Need Help Please ... Mask Removes Skin

[janp]

Finding the right mask is tough enough, but I've developed a second problem that has become a major issue in my XPAP therapy.

Any and all suggestions would be greatly appreciated.

I've been on Coumadin for a year now because of a pulmonary embolism. I'm 74 years old (gasp!), where the skin normally becomes thin.

The combination of the two has made a normally "fair" skin extremely thin.

My profile lists the hybrid mask. The Hybrid has done the best job in my apnea therapy ... for two nights! I have problem with mouth breathing which the oral mask portion resolves, while minimizing the silicone to skin contact.

I can no longer use tape on my mouth, because the tape will pull the skin off of my face. An oral device that I was using to stop mouth breathing no longer works for me.

With the Hybrid (or any mask that uses a skin to silicone mask contact) ... the mask to skin contact will literally take the skin off my face.

I tried to resolve the problem by coating the silicone contact area with lanolin (Lansinoh) ... but that didn't work. The seal stayed good ... but the skin still got removed.

Does anyone have any ideas as to how I can overcome the skin removal from the silicone to skin contact ... preferably with my continued use of the the Hybrid mask?

Thanks,

Jan

[BleepingBeauty]

Why not try a cloth "gasket" between the mask and your face? I've read about others here who do that (cut out of old t-shirt material or something similar to mimic the shape of the silicone seal, but a bit larger) and have had less (or no) skin irritation as a result.

I know others put a thin film of Milk of Magnesia on their face and let it dry before applying tape (which aids in removal). Maybe try the MoM on your face where the mask touches it?

Sorry you're having such difficulty. Hope either of these suggestions is helpful.

[Scarlet834]

Why not try a cloth "gasket" between the mask and your face? I've read about others here who do that (cut out of old t-shirt material or something similar to mimic the shape of the silicone seal, but a bit larger) and have had less (or no) skin irritation as a result.

I'm a very new user of a nasal mask--but I immediately had problems putting adhesive of any kind on my face. I seem to be having very good luck with thin microfiber between mask edges and skin. What I'm using is material that used to be used to clean eyeglasses. The cleaning cloths I see in the store these days are more smooth, less cushy, and I haven't tried that material out. Anyway, I recommend trying the fabric idea.

[Julie]

Search for Pad-a-Cheek on the forum, or just Google it. They make padding specifically for cpap masks and headgear. Hope you can find something that works for you. You might also want to talk to a dermatologist, and bring your masks along (reminding him/her that keeping the seal is vital... I can't believe Lanolin didn't make it useless!).

[rosiefrosie]

Coumadin really effects the skin, makes it thinner and easy to tear. Do you have to be on this long term? Hopefully the cloth gasket will work for you.

Rosie

[janp]

BleepingBeauty ...

Thanks. Unfortunately my skin is so thin, that even with the Milk of magnesia approach, my skin couldn't handle the tape.

Scarlet834 ...

Does the mask hold its seal with the microfiber material between the silicone of the mask and the skin (in this case the oral part of the mask)? How do you hold the material in place under the silicone?

Julie ...

Thanks, but the Pad A Cheek doesn't include the silicone to skin contact of the mask itself.

Rosie ...

You are so right. The Coumadin does make the skin thin to where it tears easily.

Unfortunately, I be taking Coumadin the rest of my life.

Thank you again all for responding and trying to help.

Jan

[mdintx]

Sounds like the best bet for you is to get some moleskin or fabric and make a gasket for the part that touches your face. BleepingBeauty posted a pic of how she uses moleskin on her FullLife mask.

[BleepingBeauty]

Sounds like the best bet for you is to get some moleskin or fabric and make a gasket for the part that touches your face. BleepingBeauty posted a pic of how she uses moleskin on her FullLife mask.

That's a great suggestion, md.

Jan, you can find moleskin at most pharmacies (near the Dr. Scholl's supplies) if you want to try this. Works for me (although not because of sensitive or too-thin skin, per se, but more to alleviate the pressure exerted on the bridge of my nose from the FFM). The moleskin is very soft and comfortable, and it stays in place. I don't have any issues with leak because of it, either.

This is how I apply it to the FullLife; you could do the same all the way around your oral cushion's seal:



I hope you find some relief, somehow. Let us know how you make out.

[Muse-Inc]

...[/

Why not try the MoM on your skin where the silicon touches; if that doesn't work, try the moleskin on the silicon...maybe you'll need both to protect your skin. Are you sure there are no soap residues (after rinsing spray with vinegar & let sit 2-3 mins before rinsing)?

[janp]

BleepingBeauty ...

I tried the moleskin last night. It was quite a challenge getting it cut right.

While it did keep my skin from getting torn up ... the the leak rate went way too high, allowing my AHI to go above 30, where the mask had initially produced an AHI below 5. The mask had handled my mouth breathing, keeping the leakage and AHI low.

I had to make a very minor adjustment for a leak (oral portion) when I first went to bed ... but after I went to sleep, apparently the seal of the oral mask went bad.

I hate to over tighten the mask for fear that I'll start breaking skin again ... it takes almost 2 weeks for my face to heal. That means no APAP therapy during that time.

After you put the moleskin on your mask ... did you find that you had to significantly tighten the mask to make up for the moleskin and to retain a good seal against leakage?

Also, how long were you able to use the moleskin on your mask before replacing it?

Thanks for your suggestion.

Muse-Inc ...

I've used liquid Ivory to wash my masks and I do rinse them very well. I've used the Ivory for almost a year without a problem with all of the varieties of masks that I've tried in searching for "the right one" ... but apparently the Coumadin effect is cumulative, making my skin more fragile with time.

Thanks, but I believe that it's the silicone itself against my skin ... where even minor movement (rubbing) against the skin (as I move during sleep) is enough to rub very fragile skin away.

Thanks for trying to help.

Jan

[Muse-Inc]

...liquid Ivory...

Too irritating for my skin. I tried unscented Dr Bonner's castile soap and it was also too irritiating.

...even minor movement (rubbing) against the skin (as I move during sleep) is enough to rub very fragile skin away...

I get blisters where my mask rubs if I have an active night (rare, thankfully)...much less blistering if I use the techniques I described elsewhere. Just one of the things I gotta do 'cause I've been 'blessed' with my family's touchy skin.

Good luck in finding a resolution.

[timbalionguy]

Here's a crazy idea I just thought of. Wonder if it has ever been tried.

I am wondering if you were to coat your skin with 'flexible collodion' along the area where the mask contacts your skin, if it wouldn't make your skin tough enough to handle the mask. It may also improve the seal.

Flexible collodion is most commonly mixed with salycilic acid, and used to remove plantar warts. You very definitely do not want the acid in this case, as the acid is intended to make the skin soft for easy peeling in that case. Ask your pharmicist if he can get you some flexible collodion without the salycilic acid. (My dad, a pharmacist, used to compound this stuff for me when I needed it to deal with plantar warts when I was a kid. He could make it with or without salycilic acid.) You can leave it on your skin, it will stand up to a gentle washing or two.

[BleepingBeauty]

BleepingBeauty ...

I tried the moleskin last night. It was quite a challenge getting it cut right.

Well, that's a bummer. I thought you'd be able to trace the oral cushion on the backing of the moleskin or a piece of paper (like a pattern), then cut it out and then cut out the center. If you decide to continue with the moleskin, make yourself a template and then just use that to cut future pieces to fit.

While it did keep my skin from getting torn up ... the the leak rate went way too high, allowing my AHI to go above 30, where the mask had initially produced an AHI below 5. The mask had handled my mouth breathing, keeping the leakage and AHI low.

I had to make a very minor adjustment for a leak (oral portion) when I first went to bed ... but after I went to sleep, apparently the seal of the oral mask went bad.

Okay, so we know it can work for you from a skin tolerance standpoint. The trick now is adjusting the mask to accommodate the moleskin without leaking.

I hate to over tighten the mask for fear that I'll start breaking skin again ... it takes almost 2 weeks for my face to heal. That means no APAP therapy during that time.

I don't blame you! But you obviously do have to make an adjustment or two to stop the leaks. I'm not saying make it tighter. In fact, maybe you need it a little looser now, since the moleskin is between your face and the seal.

After you put the moleskin on your mask ... did you find that you had to significantly tighten the mask to make up for the moleskin and to retain a good seal against leakage?

I started using the moleskin a few days into my use of the FullLife. After three consecutive nights with the mask alone, my nose was red, swollen, and extremely tender. I gave myself a night off (used my old Swift LT) to give my nose a break, and then I went back to the FullLife with the moleskin. So I was still in the beginning stages of adjusting the mask when I began using moleskin, and many tweaks occurred. Maybe someone else (who used a mask for a long time before adding the moleskin) can answer that question better than I can. But FWIW, my mask isn't tight enough to hurt, even with the moleskin.

Also, how long were you able to use the moleskin on your mask before replacing it?

Thanks for your suggestion.

I can get a good number of nights out of a piece of moleskin. When I wash my mask, I peel off the moleskin and stick a corner of it to the bathroom mirror for safekeeping. Later, when the mask is dry, I reapply it (as long as it still looks "clean" and has enough "stick" that I can use it again). I guess the answer to that question, for you, would depend on how sensitive your skin becomes to the repeated use of the same piece of moleskin.

HTH, and best of luck making something work.