Acrylic nails and allergic contact dermatitis

We have recently seen an increase in the number of cases of allergic contact dermatitis (ACD) to acrylic chemicals used in nail cosmetics. While most of these have involved nail technicians, we had a recent worrying case of a consumer who had purchased products for home use on the internet.

There are two types of acrylic nail products that cause problems; the first is the traditional acrylic or gel nail, and the second is Shellac®, which is a newly available type of long-wearing nail polish, which is becoming increasingly popular. The chemicals which can cause allergy in both of these nail products, are acrylates.

Many people are unaware that acrylates are allergenic and can cause ACD, which can result in significant skin problems. Because Shellac® looks like and is applied like a traditional nail polish, it may not be recognized to be acrylate-based. It is also important to note that when ultraviolet (UV) light is required, it is indicative that the nail ingredients are acrylates and need curing to progress from the allergenic monomer to the inert polymer state. This includes home style nail packages sold on the TV or internet.

Increasing use of these new acrylic nail products means that dermatologists need to be more aware of the possibility of ACD caused by them. There also needs to be greater understanding of this hazard within the beauty industry. Many beauticians and nail technicians are unaware that a single episode of skin contact with these chemicals may lead to sensitisation and the subsequent development of ACD. Based on international experience, we advise that people protect themselves from acrylates by wearing two pairs of disposable nitrile gloves when handling acrylate chemicals.

Finally, our experience of testing with acrylates used in nail products has led us to conclude that testing with hydroxyethyl methacrylate (HEMA) alone is an adequate screening agent for acrylate allergy. It was previously recommended that people in contact with acrylic nails were tested with the full methacrylate nail series. However, after reviewing 20 years of patch testing data, we now recommend that people only need to be tested with this one acrylate which is in the Australian Baseline Series, as all patients with ACD to nail acrylates reacted to this one key allergen.  This prevents patients having multiple, severe reactions to all the acrylates that they previously would have been tested to.