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Should You Wear a Surgical Mask On Top of an N95?

Joe Biden wears two masks while campaigning in Michigan

 Getty Images

Key Takeaways

  • Wearing a surgical mask on top of an N95 mask may be the key to preserving an N95 for further use, says one doctor in a tweet earlier this month.
  • N95s are crucial to the healthcare field and regularly in short supply, so this method is one worth considering, some experts say.
  • An N95 standard mask is different than an N95 surgical mask, the latter of which is reserved for operative or procedural settings (e.g. during surgery).

The more, the better, or so the saying goes. But when it comes to mask-wearing, is it true that doubling up on masks can help protect, say, a highly-sought-after N95 mask, allowing it to be used again in the future? It’s a conversation initiated earlier this month on Twitter, and it sparked a debate about whether or not double mask-wearing does indeed pull double duty. 

“This preserves the N95 with a cheaper mask,” Esther Choo, MD, wrote on Twitter about a picture of Joe Biden wearing a surgical mask over an N95 mask. “So you can swap out the top mask and keep using the N95. The VP is helping us conserve our precious PPE!”

But is wearing a cheaper or less-protective mask over an N95 actually a method for preserving an N95? Or is it just another coronavirus mask myth? Here, experts weigh in on the ins and outs of double mask-wearing, as well as a few tried and true rules you’ll want to keep sticking by.

What Is an N95 Mask?

For starters, it’s important to know the difference between an N95 and your standard cloth or surgical mask.

There are actually two types of N95 masks, a standard N95 (particulate respirator) and a surgical-grade N95 (also known as a medical respirator). A June 2020 report from 3M Company classified standard N95 masks as the following:

[These masks] are designed to help reduce the wearer’s exposure to airborne particulate hazards. In the U.S., respirators are tested and certified by the U.S. National Institute of Occupational Safety and Health (NIOSH). N95-rated filtering facepiece respirators have a filtration efficiency of at least 95% against non-oily particles when tested using the NIOSH criteria.

On the other hand, a surgical N95 mask is recommended for use by healthcare professionals who need protection from both airborne and fluid hazards (e.g., splashes, sprays), according to the Centers for Disease Control and Prevention (CDC).

What Does PPE Mean?

In her tweet, Choo mentions that Biden’s mask-wearing method is “helping us conserve our precious PPE!”

PPE simply stands for personal protective equipment, a term used to encompass a number of personal protection in healthcare settings, including gloves, gowns or aprons and, yes, masks.

Theda C. Kontis, MD

[At the office], I wear an N95 mask with another surgical mask covering it. This protects both my patient and me, as well as allows me to re-use my N95.

— Theda C. Kontis, MD

So Is the Tweet Accurate? 

While you certainly can’t believe everything you read on Twitter, Theda C. Kontis, MD, says Choo’s suggested method is one she uses in her own practice. 

“At the office, I see patients with their face masks removed, so I wear an N95 mask with another surgical mask covering it,” she tells Verywell. “This protects both my patient and me, as well as allows me to re-use my N95.”

But Jay Woody, MD, chief medical officer of Intuitive Health and a co-founder of Legacy ER & Urgent Care, says it's important to note the difference between doubling up on masks to protect an N95 and wearing two masks for extra protection. As for the latter, Woody says it's simply not the case.

"As the name implies—the N95 filters out 95% of all particles," he tells Verywell, noting that healthcare personnel must be properly fitted to ensure the mask's effectiveness. "N95 masks are the strongest face masks available and do not need additional coverings."

Woody adds, "The only reason I can think of for adding an additional mask to the N95 would be if it had a valve that allowed for unfiltered air that the wearer breathes out.”

When she’s not at work, Kontis says she sheds the N95, opting instead for a spandex mask, a style she finds the most comfortable for everyday mask-wearing.

“Of all the styles I have tried, it is the most comfortable because the ear openings are not elastic straps but actually are cut out of the spandex,” Kontis says. “The mask is breathable, doesn't fog my glasses, and fits snugly over my face.”

Kontis says the key to mask-wearing in public is continued adherence to social distancing to “prevent aerosolized particles from exiting and/or entering.”

Which is another way of saying, the same safety precautions are still in place, which means continued adherence to safety precautions like mask-wearing, maintaining social distance, regular hand-washing, and avoiding large gatherings, especially indoors.

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Article Sources
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  1. 3M. Surgical N95 vs. standard N95 – which to consider?. Technical Bulletin. Updated June 2020.

  2. Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19)

  3. Centers for Disease Control and Prevention. Guidance for the selection and use of personal protective equipment in healthcare settings.