Vanity burns: an unusual case of chemical burn caused by nail glue

Adverse Effects of Do-It-Yourself Nail Cosmetics: A Literature Review

Background

As self-applied manicures have gained popularity, it is important for physicians to remain informed about potential associated side effects. Traditional polish remains most popular among nail enthusiasts, but the pursuit of durability and convenience accelerated development of other nail cosmetic products, including gel polish, acrylic nails, and press-on nails. Despite documented adverse effects among beauty professionals and salon customers, individuals practicing at-home nail care routines may face similar, if not more, frequent complications due to misinformation, inadequate training, and social media trends.

Summary

This review provides an overview of adverse effects associated with different at-home nail cosmetics. Allergic contact dermatitis is the most prevalent adverse event, primarily attributed to (meth)acrylates found in nail glue, gel polish, and acrylic nails. Other adverse effects include infections, chemical burns, and complications from ultraviolet nail lamps.

Key Message

The review highlights the importance of transparent product labeling and appropriate warning labels from manufacturers, as well as physician education and awareness for minimizing risks related to at-home nail cosmetic applications.

Nickel, cobalt, and chromium in nail sticker and tip products in Korea

BACKGROUND

Nail stickers and nail tips are increasingly used nail products in Korea, and the rest of the world. However, no studies have examined if these specific consumer products might contain nickel, cobalt, and/or chromium, that is, metals known to provoke contact allergy.

OBJECTIVE

We aimed to assess the release and content of nickel, cobalt, and chromium in nail stickers and tips by performing qualitative and quantitative analyses, respectively, of 50 convenience samples purchased in Korea.

METHODS

Eighty-six qualitative spot tests were performed to determine the release of nickel, cobalt, and chromium on 35 nail stickers and 15 nail tips across five brands. Subsequently, the metal contents were quantified using inductively coupled plasma-optical mass spectrometry (ICP-MS).

RESULTS

According to the spot tests, nickel was released in 7/86 (8.1%) tests before and 10/86 (11.6%) tests after exposure to artificial sweat. Cobalt and chromium (VI) spot test results were negative. However, ICP-MS detected nickel, cobalt, and chromium in 11%, 6.3%, and 16.7% of the samples, respectively. Detection rates were higher in nail tips than in stickers and were most common in rhinestones.

CONCLUSION

Nail stickers and tips may contain nickel, cobalt, and/or chromium.

Burn Injury Due to Cyanoacrylate-Based Nail Glue: A Case Report and Literature Review

Cyanoacrylate is used in the manufacturing of surgical adhesives, nail glue, and super glue. After contact with cotton or wool, among other catalysts, an exothermic reaction is ignited, inflicting thermal damage to the skin underlying clothes. Nine papers have been published about such an incidence, majority of which involve children. This is the first paper that presents the case of such a burn condition in Saudi Arabia. A four-year-old girl suffered a mix of first- and second-degree burns due to cyanoacrylate spillage over the digits, anterior aspect of the right thigh, and a patch of the skin on the left upper abdomen, spanning 4% of the total body surface area. The clothes were forcefully removed by the mother, and shampoo was applied over the area. At the emergency department, irrigation with normal saline was performed followed by dressing with paraffin-impregnated gauzes and silver sulfadiazine. Volar slabs were placed on the hands. The dressing in the hands was later changed to fusidic acid as the burn healed. Silicone sheet dressing was initiated 28 days later after the burned skin had healed. At one-year follow-up, the wounds were fully healed with no abnormal scar formation. This paper aims to improve awareness about proper first-aid burn management, which determines the quality of the outcome. Further emphasis is required on providing a safe environment for the children and clear, comprehensible warning of hazards on the label of the cyanoacrylate based-products.

Exposure to Nail and False Eyelash Glue: A Case Series Study

The use of artificial nail tips in professional manicure services and the application of false eyelashes are a growing trend among young women. Often, this “beauty routine” is performed at home without the supervision of an expert beautician, raising health problems due to either the spillage of these products or to accidental exposure to children. The aim of this study is to review the Pavia Poison Control Centre clinical records to identify the frequency, the most common route of exposure, and the possible risks associated to these events to support the decision-making process in emergency departments. The Pavia Poison Control Centre database was retrospectively searched for records reporting nail or false eyelash glue exposure from January 2007 to April 2020, and 42 patients were identified. Among the patients, 76% presented symptoms from mild to severe, while 24% were asymptomatic. The most common route of exposure was dermal, through cutaneous contact, as determined for 19 patients involved. Among these, seven patients presented with second-degree chemical burns, cutaneous erythema, and ocular symptoms. The most dangerous glue component was cyanoacrylate, leading to symptoms in 16 out of 22 patients, while three cases remained asymptomatic. Even if this exposure is relatively rare, nail and false eyelash glue can be seriously harmful, especially when exposure occurs via dermal or ocular routes. In the case of emergency, it is important to treat the patient as fast as possible to limit the damage caused by a burn. Moreover, even though these products are often perceived as harmless, safety precautions should be taken to prevent children from accidental contact.

Rare chemical burns: Review of the Literature

There are many chemicals that can cause burns. Although they are generally acidic and basic in nature, there are more than one million known chemical compounds, of which 300 have been declared highly hazardous chemical substances by the National Fire Protection Society. Chemical burns account for approximately 10.7% of all burn injuries and 30% of deaths because of burns. Chemicals can be classified as acid, alkali, organic, and inorganic compounds. Acids act by denaturing and coagulating proteins. Alkaline burns cause deeper burns than acid burns.

Full-thickness Pediatric Burn following Reaction between Cyanoacrylate Nail Adhesive and Cotton Shirt

Cyanoacrylate is an acrylic resin that is used as an adhesive in acrylic nail glues and various other strong, rapidly acting adhesives, such as “Dermabond” and “Super Glue.” This adhesive is very effective in a variety of settings; however, when cyanoacrylate comes into contact with cotton fibers, an exothermic reaction occurs that is severe enough to cause a full-thickness burn to the underlying skin. Full-thickness burns requiring excision and skin grafting can be psychologically devastating for patients, especially the pediatric population and their parents, who may believe they are to blame for their child’s burn. We present the case of a 2-year-old boy who developed a full-thickness burn after spilling acrylic nail glue onto his cotton shirt. Fortunately, his burn was small enough that excision with primary closure was able to be performed. However, he unfortunately developed hypertrophic scarring postoperatively. Owing to the widespread use of cyanoacrylate adhesives in the general population, it is important to spread awareness of the potential dangers associated with these adhesives to prevent potential physical and psychological injuries related to improper use of these adhesives.

Paediatric burns secondary to nail adhesives: a case series

Background

Nail adhesives are widely available beauty products that are used in the cosmetic industry and households to attach false nails. Nail adhesive burns are uncommon, and it is crucial that healthcare providers and the public are aware of its potential to cause chemical burn.

Case Presentation

Case series of accidental burns secondary to cyanoacrylate nail glue treated at the Welsh Centre for Burns and Plastic Surgery (WCBPS) in Swansea, United Kingdom.

Conclusion

All of the burns were observed in children and occurred due to accidental spillage. Therefore, it is important for the public to be aware that nail glue is a chemical agent which should be stored safely away from the reaches of young children. The case series highlights the importance of first aid in reducing the severity of chemical burns secondary to the nail adhesives, and its early recognition and treatment are emphasised.

The solution to pollution may not be dilution: A paediatric burn from accidental fingernail glue spillage

The use of fingernail glue in cosmetics is widespread, but the serious effects of spillage directly onto skin causing a burn have not been previously reported. We describe a 2-year-old male suffering full-thickness burns to the dorsum of his left foot 9 days after direct contact with cyanoacrylate-containing nail glue. Conservative management failed and formal surgical excision with skin grafting was needed. First aid advice from product safety and medical literature is ambiguous, as despite timely intervention with recommended measures, a serious burn injury resulted. Review of the literature revealed two other cases of indirect nail glue burns, both requiring surgery, with clothing acting as an interface between glue and skin, distinguishing it from our case. We propose possible mechanisms of injury and present this case to increase awareness of the consequences of contact with a seemingly trivial cosmetic chemical, recommend its better labelling and hope to educate medical professionals about this unusual, but serious mechanism of burn injury. This would obviate additional psychological stress on child and parents due to unnecessary referral to social services for investigation of a possible non-accidental injury.