The correct order for removing PPE is gloves, goggles or face shield, gown, and then mask or respirator, with hand hygiene performed immediately after everything is off. This sequence, recommended by the CDC, is designed so you remove the most contaminated items first while your hands are still protected, and leave the mask for last since it shields your nose and mouth throughout the process.
Getting this order wrong carries real consequences. In a randomized study of 152 doffing attempts, participants contaminated themselves 28% of the time. The most common spots were the arms (33% of contamination events), the abdomen area of clothing (24%), and the lower limbs (23%). Nearly half of those who self-contaminated did so in more than one location. The removal sequence exists specifically to minimize these risks.
Step 1: Remove Your Gloves
Gloves come off first because they are the most heavily contaminated item. You’ve been touching surfaces, patients, or materials with them, so every movement from here on should avoid contact between the glove exterior and your skin or clothing.
Use the glove-in-glove technique. Grasp the outside of one glove at the wrist without touching your bare skin. Peel it away from your body so it turns inside out. Hold the removed glove in your still-gloved hand. Then slide your bare fingers under the wrist of the remaining glove from the inside, and peel it off so the second glove turns inside out around the first. You should end up with one glove nested inside the other, contaminated surfaces fully enclosed. Discard both into the waste container.
Step 2: Remove Goggles or Face Shield
The outer surface of your eye protection is contaminated, but the parts that sit against your head are relatively clean. Tilt your head slightly forward and grasp only the headband, earpieces, or the arms of the goggles from behind. Lift them away from your face without touching the front lens or shield surface. Place them in a designated receptacle for reprocessing if they’re reusable, or directly into a waste container if they’re disposable.
Step 3: Remove the Gown
The entire front of the gown and both sleeves are considered contaminated. Start by unfastening the neck tie, then the waist ties. Reach up to the shoulders and pull the gown forward and down off each arm using a peeling motion. The gown will naturally turn inside out as you pull it off, which traps the contaminated exterior surface on the inside.
Hold the removed gown away from your body. Roll it into a bundle with only the clean inner surface showing on the outside, and discard it into the waste or linen receptacle. Avoid shaking or flapping the gown, which can release particles into the air.
Step 4: Remove Your Mask or Respirator
The mask comes off last because it protects your airway while you handle all the other contaminated items. The front of the mask or respirator is contaminated, so you should never touch it during removal.
For a standard surgical mask with ties, grasp only the bottom tie first, lift it over your head, then do the same with the top tie. For an N95 respirator with elastic straps, slowly lift the bottom strap from around your neck up and over your head first, then lift off the top strap. In both cases, let the mask fall forward and away from your face rather than pulling it against your skin. Discard it directly into the waste container.
Step 5: Perform Hand Hygiene
Wash your hands or use an alcohol-based hand rub immediately after the mask comes off. This is not optional. Even with careful technique, brief contact with contaminated surfaces can happen during any step of the process. Hand hygiene is your final safety net.
When the Situation Calls for More Steps
The four-item sequence above covers standard isolation precautions. Higher-risk settings, such as those involving highly infectious diseases, often require double gloving, boot covers, head and neck coverings, and powered air-purifying respirators. In these situations, the WHO protocol expands to as many as 17 steps and inserts hand hygiene between every single removal step. A trained observer stands nearby and watches each movement to catch mistakes in real time.
Even in lower-risk settings, performing hand hygiene between steps (not just at the end) adds a meaningful layer of protection. If you notice a tear in your glove, contamination on your hands at any point, or any break in the sequence, stop and clean your hands before continuing.
Why the Order Matters
The sequence is built on a simple principle: remove the dirtiest items while you still have the most protection. Gloves are the most contaminated, so they go first while the gown, face shield, and mask still cover you. The mask goes last because respiratory exposure is typically the highest-consequence risk.
Research on doffing errors shows that contamination on the upper portions of PPE is roughly 2.4 times more likely to cause self-contamination than material on lower portions. This is why protecting your face until the very last step is so important, and why you handle every item by its straps, ties, or inner surfaces rather than its outer face.
Training and Practice Requirements
If you’re learning this for a workplace, your employer is legally required to train you. OSHA’s general PPE standard (1910.132) mandates that every employee who uses PPE must be trained on how to properly put it on and take it off, and must demonstrate that they can do it correctly before performing any work that requires it. If PPE types change or your employer notices gaps in your technique, retraining is required.
Practicing the sequence before you need it under pressure makes a significant difference. The self-contamination rates in studies reflect trained participants in controlled settings. Real-world conditions, where you may be fatigued, rushed, or working in a cramped space, only increase the risk. Rehearsing until the order and hand movements feel automatic is the most effective way to protect yourself.