How to Avoid Ugly Red Marks and Lines on Your Face with CPAP Mask Use

Simple Steps to Wake and Treat Sleep Apnea Beautifully

Bulky CPAP masks can leave red marks and lines on the face when used, but these can be avoided with simple steps
Bulky CPAP masks can leave red marks and lines on the face when used, but these can be avoided with simple steps. Brandon Peters, MD

If you use a continuous positive airway pressure (CPAP) machine to treat your sleep apnea, you are undoubtedly familiar with the pros and cons of your CPAP mask. Depending on your mask style, you may notice that it leaves ugly red marks and lines or creases on your face in the morning. How can you avoid marks on your face with CPAP use? Discover ways to select the right mask style, optimize the fit, and explore simple fixes like using mask liners as padding that may help.

Start by Selecting the Right CPAP Mask Style and Optimize the Fit

The most important initial choice in starting CPAP therapy is the selection of your CPAP mask. In general, it will be one of three styles: nasal pillows, nasal mask (fitting over the nose), or full-face mask (covering both nose and mouth). The amount of contact between your face and the mask will determine how likely it is to leave marks or lines. The smaller the surface area pressing into your skin, the less likely you will be left with morning creases or indentations from the mask.

Once you have selected the smallest mask that works well for you, you will want to ensure that it is sized properly. This will reduce leak. With less leak, you won’t have to tighten it down quite as much. The tighter the mask, the more it may leave impressions on your face. Therefore, keep it as loose as you can while still controlling the leak.

Higher pressures may require a tighter mask, and the use of bilevel therapy may provide some relief upon exhalation (when the amount of air in the system naturally increases).

Using Padding and Liners to Relieve Pressure from the CPAP Mask

Many masks have padding or covers for the straps. These should be used if you notice marks on your face in the morning.

If you need a little extra padding between the mask and your face, you may have a few additional options.

REMZzz liners are a soft fabric lining that can reduce allergic reactions to the plastic and potentially minimize marks. Silent Night liners are another option. PAD A CHEEK manufactures a wide array of liners, strap pads, and anti-leak mask stabilizers and additional straps. These products are commonly used. Some may be daily disposable while others are durable and even washable. If you explore online retailers, you will learn there are many products available that may be tailored to precisely fit the style and size of your mask.

If the problem seems to occur at the nasal bridge, consider the use of Gecko nasal pads or LiquiCel nasal cushions. Each of these options work best with nasal or full-face masks and do not work with nasal pillows.

Barrier creams or lotions, such as RoEzIt, may also reduce marks that are due to allergic reactions or rashes. It may be necessary to change to a different mask type if the problem persists.

What to Do If You Still Notice Marks or Lines 

What else can you do if you still are having problems with marks or lines from your CPAP mask? It can be helpful to try to sleep on your back.

This will reduce the pressure of the pillow into the mask, as can occur if you are sleeping on your sides or stomach. In addition, a CPAP pillow can be used, with a special cutout that reduces the shift of the mask.

Do not tolerate persistent redness or the formation of a sore (or ulcer) due to the pressure from a poorly fitted mask. This can become a longer-term problem if it is not addressed early. You may want to speak with your sleep specialist or equipment provider about a different style of mask that may fit you better. There are always new ones coming to market that may be a better option.

Finally, if all else fails, give yourself a little time in the morning. Within the first 1 to 2 hours of the day, the marks should fade away. If they do not, you should more urgently speak with your sleep specialist about other CPAP mask options that might work better for you.

A Word From Verywell

Finding a mask that fits is the most important initial step when using CPAP therapy. It can make the difference between adhering to treatment or quickly losing interest. Reach out to get the help that you need, either from your sleep doctor or your medical equipment provider. Time spent on a mask fitting quickly pays dividends. Once you find a mask that you like, keep using it. The improved comfort will translate into increased use and benefits from CPAP therapy.