Sarah's Health Notes: Gel nails concerns
Photo by Daiga Ellaby on Unsplash
Yes, they look pretty perfect. Yes, they last for weeks. But there’s quite a big BUT with gel nails. Some have caused not only problems with nails and nail bed over months but also a spate of allergies. Last Sunday, the Sunday Times ran a big news story on this because the issues are now becoming a pretty major concern for dermatologists and allergy specialists. It reminded me that I wrote about this nearly two years ago after a reader wrote to me, listing these same problems. Here’s the article I wrote:
Gel nail polish seems to offer everything we could desire. This hybrid of conventional nail polish and methacrylate chemicals gives glossy smooth colour that’s pretty well guaranteed to last for weeks. Before my wedding in 2012, I had my nails done in store by a leading and reputable company. I was a bit anxious about the buffing (to create a surface that the polish could grip) but very gorgeous they looked. And, untypically for me, they lasted chip-free for nearly three weeks.
So far so great. Until the polish began to wear off. Basically the nails peeled and flaked and almost lifted from the bed. At-home removal was hopeless so I had it done in store. My nails took over six months to recover. That whole episode came back to me recently when I received a desperate email from a reader about her 18-year-old daughter’s problems – this time using a home gel nail polish machine.
Since Lockdown 1.0 began in March 2020, ‘Bella’ had been using one of these lamp dryers, widely available to order online, which use UV (or sometimes LED) light to ‘cure’ the gel polish. Everything was fine at first. Then, in September, Bella noticed ‘redness and itching around my fingernails and a feeling as if my fingertips were sunburnt. I also had little lumps under the skin.’
Her doctor thought it was a fungal infection and prescribed an antifungal cream with steroids. Ellie and her mother were unconvinced but had no other clues about the underlying cause.
The condition improved slightly but then flared up again, this time with bruising underneath Bella’s thumbnails. Still not having made the link with the gel nail polish, she applied the polish and used the lamp on her fingers and toenails one evening in mid December. ‘She woke up that night with her hands on fire and blisters all over my fingers, some the size of a 5p piece,’ her mother wrote. ‘I found her in the bathroom running her hands under cold water but this time her eyelids were red and almost swollen shut and her lips had swelled. We finally put two and two together and realised it must be the nails.’
Bella and her mother’s (credible) theory was that the problem arose because the lamp had not cured the polish properly, due to two possible causes. Firstly, the lamp brands are designed for use with a specific polish formula so mixing and matching (as she had) can be a problem. Secondly, the lamp bulbs become weaker after four to six months so don’t perform as well. But their research didn't reveal the real culprit – methacrylate chemicals.
In fact, gel nail polish, along with gel and acrylic nail extensions, has been a big concern of dermatologists for several years. In August 2018, the British Association of Dermatologists (BAD) issued a warning that methacrylate chemicals, the key ingredients in all three options, were causing a contact allergy epidemic in the UK and Europe, overwhelmingly affecting women (93%).
As well as clinical experience among their members, the BAD cited a study of nearly 5,000 subjects that found 2.4% had an allergy to at least one type of methacrylate chemical. The study, led by consultant dermatologist Dr Deirdre Buckley of the BAD, was a review of 13 UK and Irish dermatology units during 2017, where a total of 4,931 patients were tested for methacrylate allergy.
Dr Buckley explains that ‘contact allergies are allergic reactions triggered when a specific substance to which someone has become sensitised through exposure comes in contact with the skin. Dermatologists have seen a huge increase in the number of allergic reactions caused by these chemicals.’
According to Dr Buckley, ‘allergic reactions may involve loosening of the nails, [and/or] a severe red, itchy rash, not just on the fingertips but potentially anywhere on the body that has come into contact with the nails, including the eyelids, face, neck and genital region. Very rarely, symptoms such as breathing problems can occur’, she adds.
The BAD is urging people to be particularly careful when using home kits. If you do use one, make sure you use the recommended lamp for curing the brand of gel polish, as using the wrong lamp may mean that the polish does not cure properly, which leads to an increased risk of allergy.
Dr Buckley advises users to follow all instructions carefully. This may not be straightforward, however, as some kit instructions were found to be inadequate in another survey. If in doubt we suggest contacting the manufacturers; yes, it’s a bother but better that than risk the sort of side effects Bella experienced. The most important instruction to follow is: don't apply gel on the skin or cuticle.
Dr Buckley advises: ‘If you suspect that you have developed a contact allergy you should raise this with your GP who may be able to refer you for testing to pinpoint the cause.’ (Unfortunately, many GPs – like Bella’s - are unaware of this problem.)
Once you have been affected however, there’s no going back according to Dr Buckley. ‘Unfortunately, once you have developed a contact allergy the only way to manage this is to avoid contact with the allergen.’
Bella is applying Fulvic Acid Nail Cream /£12 for 30ml, to help repair her nails, which is working well. Varnish is off her agenda currently but if she does succumb to the allure of polished nails, she will check the ingredients to ensure there are no methacrylates.
It’s not just at-home nail enhancements that pose a threat. Even when gel nail polish or artificial extensions are professionally applied, there is a risk of the uncured products coming into contact with a part of the skin, mostly through insufficient training given to the nail technician.
It’s important to recognise that the beauticians themselves are at risk of ‘occupational sensitisation’. Dr David Orton of the BAD has said: ‘the risk is particularly high for beauticians and other professionals who work with nail enhancements. Wearing protective gloves is not enough, as methacrylates will pass directly through many glove types. Salon owners need to consider the level of training they offer staff in this area as there is a genuine occupational hazard that should be mitigated. An important precaution is to use nitrile gloves, which are replaced and disposed of every 30 minutes and removed with a “no touch” technique. Methacrylates should be kept away from all direct skin contact. The training also needs to reduce the chances of initiating an allergy in their clients.’ (This was obviously not relevant under lockdown but is again now.)
LAST WORD Guess what’s in eyelash glue? Yup – something called PMMA or poly methyl methacrylate. It’s used to reinforce cyanoacrylate –the base material for fast-curing glue. The acrylates work together to create rapid drying, immediate bonding, and a long-lasting hold. The glue also contains other potential allergens, including latex and ammonia, and emits high levels of potentially toxic formaldehyde.
A 2019 review said: Recent studies have reported that 73.3% of patients experienced ocular side effects after the application of eyelash extensions including itching (45.8%), redness (45.5%), pain (43.9%) and heavy eyelids (41.6%) Failure to treat those reactions most often leads to other serious ocular disorders including contact dermatitis, toxic conjunctivitis, conjunctival erosion and allergic blepharitis. Many studies have investigated the cause of these ocular responses and narrowed down the sources to the lash glue adhesive and to mechanical limitations of the lash extensions themselves.’ Read the study here.
