Are Face Shields Better Alternatives to Face Masks?

Medical worker wears face shield and surgical mask outside of NYU Langone
Medical worker wears face shield and surgical mask outside of NYU Langone.


Noam Galai / Getty Images

 

Key Takeaways

  • Face shields block up to 96% of small particle aerosols, making them comparable to N95 respirators.
  • Advocates of face shields highlight their ease of use and the fact they don't hinder facial expressions or communication.

As states begin to lift COVID-19 restrictions and lockdowns, protective measures like social distancing and wearing facial coverings remain in place. Public health officials say that covering your mouth and face when out in public or interacting with others—like customers or other people standing in line—can substantially decrease the risk of spreading the infection in the community.

While the Centers for Disease Control and Prevention (CDC) recommended cloth facials coverings and bandanas in early April, an opinion article published in JAMA later that month suggests plastic face shields are a safer and easier alternative.

What Is a Face Shield?

A face shield is a clear plastic barrier that curves to covers the entire face. It's considered a type of personal protective equipment (PPE). In healthcare settings, it's typically intended to protect from bodily fluids, splashes, or infectious materials.

Advantages of Face Shields

The authors of the JAMA opinion article list several advantages of face shields over other types of facial coverings:

  • Durability: Plastic face shields can be reused indefinitely as long as they're cleaned with soap and water.
  • Expanded Protection: Face shields cover the eyes in addition to the nose and mouth, and the larger surface area prevents wearers from touching their faces.
  • Easier Communication: The visibility of facial expressions and lip movements makes it easier to communicate while wearing facial protection, and eliminates the need to take PPE on and off to speak clearly.
  • Wide Availability: Plastic face shields are easier to produce than medical masks and less likely to be out of stock.
  • Better Protection: Simulations show face shields protect against 68% to 96% of small particle aerosols. (Note: Simulations were done with the influenza virus and not SARS-CoV-2, which causes COVID-19.) According to a 2014 study, wearing a face shield reduced the exposure of infectious particles (like viruses) by 96% when worn within 18 inches of someone coughing.

Face Shields vs. Other Face Masks

How do these face shield benefits stack up to other types of PPE, like N95 respirators, surgical masks, and cloth facial coverings?

N95 respirators—which filter out 95% of airborne particles, including aerosols—are the most protective type of face mask. But they are low in supply and should be reserved for healthcare workers and first responders. Plus, they can only be used once and need to be fitted properly to an individual in order to work. The Food and Drug Administration recommends against their use in the general public.

Surgical face masks—another single-use item—are only designed to block saliva or other large particles that may be emitted when a sick person coughs or sneezes. Without an additional filter, they only block about 20% of aerosols.

Cloth facial coverings are often homemade using any type of cotton or polyester fabric. Different materials mean a range in protection; a recent study suggests cloth face masks are anywhere from 5% to 65% efficient at blocking out aerosol particles. Quilter's cotton, which has a moderate thread count of 80 TPI, offer 5% to 55% protection.

How to Wear

For the best facial protection, a face shield should extend below the chin and to the ears. There should be no gap between the forehead and the shield’s headpiece.

Because face shields don't sit snugly against your face or create a seal around your mouth, they primarily protect against particles and droplets in front of you. You may still be exposed to particles from the side or behind.

Healthcare providers who are at risk of coming into direct contact with COVID-19-positive patients often wear protective gear that includes gowns, gloves, and face masks in addition to face shields.

How to Clean

To clean a face shield at home:

  • Use warm (not hot) water and mild soap to clean the plastic and any other material.
  • Rinse thoroughly.
  • Allow to air dry or dry with a gentle cloth.

Do not put sanitizer or other disinfectant material on a face shield or any other type of facial covering. It can be toxic if inhaled.

Where to Get a Face Shield

Commercial face shields are available at major retailers like Amazon and Walmart. When marketed to the general public, they do not require FDA authorization.

While face shields are not as widely available as cloth facial coverings, more manufacturers are beginning to produce them for healthcare professionals, including Apple, Nike, GM, and John Deere. When manufactured for use by healthcare providers and in a healthcare setting, face shields are subject to FDA oversight.

A Word From Verywell's Medical Review Board

"Many of us have become accustomed to wearing face masks during the coronavirus pandemic. We now have a second option available: face shields. Which type of covering you choose is a matter of personal preference. Factors to consider include comfort, access, durability, ease of communication, and effectiveness in preventing illness. Whichever type of face covering you choose, be sure to use it consistently while also practicing other social distancing measures." – Anju Goel, MD, MPH

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Article Sources
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  1. Centers for Disease Control and Prevention. Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission. April 3, 2020.

  2. Perencevich EN, Diekema DJ, Edmond MB. Moving personal protective equipment into the community: Face shields and containment of COVID-19. JAMA. Published online April 29, 2020. doi:10.1001/jama.2020.7477

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  7. Food and Drug Administration. Summary of FDA Guidance For Masks and Face Shields During the COVID-19 Outbreak. Updated April 6, 2020.