Justin, I have had my cPAP since October 2012. I developed skin breakdown (bridge of my nose) within a few weeks of using the machine. I tried various solutions, thinking it was probably a pressure from the mask issue. I tried the gel pads, adjusting the mask straps, etc. but nothing seemed to help. I finally came across an ad for RemZZs several years later and in desperation ordered some. I was surprised when the skin sores healed, thinking it was still a pressure issue; I couldn't figure out how such a thin material could provide enough cushioning to relieve the pressure and allow healing. Then it finally clicked that the nose pads on my eyeglasses were also causing skin irritation/breakdown where they came in contact with the skin. Yep, they were made of silicone. Question answered, but no really satisfactory solution. I used the RemZZs until a year or two ago, but they sometimes slipped and were a nuisance because they had to be repositioned every time I removed and replace my mask. I searched cPAP.com for other alternatives and noticed the Silentnight cushions and ordered some. They do have an advantage in that they are adhered to the mask and don't have to be removed/repositioned every time I remove and replace my mask. The problem is the size options are limited (one size fits most--ha!). They do help the skin breakdown on the bridge of the nose, but the opening is too large for my mask (Lady ZestQ) so I still get some skin irritation below my nose since the cushion opening is too large and doesn't cover the lower part of my mask opening.( Note: I also have latex allergy.) I see an allergist regularly and do have a pulmonologist that I see for my sleep apnea, but neither of them has had any suggestions to help resolve the issue. I am managing with the Silentnight nasal cushions, but again they aren't the complete solution. I was just wondering if anyone else is dealing with this issue and how they handled it. Thank you for your help.