Lung Disease and Masks: Myths and Facts

Reviewed by Brunilda Nazario, MD on January 26, 2021

If you have a lung disease like asthma or chronic obstructive pulmonary disease (COPD), it’s important to take steps to protect yourself from COVID-19 and other viruses. But you might be wondering if wearing a face mask to lower your risk of illness will make it harder to breathe, or even make your lung disease worse.

“There are a lot of myths floating around about who should wear a mask, and how and when they should wear it,” says Frank Coletta, MD, director of pulmonary medicine and chief of critical care at Mount Sinai South Nassau in Oceanside, NY. Read on to get the facts on masks and lung disease.

Myth: Masks Aren’t Safe for People With Lung Disease

Fact: Almost all people with lung disease can and should wear a mask. “They don’t restrict your breathing,” Coletta says. “They might feel slightly uncomfortable, but that’s not a sign that you’re getting less oxygen.”

“Studies show that masks don’t impact air exchange, even for people with severe emphysema,” says Bradley Hayward, MD, a pulmonologist at Weill Cornell Medicine and NewYork-Presbyterian in New York City. “Your breath might feel warmer. But if you think that’s uncomfortable, imagine being on a ventilator because you got COVID-19.”

You might have heard that masks cause a dangerous buildup of carbon dioxide (CO2) that you end up inhaling. That’s a myth, too. CO2 particles are so small that they easily pass through masks, including special protective masks called N95s. Even so, if you do have very severe lung disease and feel uncomfortable, talk to your doctor about finding the best mask for you.

Myth: Masks Don’t Prevent COVID-19 or Other Diseases

Fact: The only way to completely guarantee that you won’t get sick is to avoid contact with other people. But masks lower your risk of COVID-19 by at least 70%. What’s more, research shows that if you do get exposed to the COVID-19 virus while wearing a mask, your symptoms may be milder. That’s because you’ll be exposed to fewer virus particles, which could make your illness less severe.

“If used properly, masks also help prevent other serious illnesses, including the flu and pneumonia,” Coletta says. “That’s extremely important, because people with lung disease often get seriously ill, sometimes even from a cold virus.”

Myth: You Need to Wear Your Mask at All Times

Fact: There are certain times when it’s safe to take off your mask. “If you’re walking around outside and there aren’t other people around, it’s OK to remove your mask,” Hayward says. Likewise, you don’t need to wear a mask when you’re home alone or with the family members who live in your house. The exception: “If anyone you live with shows signs of illness, even if it’s just the sniffles, or has been around someone who’s been sick, then wear your mask indoors around them,” Coletta says.

You might wonder if you still need to wear a mask when you’re social distancing. Staying 6 feet away from other people does help reduce your risk of getting COVID-19 and other viruses from other people. But until the pandemic is over, you should still wear a mask when you’re around people who aren’t part of your household.

Myth: You Can’t Wear a Mask if You Use Oxygen to Breathe

Fact: Most people who use oxygen can safely wear a face mask. If you aren’t sure or have concerns, talk to your lung specialist. If you use oxygen, Hayward says you can put the mask directly over your cannula (the plastic tube that delivers oxygen to your nose).

The mask should cover your mouth and nose. “If you wear it under your nose, it’s useless,” Coletta says. Even wearing a cannula, you can expel particles through your nose that could make another person sick if you’re infected. You can also inhale virus particles that can make you sick.

Myth: All Masks Are Equally Effective

Fact: Most masks will reduce your risk of getting sick, but only if you wear them the right way. Cloth masks and surgical masks are both good choices, Hayward and Coletta say. “If you use a cloth mask, make sure you wash it between uses,” Coletta adds. Likewise, toss surgical masks after every use.

The mask should cover your mouth and nose without pressing tightly on them. That’s a sign it’s too small and may make it harder for you to breathe. Your mask shouldn’t have gaps at the side, either. Tying a knot in the ear loops may help reduce gaps. Or try a different size or brand of mask.

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There are some types of masks that don’t effectively protect against COVID-19 and other viruses. “Skip the kind with an exhalation valve,” Hayward says. Valves allow larger particles to go in and out of the mask, which boosts your risk of illness. Avoid bandanas and gaiters. Research shows they don’t block droplets from your mouth or nose.

A fabric mask should have two layers. You can also wear two masks at once, as recently suggested by Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.

WebMD Feature

Sources

SOURCES:

Michigan Health: “4 Face Mask Myths that Put You at Risk,” “Mask Wearing for Pulmonary Patients,” “Yes, You Should Wear a Mask. Here’s How and Why.”

CDC: “Scientific Brief: Community Use of Cloth Masks to Control the Spread of SARS-CoV-2.”

Asthma and Allergy Foundation of America: “What People With Asthma Need to Know About Face Masks and Coverings During the COVID-19 Pandemic.”

Frank Coletta, MD, director of pulmonary medicine; chief of critical care, Mount Sinai South Nassau, Oceanside, NY.

Bradley Hayward, MD, pulmonologist, Weill Cornell Medicine and NewYork-Presbyterian, New York.

World Health Organization: “Coronavirus disease (COVID-19) advice for the public: Mythbusters.”

NBC News: “Dr. Fauci: Double masking against mutant coronavirus ‘just makes common sense.”

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