17 December 2020 Coronavirus: how this virus can affect our largest organ, the skin?

There’s no need here to list the usual clinical manifestations of COVID-19 infection. They are many and sadly may lead to acute respiratory distress syndrome and death. Let’s focus on a special topic : our skin. 

The skin symptoms have been poorly described but may include erythematous rash, urticaria and chicken pox but also hair loss, rosacea, eczema and atopic dermatitis which start a few days after first COVID-19 general symptoms.*

Scientists already know that coronavirus gets into cells thanks to ACE2, a protein on the surface of many cell types all over our body and about on the surface of endothelial cells.

Microvascular endothelial cells are the major components of dermal blood vessels and are clearly involved in skin inflammatory process.

In Spain, skin biopsies of distinctive red lesions on toes, known as chilblains, found viral particles in the endothelial cells, leading the authors to conclude that “endothelial damage induced by the virus could be the key mechanism.“**

Furthermore, lab experiments have shown that the coronavirus can infect engineered human endothelial cells.

As COVID-19 looks like to lead to a global endothelial dysfunction, we can conclude that over time, it can cause skin inflammation and oxidative stress that could be prevented with skin care products.

Impacts of the mask

Beyond COVID-19 infection, some skin disorders has also been appeared with prolonged contact with absolute necessary but impairing face masks and excessive use of hygiene products.

It is mainly due to the dryness effect of the face masks. These equipments can cause the breakdown of the epidermal barrier, contact reaction and friction, which may exacerbate an already established skin problem. Papules, scaling, maceration and erythema are the effects on skin the most frequently noticed. The symptoms observed are itching, stinging and burning.

Challenges are now high to cosmetics industry to advice and support consumers with dedicated products to prevent skin damages as face masks looks like to become usual. A new cosmetic routine will emerge to prevent breakouts and irritation. Skin cleansers will need to be noncomedogenic, pH-balanced, preserving microbiota to gently clean all kind of skins.

*Source: Vascular skin symptoms in COVID-19: a french observational study

**Source: Cutaneous manifestations in COVID-19: a first perspective. Safety concerns of clinical images and skin biopsies.