Nail damage from gel polish manicure

Nail cosmetology

Nail cosmetics is enjoying growing success due to recent technological advances. Manicures can be responsible for mechanical, infectious or allergic adverse effects. Nail cosmetics (e.g., nail varnishes, acrylic false nails, light-curing gels, and adhesive false nails) incorporate substances that harden after solvent evaporation or after polymerization. Allergic reactions can occur, remotely with conventional varnishes and locally with polymerizing substances. Artificial nails incur a risk of carrying infectious agents which can cause serious infection, and should not be used by caregivers. Recently, there has been a worrisome increase in the frequency of acrylate allergy, due to the appearance of home kits and lack of information in the general public. The infectious, allergic and toxic risks incurred by consumers and professionals regarding manicure or pedicure treatments and the application of nail cosmetics are the subject of recommendations and monitoring measures.

Prognosis and sequelae of meth(acrylate) sensitization in beauticians and consumers of manicure materials

BACKGROUND

Allergic contact dermatitis from (meth)acrylic monomers (ACDMA) in manicure products is increasing.

OBJECTIVE

To evaluate the prognosis, work performance impairment and sequelae of a cohort of beauticians and manicure consumers with ACDMA sensitized from the exposure to manicure products.

METHODS

We conducted a telephone survey with patients diagnosed with ACDMA.

RESULTS

One hundred and six patients were evaluated, including 75 (70.8%) beauticians and 31 (29.2%) consumers. All were women with a mean age of 39 (19-62). Thirty-seven of 75 beauticians (49.3%) continued to work. Twenty-seven of 106 (25.5%) patients continued to use manicure products with (meth)acrylates regularly. Seventeen of 51 (33.3%) patients who discontinued the exposure described ongoing nail/periungual changes. Nine of 58 (15.5%) patients who required dental restoration, orthodontic or occlusal splint materials recalled reactions from them; and, 25 of 96 (26%) who used sanitary napkins recalled intolerance to them starting after the diagnosis of ACDMA. Fifteen of 25 (60%) discontinued the use of sanitary napkins.

CONCLUSION

49.3% beauticians continued to work; most patients stopped wearing acrylic manicure materials; reactions from dental materials were not uncommon, however, removal of dental materials was never required; and, reactions to sanitary napkins developing after the diagnosis of ACDMA were common most leading to discontinuation of use.

Review of the literature on the efficacy and safety of a new cosmetic topical treatment containing Pistacia lentiscus and hyaluronic acid for the treatment of nail plate damages

OBJECTIVES

The objective of our study is the review of the literature on the efficacy and safety of a novel water-soluble nail strengthened (WSNS) containing hyaluronic acid and Pistacia lentiscus used for the improvement of nail plate diseases.

MATERIALS AND METHODS

We conducted literature research on PubMed/MEDLINE to identify all the studies reporting the use of hyaluronic acid and P. lentiscus in the improvements of nail alterations.

RESULTS

We found two reports and two posters published in the literature, accounting for 96 patients treated with WSNS containing P. lentiscus and hyaluronic acid. The 83 patients were affected by brittle nails and 13 patients by onychomycosis.

CONCLUSIONS

This review demonstrates that the daily application of this new product containing P. lentiscus and hyaluronic acid can be used as a cosmetic adjuvant for improving common nail diseases such as nail fragility and onychomycosis, with significant results on nail quality and appearance. Patients did not report any adverse events and its ease of application and cosmetic qualities contribute to the great compliance to treatment.

Side effects of gel nail polish: A systematic review

Gel nail polish (GNP) has recently gained worldwide popularity. We have conducted a comprehensive summary of the complications of GNP through a literature search using the PubMed, Scopus, and Google Scholar databases to identify eligible contributions. Complications were divided into mechanical and traumatic nail disorders, allergic contact dermatitis (ACD), and ultraviolet (UV)-induced lesions. A total of 12 contributions were included, identifying 88 patients, all of whom were women. Six of the reports described ACD (62 cases, 70.5%), 3 concerned mechanical nail damage (23 cases, 26.1%), and 3 reported UV-induced skin lesions (3 cases, 3.4%). ACD developed an average of 30 months after GNP initiation. The most frequent culprit allergens were 2-hydroxypropyl methacrylate and 2-hydroxyethyl methacrylate. Pterygium inversum unguis was the most frequent mechanical lesion (n = 17). Squamous cell carcinoma was reported in 3 cases. The delay between UV exposure and the diagnosis of squamous cell carcinoma ranged from 11 to 15 years. Scant literature and a lack of education among consumers and beauticians have led to the uncontrolled use of GNP. The principle of managing nail cosmetic problems is prevention through education. There is a need for understanding the processes involved and the associated complications to facilitate appropriate treatment and safe use.

Application of a three‐dimensional scanner to the quantitative assessment of the nail plate condition after a hybrid manicure procedure—Preliminary study

BACKGROUND

About 90% of women worldwide use nail care products, including manicure ones. A manicure procedure results in nail damage, therefore it is necessary to search for new, objective methods of assessing the impact of the procedures and products applied within the nail plate. In this study, an attempt was made to quantify the impact of manicure procedures on the nail plate condition.

MATERIALS AND METHODS

Twenty thumb nail plates were examined. Before the manicure procedures, alginate casts were prepared for each of the subjects. The analysis of the three-dimensional (3D) nail surface structure included the assessment of the nail sections and the assessment of differences in the nail structure after superposition of 3D images of the nail plates before and after the manicure procedures.

RESULTS

The obtained results show that the nail plate structure changed to a similar extent in each measured section after the manicure procedure. A change in the height of the nails is not a desirable phenomenon as it suggests damage to the nail caused by the substances included in the preparations applied to the nails, acetone, or filing the nail plate. This proves the great influence of the technique of removing artificial nails on the structure of the natural plate.

CONCLUSION

The use of a 3D scanner allows for precise, biometric, quantitative, and repeatable measurements of changes in the nail structure after a manicure procedure. The use of the hybrid and gel manicure procedure causes significant damage to the nail plate, especially in its distal portion.

Leukonychia: What Can White Nails Tell Us?

Changes in nail color can provide important clues of underlying systemic and skin disease. In particular, white discoloration (leukonychia) has a high prevalence with a wide array of potential relevant causes, from simple manicure habits to life-threatening liver or kidney failure. Therefore, a reliable assessment of the patient with leukonychia is essential. In the past, two classifications for leukonychia have been presented. The morphological classifies the nail according to the distribution of the white lines: total, partial, transversal, and longitudinal leukonychia. Mees’ and Muehrcke’s lines are examples of transversal leukonychia, while Terry’s and Lindsay’s nails are examples of total and partial leukonychia. The anatomical classifies according to the structure responsible for the white color: the nail plate in true leukonychia, the nail bed in apparent leukonychia, and the surface only in pseudoleukonychia. In this review, both morphological and anatomical features have been combined in an algorithm that enables clinicians to approach leukonychia efficiently and effectively.

The Influence of UV Varnishes on the Content of Cysteine and Methionine in Women Nail Plates-Chromatographic Studies

The main purpose of this work was to determine if the use of hybrid nail polishes causes changes in concentration of the most important sulfur amino acids that build nail plate structures, cysteine and methionine. We found that the average contents of cysteine and methionine in studied samples before the use of hybrid manicure were 1275.3 ± 145.9 nmol mg⁻¹ and 111.7 ± 23.8 nmol mg⁻¹, respectively. After six months of hybrid manicure use, the average amount of these sulfur amino acids in studied samples were 22.1% and 36.5% lower in the case of cysteine and methionine, respectively. The average amounts of cysteine and methionine in nail plate samples after the use of hybrid manicures were 992.4 ± 96.2 nmol mg⁻¹ and 70.9 ± 14.8 nmol mg⁻¹, respectively. We also confirmed that in studied women the application of UV light varnishes reduced the thickness of the nail plate, from 0.50 ± 0.12 mm before to 0.46 ± 0.12 mm after the use of the hybrid manicure.

Evaluation and detection of early nail damage caused by nail enamel

BACKGROUND

Many nail cosmetics have components that are considered irritants or allergens. Due to the current clinical assessment limitations, it is often too late to identify nail enamel hazards until they cause disease. Thus, it is essential to investigate effective methods of detecting minor changes and early lesions in nails before they worsen.

OBJECTIVES

To provide a reliable method to investigate and evaluate nail enamel hazards on nails earlier using ultrasonic equipment.

METHODS

Eighty-three volunteers with smooth, lustrous nails were enrolled after being clinically examined. The thumbnails and middle nails were evaluated before and after using nail enamel for 2 weeks. Nail health was then assessed using three methods: clinical evaluation, nail surface image analysis, and an ultrasonic device.

RESULTS

Using clinical diagnostic and imaging methods for analyzing the nail surface showed no visible differences before and after using nail enamel for 2 weeks. However, there was a significant difference in the nails' depth and density (p < 0.001). The depth had increased 10% for thumbnails (about 20 μm), and the density had decreased by 3.0%. As for middle nails, the depth had increased by 9.4% (about 19 μm), and the density had decreased by 3.0%.

CONCLUSION

The present study provided evidence that nail enamel can significantly irritate hyperplasia and decrease the density of the nails, but detecting that slow process of pathological changes cannot currently be assessed by conventional clinical evaluation and image analysis. Thus, our study provided a practical novel approach for evaluating these visually imperceptible nail changes.

A preliminary study of post-progressive nail-art effects on in vivo nail plate using optical coherence tomography-based intensity profiling assessment

Nail beautification is a widely applied gender independent practice. Excessive nail beautifications and nail-arts have a direct impact on the nail structure and can cause nail disorders. Therefore, the assessment of post-progressive nail-art effects on the nail is essential to maintain optimal nail health and to avoid any undesirable disorders. In this study, in vivo nails were examined in control stage, with a nail-art stage, and after removing the nail-art stage using a 1310 nm spectral-domain optical coherence tomography (SD-OCT) system. The acquired cross-sectional OCT images were analyzed by a laboratory customized signal processing algorithm to obtain scattered intensity profiling assessments that could reveal the effects of nail beautification on the nail plate. The formation and progression of cracks on the nail plate surface were detected as an effect of nail beautification after 72 h of nail-art removal. Changes in backscattered light intensity and nail plate thickness of control and art-removed nails were quantitatively compared. The results revealed the potential feasibility of the developed OCT-based inspection procedure to diagnose post-progressive nail-art effects on in vivo nail plate, which can be helpful to prevent nail plate damages during art removal through real-time monitoring of the boundary between the nail plate and nail-art. Besides nail-art effects, the developed method can also be used for the investigation of nail plate abnormalities by examining the inconsistency of internal and external nail plate structure, which can be diagnosed with both qualitative and quantitative assessments from a clinical perspective.

Prediction of a nail polish colour applied on a nail

OBJECTIVE

The colour of a nail polish varies according to the nail on which it is applied. The objective of this study was to predict the colour of the nail polish on a given nail and to study how the colour varies depending on the nail polish thickness.

METHODS

Six nail polishes were applied in one, two and three layers on the nails of one subject, thus forming eighteen samples. The spectral reflectances of the eighteen nail polishes applied on the nails with different thicknesses were obtained by spectrophotometry. The spectral reflectances of the nails without polish were also measured using the same technique. The thicknesses of nail polishes were measured by high-definition optical coherence tomography (HD-OCT). Then, to determine the physical parameters of the nail polish itself, we applied the six nail polishes on an opacity drawdown chart and we measured the spectral reflectance and the thickness of each patch using spectrophotometry and HD-OCT, respectively. The Kubelka-Munk theory was used to get the predicted spectral reflectance of the nail polish applied on the nail according to the polish thickness by knowing the parameter of the polish itself and the spectral reflectance of the nail. The predicted spectral reflectances were finally compared with those measured directly on the nails.

RESULTS

The predicted spectral reflectances were rather close to measured ones. Consequently, knowing the colour of the nail without polish and the optical parameters of the nail polish itself, we can estimate the colour of the nail polish applied on the nail depending on its thickness.

CONCLUSION

Our study showed that the Kubelka-Munk theory can be used to predict the nail polish colour. The ability to predict the real colour of a nail polish applied on a nail could help a nail polish manufacturer to improve his polish formulae in order to obtain a precise colour.

Pterygium inversum unguis secondary to gel polish

BACKGROUND

Pterygium inversum unguis (PIU) is characterized by the abnormal adherence of the hyponychium to the ventral surface of the nail plate. It can be both unsightly and painful, resulting in morbidity for patients. Gel polish is a popular nail cosmetic that has been reported to cause several complications. PIU may be another adverse outcome.

OBJECTIVE

To highlight a newly recognized adverse effect of a popular beauty technique.

METHODS

This retrospective and prospective case series reports 17 women who developed PIU after gel polish use. All study-related activities occurred at a University of Miami dermatology outpatient clinic.

RESULTS

All 17 subjects developed PIU after two to five years of gel polish application. Nine of 17 patients reported using both UVA and LED light to cure gel polish. Of the remaining eight, five used LED light only and three did not know or could not remember. All but two patients had a resolution of PIU a few weeks after switching from gel polish to regular polish manicures.

CONCLUSION

While it remains undiscerned whether PIU is related to chemicals present in the gel polish or to the application and/or removal process of such, patients and dermatologists should be aware of the potential risks of gel manicures.

Allergic contact dermatitis caused by (meth)acrylates in long-lasting nail polish - are we facing a new epidemic in the beauty industry?

BACKGROUND

Allergic contact dermatitis (ACD) caused by (meth)acrylates has been described both in occupational and in non-occupational settings.

OBJECTIVES

To evaluate the clinical patterns, the most frequent allergens and the prognosis in patients sensitized to (meth)acrylates in long-lasting nail polish.

METHODS

The files of patients with ACD caused by (meth)acrylates in long-lasting nail polish diagnosed between January 2013 and June 2016 in four dermatology departments in Spain were reviewed. Patients were followed up by telephone interview.

RESULTS

Overall, 2353 patients were patch tested. Forty-three (1.82%) were diagnosed with ACD caused by (meth)acrylates in long-lasting nail polish during that period; all were female, and all had hand dermatitis. Patients were mostly less than 40 years old (72.1%), non-atopic (95.4%) and had an occupational cause of their dermatitis (93%), which developed ∼10.1 months after they had started to use this technique. The most frequent positive allergens were: 2-hydroxypropyl methacrylate, 2-hydroxyethyl methacrylate, and tetrahydrofurfuryl methacrylate. Eight of the 22 interviewed patients were able to improve their working technique and used 4H® protective material (fingerstalls/gloves).

CONCLUSIONS

Long-lasting nail polishes have become widespread, and it is a matter of concern that we may be facing a new epidemic of ACD caused by these. Policies regulating their use are urgently needed.

Onychomatricoma has channel-like structures on in vivo reflectance confocal microscopy

BACKGROUND

Onychomatricoma is a benign fibroepithelial nail matrix tumor that infiltrates the nail plate leading to multiple tunneled cavities lined with matrix epithelium and filled with serum. Diagnostic features of onychomatricoma on reflectance confocal microscopy (RCM) have not been previously described.

OBJECTIVE

We sought to demonstrate the feasibility of using RCM to diagnose onychomatricoma.

METHODS

Reflectance confocal microscopy was used to evaluate four patients with onychomatricoma before tumor excision. We evaluated the affected nail and one unaffected nail of each patient with VivaScope 1500 (Lucid Inc., Rochester, NY, USA).

RESULTS

Reflectance confocal microscopy evaluation of onychomatricomas revealed longitudinal dark areas and bright/grey lines, forming channel like structures. The channels were outlined by bright circular lines with grey dot centers. These RCM features correlated with the pathology of the onychomatricomas within the nail plate.

LIMITATIONS

Proximal portion of onychomatricoma was not reach by RCM.

CONCLUSIONS

Reflectance confocal microscopy can assist in rapid and noninvasive diagnosis of onychomatricoma showing characteristic channel like structures within nail plates.