I came across your post when I was researching allergic reactions to CPAP masks as I too have been having problems and though I may not be able to help you directly, I thought it was worth sharing what allergy problems I have been having and not only that, there may be others out there who also have been having similar problems and perhaps we can all help each other in some way.

My story: I have been using ResMed S8 Series 11 CPAP Machine + ResMed HumidAire 3i with the ResMed Mirage Quattro Full Face Mask for just over a year now. Two weeks prior to Christmas just gone (2008) I noticed small red blotchy spots appearing on either side of my chin just below my mouth. I had also recently noticed each morning when I took off my mask I had an accumulation of saliva left in the mask, so when I noticed the rash appearing I immediately put it down to excess saliva leaking out and being trapped between the mask seal and my skin.

I contacted my CPAP clinic and they suggested that my Humidifier was set too low, on account of the extremely hot weather we had been having here and as it was not on a high enough setting my body was producing additional amounts of saliva because I was becoming dehydrated over night. I was also advised to drink more water before going to sleep however for me that was not an option due to a incontinence problem I have as a result of lower back surgery. So my only option was increase the setting which is what I did the following night. My Humidifier setting had been on 3, so the first night I turned it up to 5 however that produced too much moisture, so the following night I tried the 4th setting which seemed to be the better setting of the two. I continued on this setting for a couple of weeks and the amount of saliva I was producing did infact decrease however it did not make any difference to the rash on my skin, infact the more I used the mask the worse my skin became and the larger the rash became.........it spread across my whole chin.

At this point I contacted my actual Sleep Disorder Specialist and he advised me to have a two week break from the Full Face Mask and to try using the Nasal Mask instead, however as I have other medical conditions, I am unable to tolerate the Nasal Mask for any longer than an hour without removing it during the night. So my only option was to have a complete break from the CPAP.

As the rash had become quite inflamed at this stage and the fact that lots of small blister like lumps had started to appear I also sort treatment from my local General Practitioner (GP). She advised me that she had other patients who also had allergies on account of the CPAP mask and it had been difficult to treat. She went onto advise me that my rash had now developed into Dermatitis and that I would require a cortisone steroid such as "Elocon Ointment" to help treat the problem.

In January this year I started using the Elocon Ointment and immediately noticed significant improvement and after a week you could no longer feel any of the blisters and the redness had almost completely disappeared. However no sooner did I stop the Elocon and go back onto the CPAP machine with the Full Face Mask did the now Dermatitis appear back with full vigour. I was back to square one, so I went off the mask again and went back to using the Elocon ointment and again the rash cleared again but no sooner did I stop the ointment the Dermatitis was back worse than ever and this time I had not even been back on the CPAP.

Last week I returned to my GP and she took me off the Elocon ointment and put me on a three week course of antibiotics called "Doxycycline" and for the first few days they did seem to help, however over the last couple of days I have noticed that the redness and the small blisters have started to reappear. I am not sure if these tablets are working but it has only just been over a week and I still have another two weeks of treatment, so it may take the full course for them to work, so I haven't given up yet. I would also definitely recommend atleast trying the Elocon Ointment or something similar to help with rash you are experiencing as it does work while you are using it and it may provide you some relief in the interim.

As what to do about the allergy with material on the CPAP Mask I am not sure.................my thoughts are that if the rash was an allergy to the materials used on the mask I personally would have the Dermatitis rash on the parts of my face where the mask touches my skin but that is not the case, the rash is only on the lower part of my chin.................which brings me back to my original thought that it has to do with excess saliva leaking from the mask and being trapped between the mask and the skin overnight and the skin is continually kept damp and thats why the skin is being aggravated................the only thing I can think of is that maybe something needs to be put inside the mask to soak up the excessive moisture/saliva and then some sort of absorbent dry protective barrier needs to be put between the mask and the skin, this will then allow the skin to remain continually dry and avoid any further aggravation.......................Whether something like this could be done and would work, I am not sure however I think it would be worth looking into and maybe someone else out there has some ideas how this could be achieved and could perhaps post some suggestions. I would be also interested to hear if yourself or anyone else out there has been experiencing excess saliva/moisture as well.

I have also uploaded a photo of my skin as an example of the Dermatitis Rash I now have and have done this also to see if either yourself or anyone else finds their rash similar to mine and perhaps if they do, they could also post a photo to see if we are all experiencing the same thing.

I apologise for the length of my post but again thought if I could tell you what's happened to me, it maybe similar to yourself or someone else out there and some how we can find some definitive help for us all.

[MLT]

Hi. Thank you for your reply. Your rash looks very severe. Mine is only a spot on my lip, so I am fortunate. At any rate, there must be something in these mask materials that is not good for our skin.

MLT

[Becky]

Hi,
I'm using RemZzzs cpap mask liners, not for any rashes, but for leaking air and other discomforts. BUT, I have heard of 2 other people who use them because of skin allergic-reactions from the silicone, and have found that they help alot. It's on remzzzs.com. Good luck, it must be very discouraging. My thoughts are with you.

[Martha]

I have had dermititis since starting cpap 4 weeks ago...lip lickers eczema-like rash around lips on skin and thickening of lips and flaking.
I tried using cushion, pillows and mask...with humidifier...all result in persistent dermititis under my nose: above and below lips on skin.
Very uncomfortable. Tried lip balms, moisturizers and Elidel Rx.
Can't get rid of it.
Stopped using the cpap.

[glenda]

I have noticed that if I apply Mary Kay night cream (pink stuff) it really helps with this. Funny, until I found this sight I thought it was just me. But I think I am sinsitive to the materials of the head gear and mask. But can't sleep without my CPAP, even when napping.

Hope this helps.

[glenda]

I thought I was the only one to have a problem like this. I have been using the CPAP since 2001 and have had constant break outs unless I apply Mary Kay night cream. I am not trying to sell Mary Kay products but it was like my skin was dry and so I used this. I am going to my doctor to see if there is another product that can be exchanged in the mask and head gear. When I tried using the nasal pillows my skin burned like it was on fire, but if I applied the MK night cream it helped, I just would wake up several times during the night to reapply the cream, so I went back to the nasal cover mask but still use the MK cream.
hope this helps.

[Tanya]

Hi Everyone, its been a couple of weeks now since I posted but thought I would post an update. Since posting on the 6th of March 2009 when my Dermatitis rash was at it worst, my skin is now starting to look somewhat normal again, which in thanks very much to the medication I have been on and also the "RemZzzs" that Deborah recommended which I cannot thank you enough for Deborah............the site you listed www.remzzzs.com has been a godsend and I recommend anyone who is experiencing similar skin problems to definitely give their products a try. I will explain more in detail shortly but first I want to explain what has happened since I posted.

In my last post I mentioned that my doctor had prescribed Doxyciline to help with my rash........well since then I have found out that the type of Dermatitis that I have had is called "Perioral Dermatitis" which affects mainly women and the rash appears around the mouth and nose with small type lumps and blisters almost looking like a type of acne. The worst thing you can do for Perioral Dermatitis is use topical steroids as that will only aggravate the skin even more, especially on cessation of the ointment and that is exactly what happened to me. Whilst I was using a steroid cream my skin seemed somewhat better however as soon as I stopped it, my skin just exploded in a very red firey rash with tiny blisters all over my chin.....................had I know that at the time I would never had used the steroid ointment................however it took another doctor a minute to look at my skin and tell me exactly what it was and that it can be treated but it could take anywhere from 4weeks up to many months to clear the Dermatitis completely and the only way to do that was to take Doxyciline, which thankfully my other doctor had already started me on that treatment.

In the two weeks since I have been on it, you can definitely notice an improvement and when I get a chance I will post some updated photos, so you can see the difference. In addtion to the antibiotics, I am also using a High Potency Vitamin E cream on my skin, which has helped a great deal as well, especially with the dryness.

Since investigating Perioral Dermatitis and re-reading the other posts that you have written especially Martha and Glenda, I believe some of you may be experiencing the same "Perioral Dermatitis" as me and would highly recommend a trip to your local doctor to see if this infact the case, as that way you can get on some antibiotics asap. As for MLT, Im glad your rash is not as severe as mine but I do wonder if this may be the start of the same thing and wonder also whether it is worth a trip to the doctor to ask about Perioral just as a precaution and maybe prevent it from getting worse.

Apart from my photos showing my rash on my previous post, there are many examples of Perioral Dermatitis Rashes on the internet which are worth looking at to see if they do infact match yours. For ease I have attached a link to a medical site that shows just one example, plus a full delineation of the disease and its treatment http://www.medicalobserver.com.au/medical-observer/articles/Clinica...

As mentioned at the beginning of this post, I have also checked out the RemZzzs products that Deborah mentioned and have since had the opportunity to try them and they are fantastic. Basically what the RemZzzs are is a cotton liner that covers the entirety of the CPAP mask whether it be Full Face or Nasal, including a seperate cotton liner for the forehead. The Cotton liner allows you to continue using the CPAP Masks without any of the silicone touching your skin. By wearing a liner each time you use the CPAP it allows your skin to breathe and not sweat and react to the silicone as the silicone is no longer touching your skin.

I have also found that not only does it provide the perfect barrier against the silicone but it also stops a vast amount of mask leakage over night and in addition to that, it also takes away the nasty indents normally left by the silicone which sometimes for me have taken the whole day to disappear, now with the use of the RemZzzs any indentation from the mask is gone within the first 20mins of the morning, if that. I have also noticed that with less leakage I am producing less saliva and so far in time I have been using them, any saliva that did accumulate, accumulated on the top part of the cotton lining which is inside the mask and no longer gets on my skin nor in between my skin and the mask.

As the liners act as a barrier, they also allow you to put moisturisers and creams on your face, as the liner again becomes a barrier between your skin, the moisturiser and the silicone, so there is no more slipping, sliding and leakage as before. There just to be seems to be so many positive things about these products and normally I am a sceptical person and don't believe everything I read nor do I post comments on products but in this case, as I have now tried them personally, I can't help myself, I can honestly say again these liners are a Godsend and I hope you all give them a go and try them, I think you will be surprised at just how great they are and a big "Shout Out and Thank you" to Deborah for the link to the site, I will be forever grateful to you.

So you could say for me at this point in time things are finally looking up, my skin is finally starting to heal, with the help of the Doxyciline antibiotic and the vitamin E cream and the RemZzzs liners are helping with the allergy to the silicone and also with mask leakage which is allowing me to finally have a really good nights sleep after so long.

Again I really hope that you all can try the RemZzzs products as I really feel that you will find some relief especially with the silicone allergy and if you think that you do in fact have the same Perioral Dermatitis as me and can get on some medication asap, I believe that will also help a great deal.

If you would like to ask me any questions on what I have posted please reply to this post and I will get back to you as soon as I can.

All the best and Kind Regards
Tanya
Adelaide Australia

[Martha]

Thank you ALL for this great information. I did not use topical steriods though. Elidel is not steroid.
My rash is due to 'Humidity' onthe skin.
I use nasal pillows/cushion, so the remzzz products aren't applicable.
Until they get something other than silicone...I am not sure I can be compliant.
Good thing I didn't get silicone breast implants. :-)
I need sleep.

[Zan]

I have been using a CPAP for almost 10 years, 4 of those using ResMed's Activa mask. I love the mask, and suggest it for anyone using CPAP. Except now I have a problem.

I got a new Activa mask a couple of months ago and started getting contact dermatitis from an allergic reaction to the silicone in the mask. This is a self-diagnosis until I go to my dermatologist again. I am getting reactions around the cheeks beside my nose, my upper lip, and now on the bridge of my nose.

Weak steroids, such as hydrocortizone do not seem to help. At this point I am going to use the old Activa mask that I had no problems with.

My history includes severe allergies, taking allergy shots for 3 years, eczema, and asthma. I have had a very high sugar/carb diet lately so I plan on changing that to see if it helps. I plan to share my experience with my allergy doctor, dermatologist, and CPAP clinic.

[Jim Newman]

I am fairly new CPAP user, and have encountered same contact dermatitis on cheeks, chin, forehead...anywhere the ResMed Mirage mask touches. I have a theory that the problem is not so much the actual silicon; but, the mold-release chemicals used in fabricating the mask that cause my problem. First, without a mold-release, you can't get the mask out of the mold when is is made, so even if cleaned there is a residue. Washing thoroughly with warm, soapy water helps, and the allergic level improves as the mask ages...then a new one would start high sensitivity all over again. I haven't yet tried the cotton shields but plan to immediately. Thanks for all the information and suggestions; this is my first visit to the site and it is very helpful1