Nail Polish Allergens and Testing
Standard nail polishes, while widely used, contain chemicals that can trigger allergic contact dermatitis (ACD). Acrylate-based nail products are inducers of ACD and distant dermatitis (Baran, 2002).Signs of allergy to nail products include pruritic eczematous dermatitis of the fingers, hands, and wrists, although up to 10% of patients may have dermatitis localized only to the face or neck (Gonçalo et al., 2018). Consider that acrylates are not a component of the thin-layer rapid-use epicutaneous patch test (SmartPractice). Instead, patients suspected of having an acrylate allergy should be patch tested to the acrylate series used with the chamber method. Some authors recommend an initial screening with 2-hydroxyethylmethacrylate (HEM) and ethyl cyanoacrylate, followed by extended acrylate testing if both are negative (Atwater and Reeder, 2019; Gonçalo et al., 2018).
Nail hardeners
Nail hardeners are another potential cause of ACD and distant dermatitis (Mestach and Goossens, 2016). The active ingredient in nail hardeners is up to 5% formaldehyde. In sensitized individuals, a concentration of formaldehyde as low as 0.006% can trigger ACD (Mestach and Goossens, 2016). Products that contain formaldehyde should be completely avoided.
UV Lamps and Skin Cancer Risks
UV lamps, commonly used to harden gel nails, have been linked to potential skin cancer risks. These lamps emit UV-A radiation, a known carcinogen, and their regular use can expose the skin to harmful levels of radiation. A study by MacFarlane and Alonso found that the UV exposure from these lamps is comparable to spending an additional 1.5 to 2.7 minutes in direct sunlight daily for two weeks. While the overall risk may be low, the Skin Cancer Foundation recommends applying broad-spectrum sunscreen or wearing nitrile gloves during UV exposure.
The Rise of Pterygium and Other Nail Issues
A newly recognized condition, pterygium inversum unguis (PIU), has emerged due to the prolonged use of UV light-cured polishes. PIU, characterized by the painful attachment of the hyponychium (the skin beneath the nail) to the nail plate, is linked to gel polish application. Research by Cervantes et al. (2018) identified PIU in patients who had used both LED and UV-A light for nail curing, highlighting the need for caution with these products.
At-Home Gel Kits: Risky
At-home gel polish kits pose even greater risks than professional salon treatments. Untrained users often extend the duration of exposure to irritants found in nail products, leading to side effects like painful dermatitis, brittle nails, and even nail loss. Covering nails with polish can also conceal early signs of irritation or more serious conditions like malignancies.
Acrylic Nails: More Than Just Aesthetic Risks
While acrylic nails may create the illusion of strength and beauty, they often come with hidden dangers to your nails, skin, and overall health. The chemicals in acrylic nails can thin and weaken your natural nails over time, and the substances used for application and removal can irritate your skin.
It is well-documented that acrylic nails can cause health issues, such as allergic reactions and dermatitis. A case study by Piraccini et al. revealed a heightened risk of developing psoriasis from frequent use. Acrylics contain acrylates, which can trigger allergic contact dermatitis (ACD) and even cause skin irritation in areas beyond the hands. Additionally, "worn-down nail syndrome" is a known consequence, leading to thinner, more fragile nails. A 2022 study also found that prolonged exposure to acrylic nails increases the likelihood of hand eczema, with contact dermatitis being a common reaction.
How Acrylic Nails Impact A Person’s Health
These symptoms can affect people who use artificial nails and beauty professionals who apply them.
Skin symptoms of hand eczema may include not only pain but also:
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redness or discoloration
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itchiness
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areas of peeling
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cracked or scaly patches
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dryness
It is important for individuals who use acrylics to regularly be followed by a naturopathic doctor even before there are symptoms mentioned above.
As an example one 2020 case study about a woman who had a six-month history of routine gel manicures, with reapplication occurring approximately every 2 to 4 weeks to her fingernails resulting in nail damage after acrylic use. She showed symptoms of onycholysis, a condition involving the nails separating from the nail beds. She also experienced red and thickened skin around her nails. She continued the applications during the period of her antifungal therapy and this is how her situation was : very disfigured fingernails and toenails, moderate pain in her fingers and toes, the fingernails exhibited distal onycholysis, splinter hemorrhages, notable plate thinning with near anonychia of her left first fingernail, and minimal subungual hyperkeratosis. There was also significant erythema and scaling of the distal digit continuous with the periungual region. Her toenails exhibited onycholysis, pronounced nail plate thickening, subungual hyperkeratosis, with erythema and edema of the periungual skin.
Multiple cases have reported onychodystrophy secondary to acrylic nails. Here an example of a case of onychodystrophy with psoriasiform nail changes, including onycholysis, splinter hemorrhages, hyperkeratosis, and nail plate thinning, caused by gel manicures. The diagnosis was difficult. Some of the nail features displayed characteristic psoriatic nail changes, other key features of nail psoriasis, including oil spots, salmon patches, and pitting, were notably absent. In this particular example the development of these nail changes following gel manicure and pedicure application and the improvement of the onychodystrophy with topical and intralesional steroids support the diagnosis of psoriasiform onychodystrophy.
Recently there has been an increase in reports of onychodystrophy secondary to photobonded acrylic nails, commonly known as gel manicures.Insufficient polymerization of acrylic monomers can lead to sensitization and consequential ACD of the nail unit. Several case studies have reported nail changes, such as subungual hyperkeratosis, onycholysis, and periungual dermatitis secondary to the application of artificial nails. In two cases reported by Mendonca et al, patients presented with psoriasiform changes in the nail and severe onychodystrophy shortly after receiving gel manicures. Contrary to previous case reports, the patients in Mendonca et al’s case report presented with nail changes in the absence of coinciding periungual dermatitis. Patch testing in some of these cases were subsequently performed to analyze the potential of a contact allergy.
One of the most common acrylates that had confirmed allergenicity in the affected patients is 2-hydroxyethyl methacrylate (2-HEMA), which is universally found in the lacquers used in gel nails but inconsistently found in acrylic nails.
Moreover Acrylic nails can be extremely dangerous in case of an accident or contact with fire. It has flammable properties. People with acrylic nails are more likely to pick at these artificial nails. Picking at the nails can damage the natural nail plate and thin a person’s nails. This behavior may also cause a person’s nails to flake or develop pits along their surfaces.
Acrylic nails trap more bacteria than natural nails can. Soak-off gel nails may pose less risk of nail damage than acrylic nails. A person may also wear nail polish alone as another less abrasive option.
Beauty at a Price
Nail cosmetics, while enhancing beauty, often come with a hidden cost. We must ask ourselves: what is beauty to us? Is it truly worth sacrificing our health for the sake of outward appearances? Why do we chase perfection for the world to see, but neglect the well-being beneath the surface?
These are questions we should reflect on deeply. Are we willing to risk long-term damage to our health for the fleeting allure of perfect nails?
True beauty begins with self-love and prioritizing health. Staying informed and choosing safer alternatives is not just an option—it's an act of self-care. A naturopath like myself can guide you in preserving your well-being before any problems arise, ensuring that your pursuit of beauty does not come at the expense of your health.
Our nails can tell us a lot about our overall health, signaling underlying issues with vital organs such as the skin, kidneys, or liver. By paying attention to the natural state of our nails, we empower ourselves to recognize these signs early on and take action.
As we age, the risk of nail conditions like onychomycosis, paronychia, and onycholysis increases. In fact, up to 20% of individuals over the age of 60 experience these problems. A naturopath can help rejuvenate your nails, keeping them strong and healthy as they adapt to the natural changes that come with time.
Don’t wait until the damage is done. Embrace the beauty of health—reach out today, and ensure your nails stay vibrant and resilient for years to come.
References
Piraccini BM, Alessandrini A, Magnano M. , Psoriasiform nail lesions in a patient with artificial
nails. G Ital Dermatol Venereol. 2015;150(6): 761–763.
Psoriasiform Onychodystrophy Induced by Photobonded Acrylic Nails by CHRIS G. ADIGUN, MD, and HANNAH SHOAF, MS , Dr. Adigun is with the Dermatology & Laser Center of Chapel Hill in Chapel Hill, North Carolina. Ms. Shoaf is with the Center on Science & Technology Policy at Duke University in Durham, North Carolina. J Clin Aesthet Dermatol. 2020;13(12):18–20.
https://www.medicalnewstoday.com/articles/are-acrylics-bad-for-your-nails#summary
Review “Nail health in women” Jessica K. Reinecke a , Molly A. Hinshaw, MD, FAAD b,⇑
a University of Wisconsin-Madison, Madison, WI, United States, b Department of Dermatology, University of Wisconsin-Madison, Madison, WI, United States, Accepted 29 January 2020, International Journal of Women’s Dermatology 6 (2020) 73–79
