The Unintended Consequences of Mask-Wearing

We’ve all heard the saying about having to choose between the lesser of two evils. 2020 seems to be the breeding ground of perfect examples. Most of the world is navigating orders to socially distance and wash our hands after every single activity, which seems logical enough in the throws of a global pandemic, but there may be more than just caution hidden beneath the masks we’ve all been wearing. Some of the repercussions that come from wearing them may open the door to an entirely new list of problems. From new health issues to the social and psychological impact, problems are coming to light in ways we never could have anticipated.

What You Can’t See Can Hurt You

Research hasn’t even begun to reveal the full implications of mask-wearing and the potential for spreading disease. Take just one vital example: Helicobacter pylori, or H. pylori for short, an extremely common bacterial infection. A huge portion of the population gets it, and most will likely never know. People can be carriers for a long time, often an entire lifetime, never to be affected, but for those who are harmed, the health ramifications can be deadly. 

First, A Little Background

H. pylori is sustained in stomach acid and can survive outside the body for hours, which is enough to infect others who come in contact. Health experts “believe the germs can be passed from person to person by mouth, such as by kissing”. Because it is often transmitted through saliva, and can live on surfaces for hours, the mask provides a new surface in close proximity, when touched, adjusted, removed and replaced, it can facilitate spreading H. pylori more widely to others. Researchers have found that approximately half of the people carrying H. pylori can infect others via their saliva directly through kissing, and indirectly with shared surface contact, which is where mask-wearing enters in. It is an extremely common “pathogen that is able to alter host physiology and subvert the host immune response, allowing it to persist for the life of the host.” 

What many do not know, is that H. pylori is the primary cause of peptic ulcers and gastric cancer, the latter which kills over 700,000 people every year. In fact, it’s the first bacterial species proven to cause cancer, “classified as a group I carcinogen by the International Agency for Research on Cancer”. 

Allowing that grim number to sink in, prior to the coronavirus, the numbers of people affected by H. pylori were shrinking, but for those harmed the greatest, antibiotic resistance has been a crisis that only intensifies the threat, and it’s doing so at an alarming rate. Ulcers and deadly cancer may be at the top of the list of concerns, but H. pylori is directly connected with damage to the liver and gallbladder, is linked to bronchiectasis and chronic obstructive pulmonary disease, ocular disease, Alzheimer’s and Parkinson’s, cardiovascular disease, autoimmune disorders, thyroid disease, and even multiple sclerosis.

Since more than half of the people in the U.S. with the bacteria are over 50 years old, and considering the increased health risk for those infected with COVID-19 in this age group, the connected risk is not to be underestimated.


A less lethal, but growing health concern from mask-wearing is people who are experiencing acne, or “maskne” as the new vernacular permits. Skin issues resulting from heat and moisture while wearing masks are on the rise. It’s a problem dermatologists are seeing first-hand, adding maskne to a list of the most common issues they’re treating. Medical spas like the Wellness Jar are using light therapy to treat acne skin breakouts resulting from skin irritation that result from wearing masks.

Just Take a Deep Breath; Or, Don’t?

We need oxygen to survive, but there’s a growing controversy about the dangers of re-breathing our own carbon dioxide while wearing the most common face masks. While growing numbers are complaining about dizziness and lightheadedness, the experts claim the most common cloth masks, and even N95 masks won’t cause breathing issues. Those who deny the potential for breathing dangerous carbon dioxide levels open the discussion for an even deeper level of controversy. Since experts state that the seal around one’s face isn’t tight enough to cause carbon dioxide re-breathing side-effects, and cloth masks are supposedly porous enough to avoid the same, one has to wonder how they are effective against the tiny-sized coronavirus droplets from which they’re said to protect us? The scientific community has both ruled out the possibility of being harmed, while also stating there are no official tests providing data. There is medical recognition of a known rise in headache complaints from extended mask-wearing, but this is minimized by the medical community, suggesting that most people simply don’t wear masks long enough to experience the inconvenience.

People who suffer from asthma and COPD have described a worsening of conditions and even used this as an exemption to wearing a mask, but there continues to be conflict from medical experts on whether to officially sign-off on these exemptions. The outspoken voice of science says there is no impairment, but one has to wonder if they are truly listening to their patients.

Professionals suggest repeating self-encouraging mantras and to search for a comfortable mask, even if it’s homemade, suggesting that even insufficient protection will reduce spreading the virus better than nothing at all. This appeals to our sense of logic, but again, does the science really support this reasoning? If the virus is tiny enough to pass directly through even some of the least porous materials, and openings to the side allow the safe passage of air, then are masks actually providing us any real safety, or just a surface perception of caution?

What’s On Your Mind?

It isn’t hard to see how wearing face masks is inviting new possible risks to our health, potential  infections, skin irritations and breathing patterns, but how are they affecting people’s psychological well-being? A study at Bielefeld University, Germany revealed that “observers mostly relied on the eye and mouth regions when successfully recognizing an emotion”. Much of new mental anxiety stems from how we fill in the visual cues that are now missing. There is a small exception, like those who suffer social phobias who take comfort in veiling their emotions from the public. For example, people who suffer erytrophobia, the fear of blushing in public may likely take it as a blessing that wearing masks in public greatly reduces their anxiety, but for the majority, there is a spike in discomfort and stress that comes from the expressiveness that is concealed. People are unable to distinguish important emotional cues that balance social interaction with emotional well-being.

When Nicole Ellerbrock, a “hospice nurse from Minnesota” was told about their order to wear a mask at all hours at work, she was unable to sleep. She began to experience claustrophobia, which only worsened as the summer months got hotter and they added a requirement to also wear a face shield. Psychotherapists suggest that “nodding the head” or “giving a thumbs up” can help fill in for missing emotional facial cues, but for those who suffer anxiety, they tend to fill in a lack of visual information with more alarming data that is otherwise neutral.

We’ve observed waves of citizens across the globe rising up to rebel against shelter-in-place and mandatory mask orders, with the U.S. cited most often in the media. The U.S. isn’t the only country to rebel against wearing masks on the basis of their rights to liberty, but it is notable that even in the great pandemic of 1918, Americans were widely reported for their strong reactions against wearing masks. Perhaps it is often the simple freedoms that are the most symbolic, and in the case of the year 2020, all of us have a lot of new restrictions to digest and ponder.

The mask may in fact, be a partial deterrent against the deadly COVID-19 pandemic. History has taught us that often the very things meant to protect our lives, can open a door to new dangers we couldn’t see coming. With a microscopic disease added to the invisible air that we breath, the potential to spread deadly bacteria we were already battling to a higher degree, the mask represents a wide range of emotions, from safety to fear, anxiety to uncertainty. So, we’re curious what you think? Are masks making a huge difference in reducing the number of COVID-19 infections? Do you think that the risk of passing on H. pylori has gone up because of increased surface contact with masks? Do you think that people who complain of suffering carbon dioxide poisoning are imagining their symptoms? Or, is there some truth to the logic that the very safety mentioned with masks, allowing air to pass from the sides and being porous enough to provide proper ventilation could mean they’re just as likely to allow the coronavirus to pass? We’d love to hear your feedback.

Top Doctor Magazine
Top Doctor Magazine

Top Doctor Magazine is a magazine from doctors for doctors and patients. We cover everything from cutting-edge medical techniques and procedures to enterprising doctors, dentists, surgeons, naturopaths, chiropaths, orthodontists, and more who are thought leaders within their own medical practice and changing the way we all experience medicine for the better.

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Brianna Connors & Derek Archer Co-Editors