How a poor gel manicure can lead to lifelong health issues

For most people, a gel manicure never causes an issue. But for some it can trigger a lifetime of allergies to various medical devices, and to dental fillings and implants that contain a compound call acrylate—a key chemical in these manicures and pedicures.

Gel polishes—which require exposure to a UV or LED light to harden and dry—have been around since at least the 1980s and offer a longer-lasting, glossy finish without the regular 30-minute dry time. But if a nail technician or an amateur uses these acrylate gel polishes incorrectly, allergies are more likely to develop. A mild reaction can involve itching and redness at the nail bed; a severe one can cause respiratory decline and the weakening or loss of fingernails.

That’s in part why doctors are warning nail care clients, and individuals who bought home gel manicure kits, to be aware of the risks of this procedure and precautions they can take to get it done safely—at the salon or at home. Once you develop an allergy to acrylates, doctors say they often become permanent. It’s a problem that extends beyond nail care as acrylates are used in veneers, surgical glues, and even hair and eyelash extensions.

Allergies are one of the many side effects recorded by researchers over the years. A new study even examined the cancer risk of gel manicures, finding that the UV from nail dryers can cause mutations that increase an individual’s risk.

Experts explain how gel manicures work, signs you might be allergic, and how to get it done safely.

What’s in a gel manicure?

Gel manicures have surged in popularity in part due to their greater resistance to chipping and scratches compared to traditional nail polish, says Reena Mehta, an allergy and asthma physician in New Orleans.

As Mehta explains, one of the main differences between gel manicures and other manicures is the use of a UV or LED lamp to “cure” the polish, creating a long-lasting, semi-permanent manicure. There are usually multiple layers, and each layer is cured before the next is applied.

One reason gel manicures are durable is that they incorporate a chemical called acrylate, which can come in powder or liquid form.

“The technician may apply acrylate powders to your nails and then you might have to put your nails under a light source. That light source helps initiate the reaction to turn that powder into this hard plastic-like substance that lasts for a long time,” Rajani Katta, a physician and professor of dermatology at McGovern Medical School, the University of Texas Houston.

These acrylates trigger an allergic reaction––and not just in services marketed as “gel manicures.”

“As a general approach, artificial, acrylic, gel, and silk nails, are all the same,” says Karin Pacheco, an allergist and occupational medicine physician in Colorado. She adds that any nail treatment that requires curing “is an acrylate-based nail.”

Certain types of acrylates have been banned by the Food and Drug Administration, but many of these still exist in nail products.

What does a gel manicure allergy look like?

It’s unclear what proportion of people using gel nails suffer an allergic reaction, or what makes someone predisposed to becoming sensitized. “But what we do know is the more often you go and the longer you’ve been doing it, it’s more likely,” says Deirdre Buckley, a dermatologist in Bath, U.K. “That is true in general of any allergen. If you’re exposed over many years, you’re more likely to become allergic.”

A common allergic reaction is contact dermatitis, a condition in which the skin may become red, bumpy, scaly, itchy, or swollen at the point of contact with the allergen, says Mehta. These symptoms, when activated by a gel manicure or pedicure, typically occur on the hands, fingers, or wrists; areas that are commonly touched such as the face, neck, and eyelids may be affected as well. Allergic reactions can also appear on the toes or feet, but seem to be less common.

According to Buckley, there have also been instances where users report itching around the nail folds, near where the polish was applied.

“They may find the nails are becoming damaged and loosening at the ends, and sometimes that’s in the absence of any itching or rashes on the tips of the fingers. They may just have the nails start to fall off. That’s due to the allergy,” she says.

In severe cases, individuals may have problems breathing if they are constantly exposed to high concentrations of the substance. This means workers are at a higher risk for respiratory effects. Buckley says a customer having a respiratory reaction would be an extreme case: "As a client, you would need to be very highly allergic already to be worried about this effect."

In terms of treatment, experts recommend removing the nails, as well as treating them with topical steroids. Avoidance is also important. “If you develop dermatitis––that’s a red, swollen, painful rash of the skin around the nail—that’s telling you that you’re probably sensitized, and it’s not a good idea to repeat that exposure,” says Pacheco.

How to get a gel manicure safely

An increase in acrylate allergies has implications beyond nail care.

“Once you’ve developed allergic contact dermatitis to whatever substance has triggered it, that reaction is almost always lifelong,” says Katta. “The reason that’s such an important thing in acrylate allergies is that these chemicals are used in other settings.” The substances are used in medicine, including dentistry practice, prosthetics, and diabetic devices.

Experts understand that some people may not want to turn to other, less durable, alternatives. However, they encourage nail salon regulars to take certain precautions, and suggest the technicians wear nitrile gloves to protect against the compound.

“One of the most important things is making sure you’re going to a salon that really understands how dangerous these chemicals can potentially be,” Katta says. “You want to make sure they’re extremely careful with that acrylate powder or liquid, that it’s not on the counters, that they’re applying it very carefully, that those chemicals are not getting on your skin.”

Proper curing is also crucial. If the gel polish isn’t appropriately cured, the acrylates are more likely to prompt an allergic reaction. Because of this, experts discourage the use of at-home gel nail kits as there are many professionals who are trained to do this the right way.

“People may have spent their life savings on setting up a business and training to be nail technicians, so I really don’t want to in any way say that people should not be doing this,” Buckley says. “The point is if members of the public are informed, they can make an informed decision on whether they should have these treatments.”