Face Masks and Hearing Aids

by Thomas A. Powers, PhD


The COVID pandemic has touched almost every aspect of our daily life.  It has had a tremendous impact on healthcare, including hearing healthcare.  One of the most important ways to avoid COVID is through the wearing of a mask, as recommended by the Center for Disease Control (CDC).  However, for hearing impaired individuals, wearing a mask creates two separate issues, one in the visual domain and one in the acoustic domain.  In addition, the need to be socially distanced further impacts the ability to effectively communicate due to the reduced volume of the normal speech signal.

The visual impacts relate to the elimination of the ability to lip-read, since the mask completely covers the mouth of the person speaking.  The development of masks with a clear plastic area around the speakers’ mouth have provide a partial solution.  The clear mask allows the hearing-impaired individual to see the movements of the mouth and lips during the conversation.    However recent research1 has shown that while improving the visual clues for speech, clear masks may have a negative effect on the high frequencies sounds such as  “s’, “sh”, and  “z” which are important for speech understanding.   In addition, clear masks may become foggy due to the exhaled breath of the speaker.  The manufacturers of the clear masks are currently working on this issue. While clear masks may not be in use for everyone, they  do provide an additional tool for healthcare providers to be able to communicate with their hearing-impaired patients.

The second issue is the acoustic impact of the mask.  Several research projects have shown that the mask reduced, or attenuated, the high-frequency sounds of speech, making the speech sound muffled.  The reduction ranges from about 3 dB to as much as 12 dB for the N95 mask.  This amount of reduction can lead to significant impact in speech understanding.  Even persons without hearing loss  have noticed that it is more difficult to communicate when wearing a mask.

These impacts can be noticed in quiet environments and becomes even more difficult and frustrating when trying to communicate in a background noise environment, like a grocery store. To overcome this acoustic issue many of the hearing aid manufacturers have introduce “mask programs” that increase the high frequency amplification to offset the reduction in the speech clues caused by the mask.  If you feel a mask program may be of help, it is important that you work with your hearing healthcare provider to create the mask program that is appropriate for your hearing loss.  Some of the issues to consider when creating the mask program include:  ensuring the increased amplification does not create feedback issues when using the program; checking that the increased amplification does not become uncomfortable; or the mask program causes quality issues with the speech signals.

While many hearing care offices are beginning to open, tele-audiology may be an effective way to add a mask program or make other changes to your hearing devices without the need to visit the office. 

To overcome these new challenges, the hearing healthcare team has been working diligently to provide solutions that can benefit all users of hearing devices.  For more information please contact your local provider.


1. Martin L. NAL update: Impact of face masks and face shields on communication. Hearing Review. 2020;27(10):28-29.

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