Medicine For People!

June 2020: Face Mask Tips and Tricks

man with bandana
Chase Elliott Clark from Cambridge MA, USA, CC BY 2.0, via Wikimedia Commons


While a bandana might have worked great for robbing trains, it sucks for disease protection. Air easily goes through and around it.

No matter what kind of mask you wear, the better it fits your face the more it protects you and everyone else. When you breathe in, you want the air coming through the mask, not around it. Breathing out, same thing.

Improving the Fit of a Standard Medical Face Mask

Using the mask alone

Surgeons' masks have ties that go behind the head to create a tight fit over the nose and cheekbones, and a tight fit beneath the jaw.

The ear loops of most of the masks you find in the market don't work as well.

This one minute video shows you how to make them fit better.

How to make your mask fit better by tieing the ear pieces together
Image credit

Be sure to fit the metal strip over your nose to seal the area between the nose and cheekbones.

Using a secondary device

This soft silicone appliance can hang around your neck when not in use, and pulls up over your head to create an effective seal between a standard medical mask and your face.

Use secondary face mask device
Image credit

Using a Mask Fitted to Your Face

This reusable three-layer cloth mask, intended for active adults, comes in six sizes with a nosepiece to close the opening between the nose and the cheekbones. As you can see, the nosepiece is not invisible to the user and some people find this distracting.

Reusable three-layer facemask
Image credit

Fit is the Key

A well-fitting three-layer standard face mask, the kind you can buy at any drug store, is going to protect you better than a carelessly fitted N95.

Assuming the fit is correct, here is the ranking on the material, worst to best.

  1. Single layer cloth mask
  2. Multiple-layer cloth mask
  3. Three-layer surgical mask
  4. Five-layer N95 or KN95 mask

Many mask makers incorporate a pocket for a PM2.5 filter. Unless the filter covers the entire mask area, air will go around it. Don't bother!

Mask Strap Extenders

Mask Strap Extender

A face mask strap extender can spare your ears, tighten your mask, and perhaps prevent loss of a hearing aid.

When to Wear Which Mask

  • Strenuous outdoor athletic activity with no proximity to other people is the only situation in which a neck gaiter is acceptable. Pull it up over your nose in case needed. This one has an adjustable top with metal nose piece. Forget the PM 2.5 filter.
  • For less strenuous activity or more proximity to other people, use a cloth mask or a well-fitted three-layer mask as pictured above.
  • Avoid indoor public spaces, especially if crowded. When you enter such spaces, wear a well fitted three-layer or five-layer mask.

Loose Lips Sink Ships

As I write this in December of 2020 we are losing one or two Titanics's worth of Americans a day. This is the time to install a barrier between your lips (and nose and mouth) and everyone else's.

Please Leave Comments Below

If you know of a mask that might be better than the ones we've mentioned, or you have a tip about using face masks, please share them with us in the comments below.

Thanks to Jill Buhler Rienstra for editorial assistance.



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Medicine for People! is published by Douwe Rienstra, MD at Port Townsend, Washington.