The PPE most likely to reduce pressure points includes properly fitted elastomeric respirators with silicone seals, goggles with foam gaskets, and masks with wider straps or adjustable headbands. But the equipment itself is only part of the solution. Prophylactic skin barriers, strap accessories, and correct sizing all play a role in preventing the soreness and skin breakdown that come with prolonged wear.
Where Pressure Points Develop
A systematic review in the Journal of Clinical Nursing found that the nasal bridge is the most common site of PPE-related skin problems, reported in over half of healthcare workers studied. Cheeks and ears were close behind, each affected in roughly a third of workers. The forehead, chin, and area around the eyes are also vulnerable, though less frequently.
These injuries happen because PPE presses against skin that sits directly over bone with very little cushioning tissue underneath. When external pressure exceeds about 32 mmHg (the pressure inside your smallest blood vessels), blood flow to the skin gets cut off. Moisture from sweat, exhaled air, and saliva makes things worse by softening the skin and increasing friction. The longer the wear time, the higher the risk.
Respirators With Better Pressure Distribution
Not all respirators create the same pressure pattern. Disposable filtering facepiece respirators (like standard N95s) concentrate force along the nose bridge and cheekbones through a relatively rigid edge. Elastomeric respirators use a molded silicone or rubber facepiece that conforms to your facial contours, spreading contact force over a wider area. They also filter more effectively, with studies showing 60% higher filtration performance and a better seal compared to disposable masks of the same filter rating.
That said, elastomeric respirators are not pressure-free. Extended or repeated use can still cause skin breakdown over the nose bridge and sides of the face. The key advantage is that their adjustable straps and pliable seal allow you to fine-tune the fit, which helps redistribute pressure rather than letting it concentrate in one spot. If you wear respiratory protection for long shifts, an elastomeric model with a silicone skirt is generally easier on the skin than a disposable one.
Goggles and Eye Protection
Safety goggles that press hard against the brow and cheekbones are a common source of discomfort during long wear. Look for goggles with a soft foam gasket insert, which creates a cushioned seal around the lenses and reduces pressure around the eyes. Wide, adjustable elastic headbands also help by spreading strap tension across a larger area of the back of the head rather than pulling the goggle frame into your face.
Ventilated foam padding serves a dual purpose: it absorbs some of the compressive force and allows a small amount of airflow, which reduces the moisture buildup that accelerates skin irritation.
Ear Savers and Strap Extenders
Ear-loop masks pull directly on the backs of the ears, a spot with almost no subcutaneous fat to cushion the pressure. Over a full shift, this causes pain, redness, and sometimes open sores. Ear savers are simple accessories, typically silicone or plastic strips with hooks, that reroute the mask loops to the back of your head. This shifts the tension away from the ears entirely and onto the broader surface of the skull, where it’s far less noticeable.
Adjustable versions let you dial in the tightness so the mask stays sealed without excess force. If you wear a surgical-style mask for hours at a time, an ear saver is one of the cheapest and most effective ways to eliminate a major pressure point.
Protective Dressings Under PPE
Thin hydrocolloid and foam dressings applied to the skin before donning a mask are the most widely studied approach to preventing device-related pressure injuries on the face. Hydrocolloid dressings are flexible wafers made from a blend of gelatin, pectin, and other polymers. The outer layer is a breathable, waterproof film, while the inner layer locks in moisture and cushions the skin. Clinical studies have shown that applying these dressings at the points where a mask contacts the face significantly reduces the incidence of facial pressure ulcers.
There is an important caveat: adding any material between your skin and an N95 respirator can interfere with the seal. A quality improvement project that tested six different dressings under three N95 models found that most thin dressings passed a user-performed seal check, but thicker foam dressings added enough bulk to cause the respirator to slip off the nose bridge, creating a contamination risk. Regulatory guidelines state that any dressing applied under an N95 requires a formal fit test with the dressing in place, not just a quick seal check. If your workplace requires N95 protection, don’t assume a dressing is compatible without testing the fit.
Liquid Barrier Films
An alternative to dressings is a liquid barrier film applied directly to the skin. These are alcohol-free, fast-drying products that leave an invisible protective layer on the skin’s surface. Their main benefit is friction reduction. Lab testing found that a liquid barrier film reduced the friction between skin and fabric more effectively than a silicone dressing, making it a strong option for preventing the shear forces that contribute to pressure injuries.
Liquid barriers have a practical advantage over dressings when it comes to respirator fit. Because they add no bulk, they don’t interfere with the seal the way a foam or hydrocolloid pad might. One hospital evaluation found that an alcohol-free liquid acrylate film was the only prophylactic product that maintained an accurate N95 seal, provided comfort, reduced friction, and could be applied and removed without risk of self-contamination. For workers who need both skin protection and a reliable respirator seal, a barrier film is often the safest compromise.
Sizing and Fit Adjustments
No accessory or skin barrier fully compensates for PPE that doesn’t fit. A respirator that’s too small concentrates force on the nose and cheeks. One that’s too large requires overtightening the straps to maintain a seal, which increases pressure everywhere. The same principle applies to goggles and hard hats with suspension systems.
If your workplace offers multiple sizes or models of respirator, try each one. Small differences in facepiece shape can dramatically change where pressure falls. Adjustable headband-style straps (rather than ear loops) generally allow more precise tension control. For goggles, look for models with multiple adjustment points on the strap and a frame that sits evenly around the eye sockets without digging into the brow or cheekbones.
Taking scheduled breaks from PPE, even brief ones, restores blood flow to compressed skin. If your work allows periodic removal in a safe area, alternating 10 to 15 minutes without the device can make a meaningful difference over a long shift.