What Is the Main Idea?

At-home use of nail cosmetic products (NCPs) is increasingly popular but can be associated with increased risk of adverse effects compared with their use in salons. In the free-access review article “Adverse Effects of Do-It-Yourself Nail Cosmetics: A Literature Review”, published in the journal Skin Appendage Disorders, the authors assess the most common adverse effects that can result from the use of NCPs.

What Else Can You Learn?

Different types of NCPs are described along with adverse effects that can result from their use.

Take-Home Message

Users of at-home NCPs should be aware of the chemicals in the products that they use and should check that they are using NCPs correctly. If you use artificial nails, it is worth taking a break from them every few months to let your nails recover from exposure to the chemicals used to apply and remove them.

What Are the Most Popular Types of NCPs?

Although traditional nail polish remains one of the most popular NCPs, a range of other NCPs and techniques have been developed that offer the advantage of being longer lasting and harder wearing. These newer NCPs were originally available only in salons, but at-home manicures have become increasingly popular because they can be relatively easy to apply and enable people to follow nail art trends seen in video tutorials available online.

Press-on nail sets include plastic tips that range in size to ensure that one can be fitted to each fingernail, which are attached to the nail via the use of nail glue or a peel-and-stick adhesive. In contrast, gel nail polish contains acrylic- or cyanoacrylate-based compounds, which are applied as at least three layers: a base coat, a colored layer, and a top coat. The layers are then “cured” (dried and hardened) using a light-emitting diode (LED) or ultraviolet (UV) lamp.

Shellac nail polish, which similarly needs to be cured using a UV lamp, is a method that combines both traditional and gel nail polish. In contrast, acrylic nails are formed by combining a liquid with a powder to form a mixture that is applied and sculpted onto the nail, and that hardens through air-drying. Both acrylic nails and gel polish need to be removed by either soaking in acetone or the use of a nail drill.

Nail hardeners are used to protect nails and increase their strength, and are also used to deter nail-biting habits in both children and adults. Like traditional nail polish, nail hardeners often contain substances called tosylamide resin and/or formaldehyde resin, which help the polish/hardener to stick to the nail.

Can NCPs Have Adverse Effects?

The short answer is yes. The term “adverse effect” describes any unintended harmful effect that is caused by a medication, intervention or treatment. Although NCPs are not inherently harmful, a range of adverse effects have been reported following NCP use in salons over the years. Furthermore, there is evidence that consumers using at-home NCPs are at increased risk of experiencing adverse effects, due in part to a lack of training and not being aware of the potential consequences of not applying the NCPs correctly. Some nail tutorials available online do not show accurate and safe techniques for the application of the NCPs being used, and some NCPs do not come with detailed information about how to apply the NCP correctly or warnings about potential issues if the person fails to do so.

What Is the Most Common Adverse Effect That NCPs Can Cause?

The most common adverse effect caused by NCPs is allergic contact dermatitis, which is triggered when a person comes into contact with a particular substance, such as a chemical in cosmetics or nickel in jewelry. It is a type of eczema that can affect any part of the body, and can develop immediately after exposure to the substance causing the reaction or hours or days later. Symptoms vary from dry, cracked itchy skin to a burning or stinging sensation, with some people developing painful fluid-filled blisters on the affected area. In the case of NCPs, most cases of allergic contact dermatitis are caused by acrylates found in acrylic nails, gel polish, and nail glue.

What Other Adverse Effects Are Associated with NCPs?

Chemical Burns

The nail glues that are used to stick on press-on nails can cause chemical burns (these are burns caused by contact with caustic, acid, or alkali chemicals rather than heat). They often occur as a result of accidental spillage, particularly when children are using NCPs without supervision, and the burns can be severe. In some cases, people who have had chemical burns caused by nail glue have had to have skin grafts.

In many cases, part of the problem is believed to be a lack of awareness about how to best deal with a chemical burn. Any contaminated clothing needs to be removed carefully and in a way that will not spread the chemical that is causing the burn. It is also important not to wipe the skin, because this can spread the chemical over a greater area. Instead, the affected skin should be rinsed with clean water (ensuring that the water can run off the skin freely) as soon as possible without wiping or rubbing, and the person should seek medical attention as soon as possible.

Nail Infections

Extended use of press-on nails has been associated with increased risk of nail infections. This is often caused when the real nail (the nail plate) under a press-on nail is partially dislodged from the nail bed, for example if the press-on nail is knocked against something. The nail bed is a layer of skin that is visible directly under the nail plate (which is semi-transparent).

If the nail plate becomes dislodged, microbes like bacteria and fungi can get into the gap between the nail plate and the nail bed and start to grow. An example of this is green-nail syndrome (also known as “the greenies” or “chromonychia”), which is caused by infection with a type of bacteria called Pseudomonas aeruginosa. Although green-nail syndrome usually responds well to treatment, in some cases the affected nail may need to be removed.

Risk of Photosensitivity

In addition to the above, the use of UV lamps to cure nails is associated with a risk of photosensitivity (an unusual reaction or heightened sensitivity when the skin is exposed to UV radiation). This has been particularly associated with people with forms of an autoimmune condition called lupus erythematosus. Some studies have also reported concerns about whether or not the use of UV nail lamps increases a person’s risk of developing skin cancer. Although it is still not clear whether using these lamps does significantly increase a person’s risk, frequent users may wish to wear gloves or apply sunscreen before using them as a precaution.

Note: The authors of this paper make a declaration about grants, research support, consulting fees, lecture fees, etc. received from pharmaceutical companies. It is normal for authors to declare this in case it might be perceived as a conflict of interest. For more detail, see the Conflict of Interest Statement at the end of the paper.

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