6 Essentials for an Effective Face Mask

6 Essentials for an Effective Face Mask

BY AREFA CASSOOBHOY, MD, MPH | Article Featured on WebMD

A cloth face mask is not foolproof protection from COVID-19, but here is what we know about what makes a good cloth face mask.

At some point, all of us will have to leave our homes and venture into public places. For now, it may be the grocery store or the doctor’s office, but later as social distancing measures slowly ease, we may actually be able to get a haircut or return to the office for work. The new normal will be different – seating will be spaced far apart, there will be plenty of clear barriers to protect workers, and you will likely be wearing a face mask.

In many places, you are already required to wear a cloth face covering, and it makes good sense. According to Dr. Anthony Fauci between 25% to 50% of people can be infectious and spread the virus without symptoms. It is easily transmitted by respiratory droplets simply by speaking or laughing, along with coughing or sneezing.

Of course, a cloth face mask is not foolproof protection from COVID-19, but it is much better than no mask. It is another important layer to physical distancing when used in combination with 6 foot spacing from others and hand hygiene. Unfortunately, there aren’t enough N95 or other medical masks in the U.S. for everyone. We need to save those masks for people on the frontline caring for those sick with COVID-19.

Not surprisingly, the cloth face mask market is increasing exponentially to meet demand, and the science behind what makes a good cloth face mask is inching along slowly. It is difficult to know what qualities to prioritize when searching for a face mask.

Here is what we know about what makes a good cloth face mask:

Sew or no-sew: Either sew or no-sew options are fine when used correctly.  Do what’s reasonable for you.  If you’re in a rush, go with a no-sew option. If you’re crafty, make your own mask at home. Or, order your masks locally or online. Choose mask designs recommended by reliable sources like the CDC. Another option is to check your local hospital’s website. Many are posting patterns with precise instructions to make masks they’ll accept as donations.

Fabric: The best cloth masks will use at least 2 layers of a tightly woven cotton fabric. Look for a high thread count. This acts as a filter blocking respiratory droplets while still allowing you to breathe comfortable.

Filter: Some will have a space to slip in a filter for an added layer of protection. The CDC recommends adding coffee filters to homemade masks. Online I’ve seen many filter options pop-up as people experiment with products in their home. These include cutouts from reusable fabric grocery bags made of polypropylene non-woven fibers, nylon fabric from pantyhose, paper towels, kitchen towels, bra pads, denim, and canvas to name a few.

We do not have much science to go on, so common sense is critical here. Is the filter worth adding when you consider safety and usability? The filter needs to be dense enough to block tiny, moist particles while also being breathable and comfortable. Are you inadvertently breathing something toxic? For example, some HEPA (high-efficiency particulate air) filters can have fiberglass, which would be very dangerous to inhale. Definitely do your own research to keep up with new information.

Fit: You need to be able to breathe comfortably with the mask on so that you do not have to slip it off while you’re in public to take a breath. The face mask must have a snug fit from nose to under the chin and back towards the ears. It’s useless if there are gaps that allow the air in. There are face masks available that come in different sizes.  Also, you don’t want to have to fiddle with the mask, for example if it’s stiff, and potentially contaminate your fingers touching the outside layer of the mask. If you feel like you can’t breathe comfortably with your mask, don’t use it, and talk to your doctor about other face covering options.

Ease of use: Once you find a face mask you like, it’s only as good as how you use it. Make sure you can easily untie or remove the loops from your face and pull the mask away from your face without being contaminated by touching the front of the mask. Infinity scarves are not a good option for masks because they’re difficult to cleanly take on and off.

Plan your outings knowing you should not slip the mask on and off to eat or talk on the phone. If you’re exercising outdoors, you may not be able to tolerate a mask when you breathe hard. In that case, choose your exercise location carefully to make sure you can keep a physical distance from others and be safe.

Durability: You will need to wash the cloth mask after each use, so look for reviews online that comment on the masks wear and tear. If the mask loses shape, you will not be able to use it. If you are adding a filter, cleaning it will depend on what kind of filter you use. A coffee filter should be thrown away after each use. Also, the fabric should be pre-washed so that you don’t need to worry about shrinkage.

When you wear a cloth face mask, it shows you care about your own health and the health of others. It signals to others to be respectful of physical distancing measures and keep a 6-foot distance from you. A cloth face covering is also a subtle reminder that the professional masks are for those on the front line. With all the cool colors and patterns out now, you can even make it a style statement.


Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

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