Why Do Japanese People Wear Surgical Masks?

For first time visitors to Japan, seeing people out and about in surgical masks can be a bit confusing. Are they germaphobes? Do they have really bad allergies? Do they have some sort of awful incurable disease that requires them to wear a mask to prevent the spread of infection? Oh, God! Should I be wearing one too!?

Okay, so maybe that’s a bit of exaggeration. But for those unfamiliar with the way things are done in Japan, the whole surgical masks being worn in public thing can be kind of strange and unfamiliar. So why do they do it, anyway?

They’re Sick

By far the most common reason people in Japan wear surgical masks out in public is because they’re sick. Chances are it’s not some life threatening, dangerous and debilitating illness – they’re just wearing the mask to be considerate of others and to help contain the spread of germs. Just think about how many people cough or sneeze into their hands and then go on to touch the things we use every day. Door handles, guard rails, the poles and rings you hold onto on the subway. People touch a lot of stuff.

These surgical masks really help as far as containing germs and preventing the spread of contagious colds and illnesses. And people aren’t going to avoid you like the plague if you happen to be in a mask either. They’ll be more likely to avoid you if you aren’t wearing one (if you’re coughing up a storm that is). In most cases, you’ll be treated just like anyone else not wearing a mask.

When I was in Japan, one of our friends got sick on the trip but was still coming out with us and going to the local college and everything. The Japanese girls encouraged her to get a mask and wear it when she was socializing. She didn’t seem too keen on the idea and saw it as an inconvenience, and the Japanese girls seemed kind of disappointed in her when she wasn’t wearing it. They thought it was inconsiderate.

So if you’re in Japan and you get a cold or a bad cough, don’t be surprised if one of your Japanese friends asks you to get a mask to wear and definitely don’t be afraid to do so. I wish more people in the United States did this, especially those in schools (those illnesses spread like crazy).

Occasionally you’ll have somebody who’s pretty into Japanese culture wear a mask like this when they get sick, but because it’s not the social convention here in America, they usually (and unfortunately) end up looking kind of silly, even if their mask is quite fashionable.

Everyone Around them is Sick

Another reason you’ll see Japanese people wearing masks out in public is because they’re afraid of getting whatever illness that happens to be going around. Maybe it’s flu season or something and they’re just trying to avoid getting sick for the third year in a row because the hand sanitizer alone just isn’t cutting it.

It makes sense when you think about it. I mean, I usually come down with something near the start of summer (I’m actually getting over a cold right now) and I usually get sick again near the start of winter. Maybe if I wore a mask around these times I would be less likely to fall under the weather or avoid the illness altogether.

But like I said before, it’s not the social convention here in America and I’d look kind of silly coming into the office in the morning wearing a surgical mask. Oh well, NyQuil and Sudafed to the rescue once again.

They Have Bad Allergies

On the whole, wearing masks because of allergies isn’t as common as wearing one because of illness, but around hay fever season in Japan mask wearing out in public becomes a much more common sight. I touched on it in a post I wrote a while back about Hay Fever Hell in Japan, but along with masks, the Japanese have a lot of things around to combat allergies and you’ll definitely see a surge of mask wearers out in public during allergy season.

They’re a Bosozoku Bike Gang Member

If you see a bike gang member in Japan I’m sure that their surgical mask is not going to be what gives them away. But it is not unusual for a bosozoku member to wear a mask like this for no other reason than concealing their face. Most likely they aren’t wearing it for allergies or germ prevention (unless of course they are a very kind, caring, and socially considerate bosozoku).

And if you want to learn more about these folks, you can read all about ‘em in a post I did a while back entitled Violent Japanese Biker Gangs Just Not What They Used To Be.

They’re Too Embarrassed to Show Their Face on YouTube

Okay, so this isn’t technically in public, but you still see it a lot (if you’re on YouTube a lot and wander to the stranger corners of it like I tend to do sometimes). This one mostly applies to the ladies from what I’ve seen, but there are a lot of videos of Japanese gals doing some sort of choreographed dance or playing an instrument on YouTube/Nico Nico Douga. A lot of these girls are shy and will wear a mask like these to hide their face/identity.

Since I can’t actually ask them why they choose to do it, I can only guess. Perhaps they are shy. Perhaps they think they are unattractive. Or perhaps they think they are too attractive and want their dancing/instrumental skills to be judged honestly, not wanting to be complimented just because the audience thinks they’re hawt. See examples below.

[yframe url='http://www.youtube.com/watch?v=7Rk-wHjzPco&feature=related']

[yframe url='http://www.youtube.com/watch?v=9h7DmJeOS3s&feature=plcp']

[yframe url='http://www.youtube.com/watch?v=RqphfvR4jcw&feature=related']

[yframe url='http://www.youtube.com/watch?v=ZLcqh1s3bDQ&feature=related']


And now you know pretty much all the reasons why you might see someone in Japan wearing a surgical mask. It’s not a weird or strange thing to do and most often they’re just looking out for the well being of others or trying to protect themselves from a seasonal illness or pollen invasion.

But what do you guys think about the wearing of masks like this? Wish you could wear one in your home country but are afraid of the social stigma? Have you ever done it in a Western country and got strange looks from others? Let us know in the comments!


[Header Image]

  • John

    But, Hashi doesn’t want the plague :(

  • simplyshiny

    Well, no one WANTS the plague.  It’s just something that happens to you. Like the chicken pox, or a bad hair day.

  • http://zoomingjapan.com/ zoomingjapan

    It does seem weird at first.
    In my home country you only wear a mask when you’re EXTREMELY sick, so when I first came to Japan many years ago I was really shocked to see so many deadly sick people ;P

    Meanwhile I’m wearing masks, too. At work we’re required to do so if we’re sick, coughing and sneezing.
    I also wear them when I have hay fever.
    I don’t think they really prevent bacteria or viruses to spread, though.

    They’re also great to hide your “gaijin-ness” – wear them in addition to sunglasses!! Hohoho~

  • MangaTherapy

    When I was in China, I saw many people with surgical masks too. I always thought it was just an Asian thing…

  • Dekinai

    i work in shops where it’s normal to wear masks all the time, and i buy the surgical ones instead because they’re a lot more comfortable than the stiff round ones.  i often forget to take them off or will just pull one i’m wearing under my chin if i’m leaving the room, but if i wore one around my own neighborhood, yeah, the staring might be a little uncomfortable

  • ですこ

    It’s really less the plague and more the flu you need to watch out for. I suppose people were thinking the same way back in 1918. I guess nobody expects the Spanish influenza.

  • Guest

    To add to what Alex said, I have several students here in Japan who will wear a mask during winter when they are not sick. They told me it helps them feel warmer and ups the humidity. They were definitely not sick at the time…

    Personally though, I really hate wearing them for exactly why my students like them in winter. They make my face too warm, itchy, and clammy. I wear them here when I’m deathly ill, but if it’s a common cold, well, colds happen to not be contagious after the first 72 hours any ways (approx 24 hours before you know you’re a carrier and 48 afterwards), so tis kind of a mute point for most of the duration of a cold. I only wear them for the first day or two if it’s a really bad cold.

  • CelestialSushi

    Totally wish Americans could get on board with this.  Goodness knows during cold and flu season people feel like they have to be out and about, and me wearing one when no one else is would make me feel super self-conscious.

  • Robert Patrick

    Oh John, why so naive after all these years ? ;-D
    The “ladies” on Youtube/NicoNico are wearing masks because they are DUDES ! “Tissue Hime”, “or the “30 days speed shred” video you chose, I’m sorry to inform you that 90% of those “girls” in stockings are males. Concealing their face helps tremendously not to be recognized as males.

  • simplyshiny

    yes, but plague is so much more dramatic

  • John

    Yeah that’s why I said it “mostly applies to the ladies” haha. Most of the dance videos with masks seem to be done by girls but most all of the instrument videos hiding the face seem to be done by cross-dressing dudes, lol.

  • http://mistersanity.blogspot.com Jonadab

    > I really wish it wasn’t so strange to wear masks in the west.

    Besides being a trifle strange, it’s also completely ineffective.  Have you noticed that despite the pervasiveness of surgical-mask-wearing in Japan people still get sick with about the same frequency as in other countries?  Yeah.

    A surgical mask is only one component of sterile technique.  Surgeons also scrub their hands to the elbow before surgery, cover any non-sterile clothes and hair with a layer of sterile clothing, and carefully avoid contact with anything that hasn’t been sterilized, for the duration of the procedure.  Everything around the patient has been sterilized.  Everything the doctors touch has been sterilized.

    If the doctors just went into the operating room wearing a surgical mask, without the other precautions, the patient would be just as likely to get an infection as if they didn’t wear the mask.  The mask by itself does nothing.  To be effective, it has to be a part of the whole system.

    Of course, Japan is far from being the only country that has customs that don’t actually make rational sense.  A lot of Americans don’t shake hands when they have a cold, but they use the same doorknobs and sink handles as everyone else and breath the same air.  Needless to say, this custom is just as ineffective as the Japanese mask-wearing.  And yet, there are significant social implications if you cough into your hand about six times and then wipe your hand on your pants and go to shake hands with somebody right afterward.  Refraining from doing so doesn’t actually matter in terms of spreading the pathogen, but it DOES matter socially, because of the culture.

  • ジョサイア

    You just think that (Shes) a guy because of the mask!
    (She) needs to hide her beautiful face! LOL

  • ジョサイア

    What? Soon you’ll be saying the McDonald’s clown was a girl.

  • http://niyoels.tumblr.com/ niyoels

    I am not arguing for the effectiveness of wearing masks; obviously, there are a lot of things you have to be conscious of to get better and prevent the spread of germs. I’m in support of not feeling I need to hole up even when I’m relatively able bodied and have things I need to do during the day.

    Though I can, and do, go about my day without wearing a mask, I think the custom of wearing one makes it somewhat more acceptable and people are less likely to avoid you like you have a deadly disease (which is probably how people would react here whether you wore a mask or not).

  • http://www.tofugu.com/ Hashi

    I dunno, if I had the plague, I could wear those sweet plague doctor costumes:

    http://en.wikipedia.org/wiki/Plague_doctor

  • http://www.tofugu.com/ Hashi

    Yikes. Once again, creepers ruin everything. :(((

  • http://www.tofugu.com/ Hashi

    Tattoos are taboo in Japan, but I don’t think I’ve ever seen somebody with a tattoo around the mouth. Maybe I need to get out more!

  • ジョサイア

    (OoO) Wow… That’s sweeter than russian gas masks…

  • ジョサイア

    (O>o<O) ""/ (==) n+a

  • http://twitter.com/NeoRyu Cory

    Awhile back I got a really bad case of pneumonia so I asked my pulmonologist if it would be a good idea for those around me to where the masks. He said that they do not help much. I do agree it’s a very smart thing to do to, it alerts those around you maybe getting sick. But then again I really can’t say much because I need help with everything.

  • John

    Well before I just thought it was a really dedicated cross-dresser and now I’m not so sure anymore, lol.

  • Maki

    Yeah I’ve heard a guy say that he was politely asked to cover his forearm tattoos at a gym and was giving clothing do so. Doesn’t make sense though in Japan the yakuza are seen as a necessary evil for example they have their own yakuza front buildings and get up to all sorts of crime and it is somewhat accepted yet tattoos are really frowned upon. 

  • Guest

    Or because they wish to conceal their identities (I notice a lot of famous people & others who simply don’t wish to be recognized wear them when out in normal life).

    I don’t see myself ever having to wear one for health reasons – thankfully, I’ve developed a superjacked immune system & haven’t caught a bug since I was in middle school. If I were to wear one, it’d probably be just to look tough/cool. :P

  • http://pulse.yahoo.com/_NMMV6AXYY4MPQ67ULYXG542TKA Jen

    You missed one: acne. A lot of my students will wear masks when they get breakouts of acne around their mouths.

  • Wonderina McMarvelous

    Haha, masks.

    One of my co-workers wears a mask from November until March.  I know she’s doing it to avoid getting sick, but probably also a bit to encourage the students to wear them too during peak flu season (during which some days it’s mandatory to wear them).  She still got sick though.  And when she did, she wore double masks and walked outside every time she had to cough.  Even other Japanese thought it was a bit silly.

    Other than the fact that they are itchy, used-breath-y, and uncomfortable I don’t have much against them.  I do think it’s nice to know who’s (potentially) sick too.  And I can’t fault anyone for wanting to hide their faces from time to time.  I’ve never used it for that but I must say I’ve been tempted!

    So, many foreigners think the Japanese affinity for masks is kind of strange, but what to Japanese think about the rest of the non-mask-wearing world?  Do they think it’s dirty?  Do they think it’s weird if a foreigner wears a mask :T?  Sometimes I feel weird like I’m “trying too hard” to be Japanese if I do things like wear a mask, or say “chokoreeto” or “suuutaaabaakusuu” instead of chocolate or starbucks (but then no one understands…).

  • http://www.facebook.com/momimnk Magdalena Grzybowska

    Who knows? Maybe someone among you can start the custom yourself and the people around you will get used to it and, what’s more, they’ll see that it works during the season of flu etc. ;)

  • Pflan2

    I feel that shyness being a reason for wearing the mask isn’t just for YouTube. It seems to be really popular for Japanese middle and high school aged girls to wear more than anyone else. I had two females students who wore the masks every class for SIX MONTHS. I did not see the bottom half f their face for SIX MONTHS! It was like the mask had really become their face, it was über excessive. But these girls were also kind of shy and I started to theorize that these girls wear them because it helps them blend in the background and they wont get noticed. It’s pretty sad, actually :(

  • John

    Oh, yeah – I never thought of that one!

  • John

    Yeah, I’d have to agree. This isn’t something I’ve experienced first hand, but it is unfortunate. It’s like one step up from those girls who grow their bangs out to cover their faces. Put that together with wearing a mask as well and their face disappears!

  • ジョサイア

    Go look at her YouTube channel…She is defiantly not a guy…

  • John

    I did, before I posted the video on here.

  • Charles

    These masks seem eminently sensible. I live in Nebraska where winters are very cold and some kind of face covering also helps keep cold air from getting into the throat where soreness is often the first sign of a cold coming on.

  • Sumo Grip

    When I was in Kyoto, I got a fever, and ran out to a Lawson and told the cashier I was sick, and immediately she dashed and grabbed a mask for me. It was so hilarious. And then after she walked me through an aisle and got me medication. Before without the mask I got many stares (because I definitely don’t look Japanese) but with it on, I completely blended in and no one even batted an eyelash my way. It was ironic and awesome.

  • Gabe Moist

    The plague doctor costume was the surgical mask of the middle ages.

  • Amy

    This isn’t completely true. I understand that wearing a mask doesn’t completely stop you from getting infected however it does lower the risk of airborne transference of your sickness. When you sneeze or cough the virus spreads rapidly outwards onto whomever you’re closest too, wearing a mask keeps this particular mode of viral transfer contained.

  • guyhey

    I’m in Japan right now. Early on in my trip I went to a cafe, and the maid had a mask, and wrote on a white board saying she couldn’t talk because she had a cold. I was nervous she would get me sick so early into my trip, but she didn’t.

    I’ve worn the mask in the US a few times to try and avoid colds, most people just keep their mouths shut if they think it’s weird.

  • sukiXrose

    I know a girl who does the fringe thing. She’s really shy. But i think the fringe just makes her stand out more, because everyone thinks “why is her fringe so long?” not “oh, I guess I won’t talk to her since i can’t see her eyelids”. it’s just a shame really

  • Poemartyr1239

    Japanese girls who are under 18 and attending school cant show their faces on the internet. If the school finds their videos or photos they may be expelled, thats why XDDDD or it could be that they are just shy.

  • http://mistersanity.blogspot.com Jonadab

    > I understand that wearing a mask doesn’t completely stop
    > you from getting infected however it does lower the risk

    Intuitively, that would seem to make sense, but in practice it doesn’t work out.  It’s like protecting your house from theft by putting a good lock on one window, when the other windows are open.  If a burglar comes to your house, he’s going to get in.

    When a pathogen spreads, there isn’t just one little copy of the virus or one little individual bacterium trying to get from the infected person to someone else.  There are millions of them.  They’re in the air, yes, but they’re also on everything the person touches, among other things.  

    If you are around a sick person, you *are* exposed to the pathogen, period.  You may not get sick, depending on a number of factors (not least, whether your immune system remembers seeing something similar before), but you *will* be exposed.  Wearing a surgical mask does not prevent this.  It doesn’t even significantly reduce the probability, unless your encounter with the person is minimal (like, they walked past you briskly on the sidewalk).

  • http://mistersanity.blogspot.com Jonadab

    > I’m in support of not feeling I need to hole
    > up even when I’m relatively able bodied 

    People do that?

    Okay, I know one family that does that, but they also stay home from indoor events on rainy days.

  • Guest

    Jonadab in the future please do a little research before attempting to pass your opinion off as fact. A simple Google search and you would have found that your opinion is not supported by the scientific evidence presently available. A brief summary of my research into the matter.

    1. The exact effectiveness of surgical masks is unknown. The results of studies on the effectiveness of surgical masks range from minimal to significant.

    2. Surgical masks are more effective in preventing you from spreading pathogens to others than preventing the spread from others to yourself. Or to put it another way surgical masks are better at preventing you from putting pathogens into the air than preventing pathogens already in the air from getting into you.

    3. Surgical masks should be used in conjunction with other methods or preventing the spread of pathogens (such as washing hands).

    “Several studies have shown that masks can reduce the amount of infectious particles shed into the air while coughing, talking and breathing when someone has an infection of the respiratory tract.” -David P. Calfee, chief hospital epidemiologist at NewYork-Presbyterian/Weill Cornell Medical Center. [1]
    “Masks prevent larger respiratory droplets from reaching the mucous membranes, and so have long been used by people caring for patients with infectious diseases transmitted by large droplets, including influenza and whooping cough.” -NYTimesAccording to the CDC, “If used correctly, facemasks and respirators may help reduce the risk of getting influenza, but they should be used along with other preventive measures, such as avoiding close contact and maintaining good hand hygiene.” [2]Citations:1. http://www.nytimes.com/2011/03/22/science/22qna.html2. http://en.wikipedia.org/wiki/Surgical_mask

    TL;DR – Surgical masks are not useless. Jonadab is wrong.

  • Distantsungrrl

     i wish it was more common in the west.  the other day i was flying FinnAir and was squeezed between 2 sneezing and coughing ladies neither of whom seemed to attach any importance to the fact that they may be spreading the bug.  So i ended up asking the flight attendant to puhleeeez move me somewhere, don’t remember what reason i cited but she did offer me another seat.  on another note I will never forget how i once showed up in the office wearing a surgical mask because i was sick and people were giving me weird looks and someone asked me if i got plastic surgery or something! (sic!)  I was laughing sooooo hard!!! i never did it again…

  • Bimotarich

    Girls often also wear masks when they have had no time or could not be bothered to put on their make up… 

  • http://twitter.com/waitingforshoet Hadenoughalread

    If faced with wearing a mask and/or being stuck at home, I go with the mask!

  • http://www.japaneseruleof7.com/ Ken Seeroi

    Because Japanese people don’t cover mouths when we cough.  It’s unfortunate for the people around us.  Maybe we don’t like to get our hands dirty, I don’t know, but wearing a mask, we don’t have to worry about it.

  • http://www.facebook.com/RowanAmber Rowan West

    When I caught a terrible cold in the spring but still had to go to school (in Utah, US), I wore a mask to my classes. People were startled initially, but when I told them why I was wearing it they invariably thanked me for thinking of them. I’m definitely going to do it again next time I get sick.

  • Envy

    Do they wear it when they’re jogging/exercising? Could this mask help with asthma? I got asthma as a kid because my middle school had us running near a lot of car exhaust every week.

  • Heisenberg

    i’m surprised he had nothing else to say after proving him wrong with actual facts. nicely done.

  • Budthestud

    Wait, so you’re telling me none of them are doctors who just got off work? Think man, they’re Asian!