key: cord-0687094-i9o6dnn6 authors: Noronha, Malcom; Jindal, Anuradha; Mysore, Venkataram title: Modified mask for aesthetic procedures on face during COVID‐19 era: chiseling our armamentarium date: 2020-06-15 journal: Dermatol Ther DOI: 10.1111/dth.13819 sha: e222c69d720410d9c637f4f488f493ecee00489d doc_id: 687094 cord_uid: i9o6dnn6 nan Severe Acute respiratory syndrome coronavirus-2 (SARS-CoV2) is a highly contagious enveloped RNA virus which has infected more than 4.9 Million across the globe. As the world has been captivated by the spread of corona virus aesthetics and procedural dermatology has taken a seat back. The drop out in consultations is between 80-90% in both public and private practice. 1 The halt to procedures is not only due to rational fear in minds of both patients and doctors but also due to lack of guidelines and methods to overcome the hurdles faced while conducting procedures the procedures. SARS-CoV-2 spreads via respiratory droplet transmission or contact transmission. The viral particles present inside the droplet nuclei can survive for longer periods over inanimate surfaces and can travel longer distances to transmit the infection. 2 The existence of corona virus will become an integral part of all our decisions in future in our dermatology practice. 3 Dermatologic surgeon/aesthetician must be prepared to learn and adapt to the changing paradigm of the dermatology practice. The risk involved in viral transmission during procedures depends on factors - Level of protection of the patient 4 • Level of protection of the treating dermatologist 4 • Type of procedure -aerosol generating procedures are considered high-risk. 5 • • Use of smoke evacuator for aerosol generating procedures 6 • Ventilation of the room 6 One plausible issue we faced in our practice amidst SARS-CoV2 was procedures over face, as it poses a higher chance of transmission due to close proximity to the upper respiratory tract. Hence it is mandatory for the patient as well doctor to wear a mask. But the current masks (N-95/surgical mask) available reduces the accessible area for the procedures. So, we modified the mask to cover This article is protected by copyright. All rights reserved. only the nose, upper lip and lips without compromising the protection/barrier as well as provide a significant area to perform procedures. First patient is asked to wear the mask and to look straight with eyes at same level. This article is protected by copyright. All rights reserved. Based on WHO modelling, to meet rising global demand, WHO estimates that industry must increase manufacturing by 40 per cent. N-95 mask are recommended for suspected/confirmed cases of covid-19 and for health care workers who are being exposed to such patients. In view of worldwide scarcity of PPE resources we urge people to use surgical mask as compared to N95 for this purpose. Limitation of this method is procedures over upper lip cannot be done. In future, patient's pre-procedure photographs can be taken and analyzed on the computer to mark exact points of measurements. If facility available, 3-D printer can be used to print individualized, well-fitting mask for each patient. To conclude, the modified mask might serve as a useful tool in future to reinitiate aesthetic procedures over face during/after COVID-19 pandemic if used along with essential protective measures required as per the procedure being performed. This article is protected by copyright. All rights reserved. Dermatologists and SARS-CoV-2: The impact of the pandemic on daily practice Report of the WHO-China Joint Mission on Coronavirus Disease Masked" empathy-a post-pandemic reality: Psychodermatological perspective COVID -19 Pandemic: Consensus Guidelines for Preferred Practices in an Aesthetic Clinic Dermatological procedures amidst Covid-19: when and how to resume Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards This article is protected by copyright. All rights reserved