Skip to main content

Contact Dermatitis to Nail Cosmetics

Abstract

Purpose of Review

Nail aesthetic procedures, particularly the fashion of nail sculpting, gel nails and long-lasting polishes, have been expanding over the last years, with an increasing number of cases of allergic contact dermatitis both in aestheticians and customers. Clinical suspicion and interpretation of nail cosmetics patch test results require a general knowledge of the main current manicure techniques and chemicals used.

Recent Findings

Allergic contact dermatitis (ACD) to nail cosmetics, previously attributed mostly to tosylamide formaldehyde resin (TSFR), is now mainly caused by (meth)acrylates. In addition to pulpitis, periungual dermatitis, and lesions involving the face, neck, and chest, nail dystrophy can occur from (meth)acrylate-based techniques. The diagnosis of ACD can be confirmed by patch-testing suspected nail care product ingredients, namely, methacrylates, cyanoacrylates and TSFR. Hydroxyethyl methacrylate (HEMA), which detects most cases of ACD from nail (meth)acrylates, has been recently introduced in many baseline patch test series all over the world.

Summary

Ingredients in nail cosmetics may lead to allergic and/or irritant contact dermatitis. Irritant dermatitis is mostly associated with nail hardeners and cuticle and nail polish removers. The “epidemic” of ACD to nail cosmetics has increased likely due to its expansion to untrained home users. Preventive measures and stricter regulation in the field are key measures to reduce ACD in this setting. Avoidance of the culprit is not always possible, particularly in the occupational setting. Sensitization to (meth)acrylates may have further health implications.

This is a preview of subscription content, access via your institution.

Fig.1
Fig. 2
Fig. 3
Fig. 4

References

  1. 1.

    Dinani N, George S. Nail cosmetics: a dermatological perspective. Clin Exp Dermatol. 2019;44(6):599–605.

    CAS  Article  Google Scholar 

  2. 2.

    Warshaw EM, Voller LM, Silverberg JI, Dekoven JG, Atwater AR, Maibach HI, et al. Contact dermatitis associated with nail care products: retrospective analysis of North American Contact Dermatitis Group Data, 2001–2016. Dermatitis. 2020;31(3):191–201. A large retrospective analysis conducted over a 15-year period showing the frequency of allergy to hydroxyethyl methacrylate and ethyl acrylate significantly increased over time. This study also describes the most recent list of the top 5 nail cosmetic allergens in North America (2-hydroxyethyl methacrylate, methyl methacrylate, ethyl acrylate, ethyl-2-cyanoacrylate and tosylamide).

  3. 3.

    Raposo I, Lobo I, Amaro C, Lobo M de L, Melo H, Parente J, et al. Allergic contact dermatitis caused by (meth)acrylates in nail cosmetic products in users and nail technicians – a 5-year study. Contact Dermatitis. 2017;77(6):356–9.

  4. 4.

    Reinecke JK, Hinshaw MA. Nail health in women[Formula presented]. Int J Women’s Dermatology [Internet]. 2020;6(2):73–9. Available from: https://doi.org/10.1016/j.ijwd.2020.01.006

  5. 5.

    Gatica-Ortega M-E, Pastor-Nieto M-A. Dermatitis de contacto por acrilatos en kits caseros de esmaltes de uñas permanentes. Piel. 2018;33(8):483–6.

    Article  Google Scholar 

  6. 6.

    Heymann WR. Nail cosmetics: potential hazards. J Am Acad Dermatol. 2007;57(6):1069–70.

    Article  Google Scholar 

  7. 7.

    Ratycz MC, Lender JA, Gottwald LD. Multiple dorsal hand actinic keratoses and squamous cell carcinomas: a unique presentation following extensive UV nail lamp use. Case Rep Dermatol. 2019;11(3):286–91.

    Article  Google Scholar 

  8. 8.

    de Groot AC. Contact allergy to cosmetics: causative ingredients. 1987;17(1):26–34.

    Google Scholar 

  9. 9.

    Gonçalo M, Pinho A, Agner T, Andersen KE, Bruze M, Diepgen T, et al. Allergic contact dermatitis caused by nail acrylates in Europe. An EECDRG study. Contact Dermatitis. 2018;78(4):254–60. A large European study showing that the nail aesthetics industry is responsible for the majority of ACD cases caused by acrylates and suggesting the inclusion of HEMA in the baseline series.

  10. 10.

    Baran R. Nail cosmetics: Allergies and irritations. Am J Clin Dermatol. 2002;3(8):547–55.

    Article  Google Scholar 

  11. 11.

    Chou M, Dhingra N, Strugar TL. Contact sensitization to allergens in nail cosmetics. Dermatitis. 2017;28(4):231–40. This paper offers an updated description of nail manicure techniques and details the related allergens.

    CAS  Article  Google Scholar 

  12. 12.

    Ale IS, Maibach HI. Irritant contact dermatitis. Rev Environ Health. 2014;29(3):195–206.

    CAS  Article  Google Scholar 

  13. 13.

    Alves F, Morgado F, Ramos L, Gonçalo M. Hand eczema from nail (meth)acrylates in an 11-year-old child. Contact Dermatitis. 2020;82(5):315–6.

    Article  Google Scholar 

  14. 14.

    Romita P, Foti C, Barlusconi C, Hansel K, Tramontana M, Stingeni L. Contact allergy to (meth)acrylates in gel nail polish in a child: an emerging risk for children. Contact Dermatitis. 2020;83(1):39–40.

    Article  Google Scholar 

  15. 15.

    Iorizzo M, Piraccini BM, Tosti A. Nail cosmetics in nail disorders. J Cosmet Dermatol. 2007;6(1):53–8.

    Article  Google Scholar 

  16. 16.

    Montgomery R, Stocks SJ, Wilkinson SM. Contact allergy resulting from the use of acrylate nails is increasing in both users and those who are occupationally exposed. Contact Dermatitis. 2016;74(2):120–2.

    Article  Google Scholar 

  17. 17.

    Dickison P, Smith SD. Itching for nail fashion: chronic urticaria and chronic hand dermatitis secondary to acrylate and methacrylate allergy in gel nail varnish. Clin Exp Dermatol. 2018;43(1):50–3.

    CAS  Article  Google Scholar 

  18. 18.

    Atwater AR, Reeder M. Trends in nail services may cause dermatitis: not your mother’s nail polish. Cutis. 2019;103(6):315–7.

    PubMed  Google Scholar 

  19. 19.

    S Lee D Maor A Palmer R Nixon 2018 Declining prevalence of allergic contact dermatitis caused by tosylamide formaldehyde resin in nail polish Contact Dermatitis 1 79

  20. 20.

    McFadden J, Puangpet P, Pongpairoj K, Thaiwat S, Xian LS. Tosylamide formaldehyde resin. In: Common Contact Allergens: A Practical Guide to Detecting Contact Dermatitis, First Edition. 2019. p. 263–6.

  21. 21.

    Adams RM, Maibach HI, Clendenning WE, Fisher AA, Jordan WJ, Kanof N, et al. A five-year study of cosmetic reactions. J Am Acad Dermatol [Internet]. 1985;13(6):1062–9. Available from: https://doi.org/10.1016/S0190-9622(85)70258-7

  22. 22.

    Sainio EL, Engström K, Henriks-Eckerman ML, Kanerva L. Allergenic ingredients in nail polishes. Vol. 37, Contact Dermatitis. 1997. p. 155–62.

  23. 23.

    Ramos L, Cabral R, Gonçalo M. Allergic contact dermatitis caused by acrylates and methacrylates - a 7-year study. Contact Dermatitis. 2014;71(2):102–7.

    CAS  Article  Google Scholar 

  24. 24.

    Roche E, de la Cuadra J, Alegre V. Sensitization to acrylates caused by artificial acrylic nails: review of 15 cases. Actas Dermo-Sifiliográficas (English Ed [Internet]. 2008;99(10):788–94. Available from: https://doi.org/10.1016/S1578-2190(08)70367-6

  25. 25.

    Lazarov A. Sensitization to acrylates is a common adverse reaction to artificial fingernails. J Eur Acad Dermatology Venereol. 2007;21(2):169–74.

    CAS  Article  Google Scholar 

  26. 26.

    Kanerva L. Cross-reactions of multifunctional methacrylates and acrylates. Acta Odontol Scand. 2001;59(5):320–9.

    CAS  Article  Google Scholar 

  27. 27.

    Brambilla E, Crevani M, Petrolini VM, Scaravaggi G, Di PM, Roda E, et al. Exposure to nail and false eyelash glue: a case series study. Int J Environ Res Public Health. 2020;17(12):1–14.

    Article  Google Scholar 

  28. 28.

    Eleftheriadou V, Roche L, Bourke JF, Buckley DA, Orton DI, Stone NM, et al. Allergic contact dermatitis to nonmethacrylate nail allergens in the UK. Br J Dermatol. 2020;183(4):754–6.

    CAS  Article  Google Scholar 

  29. 29.

    Mestach L, Goossens A. Allergic contact dermatitis and nail damage mimicking psoriasis caused by nail hardeners. Contact Dermatitis. 2016;74(2):112–4.

    Article  Google Scholar 

  30. 30.

    Pontén A, Bruze M. Formaldehyde. Contact Dermatitis. 1992;26(1):3–6.

    Article  Google Scholar 

  31. 31.

    Dahdah MJ, Scher RK. Nail diseases related to nail cosmetics. Dermatol Clin. 2006;24(2):233–9.

    CAS  Article  Google Scholar 

  32. 32.

    García-Gavín J, Lissens R, Timmermans A, Goossens A. Allergic contact dermatitis caused by isopropyl alcohol: a missed allergen? Contact Dermatitis. 2011;65(2):101–6.

    Article  Google Scholar 

  33. 33.

    Heurung AR, Raju SI, Warshaw EM. Benzophenones Dermatitis. 2014;25(1):3–10.

    CAS  Article  Google Scholar 

  34. 34.

    Sasseville D. Acrylates in contact dermatitis. Dermatitis. 2012;23(1):6–16.

    CAS  Article  Google Scholar 

  35. 35.

    Goossens A. Semi-open (or semi-occlusive) tests. In: Lachapelle JM, Bruze M, Elsner PU, editors Patch Testing Tips Berlin: Springer. 2014. p. 123–7.

  36. 36.

    Barrett M. Differential diagnosis of atopic dermatitis atopic dermatitis Eczema Mimickers Differential diagnosis. 2017;37:90027.

    Google Scholar 

  37. 37.

    Veien NK. Acute and recurrent vesicular hand dermatitis. Dermatol Clin [Internet]. 2009;27(3):337–53. Available from: https://doi.org/10.1016/j.det.2009.05.013

  38. 38.

    Morgado F, Batista M, Gonçalo M. Short exposures and glove protection against (meth)acrylates in nail beauticians—thoughts on a rising concern. Contact Dermatitis. 2019;81(1):62–3.

    Article  Google Scholar 

  39. 39.

    Sasseville D. Acrylates Dermatitis. 2012;23(1):3–5.

    Article  Google Scholar 

  40. 40.

    Asai C, Inomata N, Sato M, Koh N, Goda S, Ishikawa H, et al. Allergic contact dermatitis due to the liquid skin adhesive Dermabond® predominantly occurs after the first exposure. Contact Dermatitis. 2021;84(2):103–8.

    CAS  Article  Google Scholar 

  41. 41.

    Hansel K, Foti C, Nettis E, Lopalco A, Tramontana M, Bianchi L, et al. Acrylate and methacrylate allergy: when is patch testing with acrylic acid recommended? Contact Dermatitis. 2020;82(4):231–3.

    Article  Google Scholar 

  42. 42.

    Mestach L, Huygens S, Goossens A, Gilissen L. Allergic contact dermatitis caused by acrylic-based medical dressings and adhesives. Contact Dermatitis. 2018;79(2):81–4.

    CAS  Article  Google Scholar 

  43. 43.

    Aerts O, Herman A, Mowitz M, Bruze M, Goossens A. Isobornyl acrylate. Dermatitis. 2020;31(1):4–12.

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Rebeca Calado.

Ethics declarations

Conflict of Interest

The authors declare they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Contact Dermatitis.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 12 KB)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Calado, R., Gomes, T., Matos, A. et al. Contact Dermatitis to Nail Cosmetics. Curr Derm Rep (2021). https://doi.org/10.1007/s13671-021-00345-2

Download citation

Keywords

  • Nail cosmetics
  • Contact dermatitis
  • Acrylates
  • Artificial nails
  • Occupational