CPAP skin irritation How to Prevent it

Just like introducing anything new to a routine, CPAP therapy is going to take a little getting used to. If you are a light sleeper, the noises coming from the machine will impact your sleep for the first little while.

This will also be true about wearing a face mask or a tube inserted into your nostrils. There is no doubt that these things sound like they will cause more issues with your sleep than performing a therapy that helps you sleep. 

But once you become comfortable with the changes, you should be able to sleep well. However, CPAP skin irritation is a very real side effect that may make the therapy even more difficult to get used to.

The Many Possible Causes of CPAP Face Irritation

CPAP Mask Irritation Causes - Full Face

Although the designers and makers of the headgear used with a CPAP machine have gone to the trouble to make it fit correctly and easy to wear, not everyone will find the apparatus comfortable. This is because everyone is different and what may work for many may not work for others. There are several reasons why CPAP skin irritation occurs. Here is a look at some of the causes.

CPAP Mask Irritation Causes - Full Face

Philips Amara View Full Face CPAP Mask

Here is a list of possible causes of a CPAP rash around mouth that are common to full face masks:

  • If your CPAP cushions contain silicone, you will find them to be comfortable however, if you have sensitive skin, it may react to that material. Also, it is not uncommon to have an allergy to silicone and this will result in a rash.
  • CPAP cushions do not last forever and over time, older ones start to break down. When this happens, their surfaces get rough and this can cause skin irritation just from rubbing on your face.
  • CPAP masks get dirty. They can attract skin cells, dust, oil, bacteria, and other debris. When a cushion covered in these items rubs against the skin, it can cause a rash to develop. Keeping the cushions clean will reduce this risk.
  • Be careful how you adjust the headgear. If you wear the CPAP mask too tightly, you can increase the amount of pressure put upon your cheeks, nose, and chin which can result in rubbing.
  • There is also the possibility that you are wearing the incorrect mask for your face. This can be remedied by either choosing a different size face mask or switching to a completely different mask design.
  • If you have oily skin, the CPAP mask will slip and slide during the night. this slipping and sliding action against your skin will rub and create a rash.
  • If you use a humidifier, be sure that it is set correctly as some CPAP masks collect moisture in the tube which will be sprayed onto your face. This will cause the mask to slip and slide in much the same manner as if you had oily skin.

CPAP Mask Irritation Causes - Nasal Pillows

ResMed AirFit P10 Nasal Pillow Mask

Here is a list of the potential issues coming from CPAP masks where nasal pillows are used:

  • The size of the nasal pillows could be wrong. If they are too loose, they will rub which can lead to CPAP skin irritation.
  • Check the instruction manual with your CPAP machine as you may be inserting the pillows too deep onto your nose.
  • If the air passing through the CPAP tubing is too dry, this will remove the moisture inside your nose which will lead to a skin rash.

How To Stop CPAP Mask Irritation

How To Stop CPAP Mask Irritation

There are several ways to reduce the risk of developing CPAP skin irritation. Here is a look at what they are.

Get The Right Size Mask

A proper fitting CPAP mask will greatly reduce the possibility of a rash developing. There are online sizing templates available for you to reference when purchasing a CPAP machine. It is also good to have the sizing figured out for more than one type of mask so that you can order a backup style to switch to if needed.

Lighten Up On The Headgear

If your CPAP mask is the right size, it should sit gently on your face. If it doesn’t, you may have to loosen the headgear until it does. Wearing a mask too tightly will eventually rub on your face leading to a rash forming. Plus, the air seal will not put excess pressure on the mask if it sits lightly on your face.

Keep The Mask Clean

If you do not own a CPAP cleaner, you can still keep your CPAP mask clean of dirt and infectious pathogens. All you need to do is use wipes or soap and water. It is a good idea to clean the mask after each use but refer to the manufacturer’s recommendations in your owner's manual.

Install Nasal Pillows Correctly

The nasal pillows should not be inserted too deeply within your nostrils. They should sit just at the edge of your nose. If this does not work for you or is not comfortable, you may need to change to a different type of mask.

Add Some Humidity

If your nose and mouth tend to dry out during CPAP therapy, there is a solution. Try using the CPAP machine in conjunction with a humidifier. Humidity is added moisture in the air and with humid air going into the CPAP tubing, your nose and mouth should remain moist.

Prevent CPAP Rainout

CPAP rainout is when too much moisture builds up inside the tubing and splashes onto your face. You can prevent this from happening by positioning the CPAP machine lower than your head when sleeping. Another trick is to increase the temperature in your bedroom or warming the humidifier temperature. One more way to warm the air in the CPAP machine is to cover the tubing with a towel.

Keep Your Supplies Current

Your CPAP machine should have a replacement schedule outlining when parts and accessories should be retired and new ones purchased. By keeping up with this maintenance schedule, you should not end up using parts or accessories that are worn out or not effective anymore.

Be Mindful of Allergies

If you have or suspect you have an allergy to silicone and your CPAP machine has a silicone mask, stop using it immediately. You will have to look at options that do not contain silicone and several CPAP masks use gel instead.

CPAP Skin Irritation - The Red Ring Around Your Face

Have you woken up in the morning after a CPAP therapy session only to find that when you look in the mirror that your face now has a red ring around it? This will be from the full face mask you wore during the night. By coping with this as a regular side effect of using a full face mask you are avoiding a situation that could get worse. Depending on how sensitive your skin is, the ring around your face could start to sting, and eventually become itchy.

The combination of the burning sensation and scratching at it will produce far more than the red ring you started with. We get it, the ring doesn’t look attractive and will get you noticed in ways you don’t want to be noticed if it is still visible by the time you get to the office. Fortunately, there are a couple of things you can do to reduce the formation of the ring in the first place.

nose lubricant

keep it clean

Tip #1 - Facial Products

Skincare lotions are a good thing to apply to your face each night before bed. That is if you do not use a CPAP machine. For CPAP users, it is best to avoid any type of skincare treatment in the evening.

Tip #2 - Keep It Clean

Another way to prevent waking up with a red ring around your face is to ensure that the cushion on your CPAP mask has been completely cleaned and dried before use. Microscopic dirt and debris, along with bacteria, work together to form an abrasive surface on the mask cushions that will leave a mark on your face.

What About Shaving And CPAP Therapy?

What About Shaving And CPAP Therapy

That’s a good question. It makes sense that a clean-shaven face will make a better seal with a CPAP mask than one with a 5 o’clock shadow. However, the skincare products used following shaving could lead to CPAP skin irritation. To find out for sure, try different aftershaves if you find yours causes a rash.

Typically, aftershave products that cool the skin are best but this may not be true if you have sensitive skin. Another problem with aftershave is that some of them will have a chemical reaction with the silicone in the mask cushion. This will irritate the skin.

In Conclusion

If you have red marks, a rash, or itchy skin after CPAP therapy, you are not alone. It is a common side effect. The good news is that for most who suffer from this issue, it can be remedied. All you have to do is identify the cause and act upon that with a solution to remove the cause. The whole idea is to ensure that you have a good night’s sleep and having skin issues will hamper that in one of many ways. The solutions listed above should solve your problem and allow you to get back to restful nights without irritation.