As consumers continue to lean into self-care and wellness trends, the nail care industry is expanding, with a 2024 global market value of $8.8 billion that is forecasted to keep growing. The experience of stepping into a salon for a manicure, however, is not completely harmless. The hidden dangers associated with some nail products and salon processes may pose health risks, and dermatology professionals can play an important role in helping patients reduce exposure.
“First is education,” said Emma Scott, BS, a fourth-year medical student at the University of Toledo. “Many people have no idea that there are any risks associated with nail product use. Everyone assumes a manicure is a benign process. That is where dermatologists come in. Dermatologists can educate their patients about what potential risks there are.”
The Hidden Dangers of Nail Products
While there is a lack of research on the hazardous plasticizers and solvents contained in popular nail products, limited data shows that regular use can irritate the skin and cause several dermatologic conditions. Allergic contact dermatitis, the most studied adverse effect from nail polish, can cause a range of symptoms including swelling, severe pruritus, nail dystrophy, and scaling.
“Allergic contact dermatitis from nail product use can look similar to allergic contact dermatitis from anything else,” Scott explained. “A person might experience redness, swelling, pruritus. There might be some blistering, and in more severe cases there could be paronychia. Severe allergic contact dermatitis can also lead to nail dystrophy or scaling.”
Exposure to toxic chemicals commonly found in nail products — such as methyl methacrylate, a bonding agent used in some artificial nails, or toluene, a solvent — can cause adverse reactions. Resulting contact dermatitis may also be transferred to the face, forearms, and neck.
The Risks of Exposure
Consumers are not the only ones at risk. Nail technicians face repeated exposure to potentially harmful chemicals and are advised to wear gloves to minimize skin contact, as well as masks to reduce inhalation of solvent fumes, especially when the nail salon is poorly ventilated. Scott pointed out that recent data suggests that many nail technicians also have a history of asthma, and their children tend to have worse asthma symptoms.
In addition to allergic contact dermatitis and nail damage, the hazardous chemicals and use of UV light during nail treatments may also contribute to skin cancer risk.
“Some data suggest a person would need to be exposed to about 200 UV light sessions,” said Scott, adding that for people who get their nails done every few weeks over many years, cumulative exposure can become significant. Other studies suggest the risk increases with exposure closer to 10,000 UV light sessions.
“There are multiple cases of squamous cell on the dorsal hand, which is what is exposed to the UV when you put it under the curing lights,” Scott noted. “These studies show a correlation, not necessarily proven causation. However, many of those patients do have very extensive nail salon use.”
Reducing the Threat
Scott pointed out that reducing the risks associated with nail products begins with patient education. Dermatologists can counsel patients on potential irritants and suggest ways to avoid them without eliminating salon services altogether.
The primary advice for patients who continue to visit — or work in — nail salons is to choose facilities with good ventilation to reduce inhalation of chemical fumes. Consumers can also look for products that do not contain toxic chemicals. Scott recommends a database called Skin Deep, maintained by The Environmental Working Group, where consumers can get information on various nail products that have been evaluated. While these products are often more expensive, mislabeling remains a concern due to limited FDA oversight of cosmetic ingredients.
Conclusion
- Toxic chemicals in some nail products pose dermatologic risks, including allergic contact dermatitis.
- Dermatologists should counsel patients about potential skin irritants and ways to reduce exposure.
- Increased oversight, improved regulations, and consumer education could help elevate safety standards across the nail industry.
