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What People With Asthma Need to Know About Face Masks During the COVID-19 Pandemic

 

Update – Aug. 27, 2021

We updated this blog post to include updated face mask guidance from the Asthma and Allergy Foundation of America (AAFA) and the Centers for Disease Control and Prevention (CDC).


Face masks are an essential tool in our fight against COVID-19 (the coronavirus). But wearing a face mask raises many questions for people with asthma.

Do We Still Need to Wear Face Masks to Prevent the Spread of the Coronavirus?

In July 2021, the Centers for Disease Control and Prevention (CDC) provided new mask guidance due to the spread of delta variant of the coronavirus and rising COVID-19 cases. They now recommend that everyone in areas of high transmission wear a mask in public indoor places, even if you are fully vaccinated.

You are fully vaccinated two weeks after getting your second Pfizer-BioNTech or Moderna shot or two weeks after getting one Johnson & Johnson (J&J) shot.

If you have a condition or are taking medicines that weaken your immune system, talk with your doctor about which activities are safe to do.

On Aug. 23, 2021, the FDA approved the Pfizer COVID-19 vaccine for ages 16 and older. It has been named Comirnaty [koe-MIR-nah-tee]. Experts expect the FDA to authorize more COVID-19 vaccines as they complete clinical trials. If you have not received a COVID-19 shot yet, plan to get vaccinated as soon as possible.

Should I Still Wear a Face Mask?

While COVID-19 cases continue to rise, wear a face mask in public places to protect yourself and others, even if you are fully vaccinated. It is especially important that you wear a face mask if you are immunocompromised (or live with someone who is) or are at risk of severe disease due to other health conditions.

According to the CDC, the coronavirus that causes COVID-19 is airborne and spreads from person to person the coronavirus that causes COVID-19 is airborne and spreads from person to person. It can spread through droplets from your nose or mouth when you breathe, talk, sing, yell, eat, sneeze, or cough. You are most likely to catch it if you are not fully vaccinated and less than 6 feet (2 meters) from someone who is infected.

Studies have shown many people have COVID-19 and don’t show symptoms. Or they may have the virus a few days before they show symptoms. The purpose of wearing a face mask is to keep you from spreading COVID-19 to other people if you are not fully vaccinated. Fully vaccinated people with delta variant breakthrough infections can spread the virus to others. This is especially important in places where you will be close to people, like while shopping, in a waiting room, or on public transportation. In Missouri, two hair stylists had COVID-19 and served 139 clients. Both the stylists and the salon clients wore face masks. None of their clients got COVID-19.

Wearing a face mask may also make COVID-19 symptoms less severe if you do get it. Several studies show that face masks may reduce the amount of particles of the coronavirus you take in, which can result in milder illness.

What Are Other Benefits to Wearing Face Masks?

Pollen can trigger asthma. Wearing a mask can help keep pollen from getting into your nose and lungs. Even though a mask can help prevent symptoms, consider going outside when pollen counts are lower.

Changes in the weather can also be an asthma trigger, so keep it in mind when wearing a mask. When it’s cold, wearing a face mask can warm and humidify the air you breathe. Hot and humid weather can make wearing a mask more uncomfortable.  Consider going out at times of the day when the weather is milder.

Exercise is important for people with asthma. Stay active but avoid situations where you would need a mask. If you are outside on a trail or in a park, you probably wouldn’t need to wear a mask. Consider working out outside or at home instead of going to a gym or exercise class that may require a mask.

Masks also can protect you from respiratory infections like the flu, COVID-19, and even the common cold. Masks provide protection for people who are immunocompromised.

Do Children Need to Wear Face Masks?

COVID-19 vaccines are now available in the U.S. for everyone 12 years old and older. Children in this age range should get vaccinated as soon as possible so they are protected from COVID-19.

The CDC recommends universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status.

Children with a disability that keeps them from safely wearing a mask and children under 2 should not wear masks.

Can People With Asthma Wear Face Masks?

Yes, people with asthma can wear face masks.

The CDC recommends that you wear a mask in public indoor spaces even if you are fully vaccinated. The WHO recommends wearing a fabric mask that allows you to breathe while talking and walking quickly.

“For people with very mild asthma or well-controlled asthma, it’s probably not going to be an issue,” said Dr. David Stukus, member of the Medical Scientific Council for the Asthma and Allergy Foundation of America (AAFA). “For people who have very severe disease and have frequent exacerbations, ER visits, hospitalizations, require lots of medications and frequent symptoms, it might cause more issues for those folks.”

It’s important to keep your asthma under control. Keep taking your medicines as prescribed. If you are having breathing issues that need your quick-relief inhaler (e.g., albuterol) more than two or more times per week, it’s a sign to call your doctor.


If you’re having trouble wearing a mask, try a different fabric or fit. Wearing some kind of breathable face mask is better than nothing. According to the WHO, medical masks when worn the right way do not cause you to breathe in more carbon dioxide or reduce your oxygen levels. Other studies back this up as well. And a face mask made of three layers probably won’t fit tightly enough to affect your oxygen either. If your mask is uncomfortable, try a new type of mask.

What Kind of Face Mask Should I Wear?

There are many options for cloth face masks. You can buy disposable or reusable face masks at many major retail stores or online, or you can make your own. Fabric made from 100% cotton, such as heavy-duty quilt fabric or a knit T-shirt, can be somewhat effective.

Finding a mask that is comfortable and fits well will provide the best protection, If you feel the need to readjust or pull on your mask, it does not fit well. The CDC recommends:

  • Masks with multiple layers of fabric
  • Masks that fit snugly against the sides of your face without any gaps
  • Masks that cover your nose, mouth, and chin
  • Masks with inner filter pockets
  • Masks with a metal strip or nose guard to keep air from leaking out
  • Using a mask fitter or brace over a disposable or cloth mask to prevent air leaking out of the sides and top
  • Wearing one disposable mask underneath a cloth mask (The second mask should push the edges of the inner mask against your face)
  • Knot and tuck ear loops of a three-ply mask (See video below)

Children two years and older should wear a mask that is made for children to ensure a snug without any gaps.



Watch on YouTube


Do not choose masks that:

  • Are made of fabric that makes it hard to breathe, such as vinyl
  • Have exhalation valves or vents which allow virus particles to escape, unless the inside of the valve/vent is covered by fabric

Do not wear two disposable masks at a time or combine a KN95 mask with any other mask.

The WHO recommends masks that have three layers:

  • An outer water-resistant layer (such as polyester or polyester blend)
  • A middle layer of non-woven fabric (such as polypropylene)
  • An inner layer of cotton

Try different styles and fabrics to see what works for you. To tell if a face mask will be effective, hold your mask up to a light. If you can easily see the light through your mask, it may not provide enough protection. Make sure your face mask blocks the light but still allows you to breathe through it.

Some types of face coverings are not effective at preventing the spread of coronavirus. Bandannas cannot fit tightly enough against your face. The CDC suggests wearing a neck gaiter with two layers or folding it in half to make two layers. If you have a mask with a vent or valve, check the inside of the mask. If you see fabric inside that covers the valve or vent, then the mask is OK to wear. If you see the vent or valve from the inside of the mask, you should not wear the mask because droplets from your mouth and nose can pass through the valve as you exhale.



face-mask-with-valve

The picture above shows examples of two types of valved masks. The mask on the top is not effective at preventing the spread of the new coronavirus because the valve is exposed on the inside. But the valve on the mask on the bottom is covered by fabric on the inside and is appropriate to wear.



Keep in mind that some businesses or schools may mandate which type of masks are most appropriate in their environment.

If you have a latex allergy, be careful with elastic ear loops. Choose face masks with fabric ear loops or that tie behind your head.

How you wear, remove, and clean your face mask is important. It should fully cover your mouth, nose, chin, and beard. Make sure there are no gaps between the face mask and your skin.

Follow these steps when putting on and removing a face mask:

  1. Wash your hands or use hand sanitizer before putting on a face mask.
  2. Avoid touching the face mask while using it.
  3. If your face mask gets damp, replace it with a clean one.
  4. Remove the mask by the ear loops or ties, trying to not touch the parts of the mask that touch your face.
  5. Wash your hands or use hand sanitizer.
  6. Wash fabric face masks in hot, soapy water right away. Throw away disposable masks immediately.

Continue to practice physical distancing even if you are fully vaccinated and wear a face mask. A face mask will not give you 100% protection from COVID-19. But it will help you and others reduce the chance of spreading it, especially if you aren’t showing symptoms.

Do I Have to Wear Face Masks on Public Transportation?

Masks are still required for travel on all public transportation even if you are fully vaccinated.

As of Aug. 27, 2021, the updated mask guidance from CDC says that masks are still required on planes, buses, trains, and other forms of public transportation. This includes traveling into, within, or out of the United States and in U.S. transportation hubs such as airports and stations.

What Can I Do If My Job Requires Me to Wear a Face Mask?

You may be required to wear a mask as part of your job. But if you have trouble breathing while wearing a face mask, what are your options?

The first step is to work with your employer. Talk about ways you can work while still helping prevent the spread of COVID-19.

Here are some ways you may be able to work with your employer:

  • Ask for time off to get the COVID-19 vaccine.
  • Ask to serve in a role away from the public or other employees.
  • Ask if you can work a different shift or from home.
  • Try different types of face masks in different fabrics or styles to find something more breathable.
  • If you are part of a union, work with your union representative to ask for reasonable accommodations.
  • Ask if you can take more frequent breaks if you feel a face mask is affecting your breathing.
  • Stay home if you start having asthma or COVID-19 symptoms.

People with asthma may be covered under the Americans with Disabilities Act (ADA). Under this act, people with disabilities can ask for reasonable accommodations so they can work. If your work requests won’t create a hardship for your employer, you can ask for accommodations.

But the ADA also says if an accommodation could cause harm to other people, then a business does not need to provide the accommodation. If a person with asthma is coughing and not wearing a mask, they might be exposing other people to COVID-19. So in this case, the employer could require the person with asthma to stay home or wear a face mask.

If your company requires a face mask, try to find one that works for you. Refer to the mask suggestions above.

Don’t be afraid to talk to your supervisor or human resources representative. They may also have some creative ideas to help you do your job while managing your asthma.

Remember, wearing a face mask is only part of the strategy to prevent the spread of COVID-19. Getting fully vaccinated, physical distancing, staying home, and washing your hands often can also help protect you and other people from COVID-19.

Medical Review June 2021 by Mitchell Grayson, MD. Updated August 2021

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The Asthma and Allergy Foundation of America (AAFA) is the largest and oldest nonprofit patient organization dedicated to asthma and allergies. Our online community includes public blogs. To post a comment, you will need to register or sign in.

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Comments (25)

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The WHO recommendations for types of material for face mask coverings are ill-advised. Have you noticed how many people have pulled their masks down to uncover their noses, or even pulled them down under their chins? It is because they cannot breathe through them. One must use breathable fabrics for a homemade face mask. Fabrics such as cotton, and not polyester or polypropylene. The CDC RECOMMENDS COTTON. On jennifermaker.com, she uses tightly woven quilter’s cotton and heavy duty cotton T-shirt fabric.  Remember: if you can’t breathe through the mask, you will not wear the mask. I find the non-medical blue disposable mask unbearable, even though my asthma is well-controlled. It does not bother my husband; but then, my husband does not have asthma. I made my masks with 3 layers of cotton, as recommended by Jennifermaker.com.

Hello @Treychene and welcome to the AAFA community. It's uncomfortable sometimes to wear masks so I do sympathize. I hope you'll join in some of the masking discussions in the forums too. Many have their favorite styles and strategies which go a long way toward making things masks easier to use.

I have asthma, severe asthma, all my life. Recently, I was diagnosed with allergies; environmental and food allergies. Both are no fun to have because one might not be triggered but the other does and vise versa. I've read comments on here about wearing a mask and I've also read on this website about wearing a mask isn't bad for asthmatic people. Let me tell you, I don't need Science to tell me, I don't need the CDC, Dr. Fauci and the WHO to tell me that mask works because...IT DOES NOT WORK...FOR ME! I am the LAST PERSON to make that choice to NOT WEAR A MASK! Since the first day when COVID started, I worn mask for the first hour and it was tough! couldn't breath, had anxiety attacks, I felt RESTRICTED! Since that time I have NOT worn a mask, never will and never have! This is America, and I have the last say for my health, NO MASK...PERIOD. NO COVID, never had it and never will, why? because I also social distance...all the time and that works for me. People choose to wear a mask, thats fine! I choose to social distance and it works for me. All I will say is YOU stay away from me when you wear your mask because if you tell me, to wear a mask, I will tell you "stay out of my perimeter! I give you the same respect, you should give me the same respect.

I had to wear a mask for hours on Wednesday. Now it is Friday. My ribcage still hurts. But I am afraid to be without a mask. I am afraid of fines and assault. People have threatened me. People say, (Real Loud) "People without masks should be drug out and shot." I have begged our politicians to say something. I have tripled my asthma meds. I get my groceries delivered. This year needs to end.

@LoriC @Lois Hi! I have moderate to severe asthma controlled on medication and also work at a high volume business where I am working almost constantly. I have found two types of masks work for me (cotton cloth and nylon with an additional cotton cloth layer). Being high risk and considered essential I would prefer you and others wear a mask because it puts me, other  people who are high risk, or their families are high risk at ease. Considering you are high risk I would not want you to come out without wearing a mask not for my own safety but for yours! Because the virus is a respiratory illness it could be fatal with asthma so please consider your health! Also most places offer online shopping or shipping directly to your door so you can avoid confrontation on the matter completely. I know it is a hard time and trust me I am itching for things to go back to normal but unfortunately cases are on the rise an mask enforcing is for the safety of everyone.

Great tips Ben! Especially practicing wearing the mask at home and build up to a longer duration. I've seen this suggested particularly for special needs kids with sensory issues.

I'm finding that the fit of the mask is most important for me. It can't press on my nose and I need a mask that is more shaped and suck in against my face as I inhale.

I am unable to wear a mask due to my asthma! Some stores will not allow a person to shop if they don't wear a mask! They want to know why & if I say medical, they ask what my medical issue is and if I have proof of the medical issue!  I politely tell them that is between me and my Dr. and is against the ADA & HIPPA! They don't care and say that it is the policy!  
I would like to know if anyone else has encountered this discrimination and how you handled it!

I'm have asthma like a lot of people do, but I don't like wearing any mask, they all feel suffocating and like I can't breathe at all because of the mask, it's in the way of how we live, I can't even run with having the mask on.

Wearing a face covering remains an important tool for preventing the spread of COVID-19. Face coverings protect not only ourselves but others who can't wear a mask, such as kids under 2 who can't wear a mask and kids under 12 who are not eligible for the vaccine. Unfortunately, face coverings can feel restrictive which can be stressful.

Finding a mask that fits comfortably and wearing it for short periods can help to see what works for an individual. Keeping nasal allergies and asthma under your best control is also important. Personally, I find ones that create a pocket where the fabric is not up against my lips the most comfortable. I know for myself, masks that touch my lips are very uncomfortable and make me feel like I can't breathe well. I have found a design that creates a sort of pocket that does not feel as restrictive to me. Being able to take "mask breaks" in a safe area also helps.

Physical distancing is very important for anyone unable to wear a mask especially if they are not vaccinated. Sometimes keeping an adequate distance is not possible especially indoors with poor ventilation. In that case, it's good to have a mask handy that can be worn until you can exit that situation.

@DeannaBu I’m sorry that you have to go through this . As someone with primary Ciliary Dyskinesia and also allergic asthma, migraines,  I understand completely. But also as an supervisor for a government agency part of  my requirements are to make sure compliance of PPE, masks .  It certainly is an interesting time that we are right now but it takes all stakeholders to come to a solution. At my job we require mask use pretty much at all times .  We also social distance. Even with social distancing mask wearing is required.  It’s a liability issue for us when people don’t follow ppe and mask rules .   Another thing to consider is many job sites don’t have the requirements for proper air flow . The employee in question can get sick , the other employees can sick . Also the virus spreads rapidly and can linger in the air , which doesn’t make the situation better . At my job we were exposed by one person literally 80 people were out in quarantine in three hours. Can you talk with your employer?   Have you asked your employer if you could maybe work from Home ? Or does your job offer FMLA program. I give my employees extra breaks so we don’t have as many employees at one time in an area,  so they can step away and take there masks off but in another room isolated by themselves .  We also have plexiglass areas installed in areas that deal with the public side . Perhaps your employer can work with you in these similar  areas ? Do you have potential solutions or ideas  that you can bring to your HR dept ? People who can’t wear masks have to have some medical documentation and they may be placed in a non work duty status at home  or somewhere else or some other program.   Some employees who aren’t able to comply or follow directions  might be considered Not fit for duty and that starts a whole other process .   Since employees are hired to fulfill certain tasks . Most employers understand the situation and will work with you but unfortunately there has to be compromise on both sides .  I wish you luck .

Welcome, DeannaBu.That's a most frustrating situation to find yourself in. I hope some AAFA community members can support you as you figure things out. There's a conversation at Having breathing issues while wearing a face mask where people are talking about work pressures. Would you share your thoughts there? 

I am currently battling my employer over my asthma.  I am dealing with constant issues of my mask not being worn well enough. It came to a head when I had to remove it to use my inhaler and wasn't wearing it in the office. I was still maintaining social distancing in a office with less than 10 people and keeping more than 8 feet apart, but it wasn't good enough. I think I'm going to have to quit because the pressure is giving me anxiety attacks on top of my asthma.

I am so sorry that happened @Jennsita. The AAFA community will know what you're talking about and will support you as best we can in this 2020 challenge. Would you be willing to share your thoughts in Having breathing issues while wearing a face mask where we can have a longer conversation. Hang in there and hugs from us all.

Last edited by Kathy P

Thanks for the name of the new mask with fans @Pete I was able to find their website and get my questions answered.  Is your sister still happy with it after a few weeks+ usage?

We updated this blog post on Aug. 13, 2020, to include information on types of face masks or coverings that aren't effective at preventing the spread of the new coronavirus.

The Asthma and Allergy Foundation of America (AAFA) is the largest and oldest nonprofit patient organization dedicated to asthma and allergies. Our online community includes public blogs. To post a comment, you will need to register or sign in.

@Pete posted:

my sister bought a mask with fans in it and it allowed her to commute without heat building up or getting sweaty. 

Welcome @Pete !  Is that an adaptation of a pre-Covid product or something new?

my sister bought a mask with fans in it and it allowed her to commute without heat building up or getting sweaty.  Although its a bit big on her face she can breathe comfortably now.  the blue masks were driving her nuts. 

We updated this blog post on Aug. 6, 2020, to include studies on how masks may prevent the spread of the new coronavirus and lessen severity of symptoms.

The Asthma and Allergy Foundation of America (AAFA) is the largest and oldest nonprofit patient organization dedicated to asthma and allergies. Our online community includes public blogs. To post a comment, you will need to register or sign in.

Last edited by Tanya B.

@LoriC try talking to the stores managers before hand call . Perhaps they can open the store early for you or shop for you .  Unfortunately it’s policy and essential employees are trying to protect their  health .  Also other patrons are trying to do the same . At my job we had passengers who knew they were waiting on a pending Covid test and still got on a plane anyway without a mask . Every situation is not going to be perfect or to your liking but many are in the same boat as you . 

As an essential worker who wears there mask all day here are some tips  it’s important to  practice wearing the mask before hand . Try it at home in AC . Take small breaks by yourself in a spot where you don’t have to wear a mask . Communicate with your employer and coworkers . Don’t just assume that it’s just you that might have a problem. Keep in mind that  wearing masks all day may cause migraines like I get . So have a plan with that ready to go as well . Also try on the masks you plan to use of course . Each one is made different.

@LoriC posted:

I am unable to wear a mask due to my asthma! Some stores will not allow a person to shop if they don't wear a mask! They want to know why & if I say medical, they ask what my medical issue is and if I have proof of the medical issue!  I politely tell them that is between me and my Dr. and is against the ADA & HIPPA! They don't care and say that it is the policy!  
I would like to know if anyone else has encountered this discrimination and how you handled it!

I understand your frustration. I can't wear any masks so far (still looking for something I can tolerate)  You're right, we shouldn't have to carry around our diagnoses on our sleeve. I've given up on any expectation of privacy any more. I suppose the clerks are just trying to do their jobs and have something to tell their supervisors, and maybe feel as safe as possible themselves. They probably would accept a brief "asthma" and a display of an inhaler. Or you could try launching into a long story about asthma and its limitations and pretty soon they will back away and leave you alone. Then you'll have the last laugh! In these tough times, it's laugh or cry.

My problem with the cloth masks is they all produce lint and I do not want to breathe in lint. I have tried washing and lint rolling them but can't get out all the lint.  i tried a surgical mask type but it was not ASTM and even though it is paper, it also produces lint like fibers and I cannot wear it. Is there anywhere i can get true ASTM surgical  masks? Any other suggestions?

I just read about a steroid called Dexamethasone being touted as a possible aid in the coronavirus. What do you know about people who are on steroids already having some benefit from them. I am currently on prednisone and was wondering if that would offer any help.

Sent from Mail for Windows 10

Last edited by Kathy P
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