The Effects of Different Manicures on Nail Health

Everyone has nails. Many people use their nails as a form of artistic expression, fashion, or even to define their personality. We manicure our nails with a simple top coat, a pop of color, or even false nails. Gel polish has become very popular for its long lasting and more natural appearance. Acrylic nails continue to remain popular, but the designs have become more intricate and the shapes and sizes more varied leading more people to experiment with false nails. 

The Basic Polish

What is nail polish? The manicure medium is created by combining cellulose fiber and nitric acid resulting in nitrocellulose.^[1] Polymers and pigments are added to nitrocellulose to make the polish flexible and colorful. The result, when applied to the nail, is a firm coating that still allows oxygen to penetrate and interact with the nail itself. The process is rather complicated and includes all sorts of compounds, but overall basic nail polish does little harm to the nail.

The most significant possible side effect to basic nail polish is a skin allergy known as allergic contact dermatitis. This condition results when the body mounts an allergic reaction and causes irritation of the skin with redness, swelling and skin breakage.^[1] But there are hypoallergenic nail polishes out on the market that completely avoid this issue and may be a good option for someone that has had a reaction in the past.^[2] Another potential reaction is nail plate staining. This happens most frequently with deep red colors. After 1 week of polish wear and subsequent removal of the polish, the nails will turn yellow. It lasts 2 weeks but will fade over time as long as no additional red nail polish is worn.^[2]

Gel Polish

Gel polish has become widespread as it is known to last for two weeks without chipping and maintains its shine. The gel polish process requires the application of several coats of polish with UV light exposure in between coats so that the nails are dry immediately – another benefit of gel polish. People have also stated that gel polish strengthens your nails. Unfortunately, gel polish has not been shown to strengthen your natural nails and, in fact, it weakens them.

There is still debate on whether the polish, the process of applying and curing the polish, or the removal process causes the damage, but we do know gel polish manicures cause thinning of the nail once the gel is removed.^[3] The difficulty with determining the cause is due to the multi-step process required to apply the polish and remove the polish. Just the removal process is harsh as it requires 15 minutes of soaking in acetone.^[3]

Gel polish causes exfoliation of the very top portion of the nail leading to thinning and/or splitting of the nail (onychoschizia) and whitening of the nail (pseudoleukonychia).^[3] The gel polish can also cause length-wise ridges in the nail (trachyonychia) and nail-pitting which can be mistaken for nail psoriasis.^[4] Long-term gel polish use on the order of 2-5 years has the potential to cause damage to the nail. One specific condition associated with long-term gel polish use is called pterygium inversum unguis.^[5] This condition is the adhesion of the nail to the skin underneath the tip of the nail.^[5] While this may sound harmless, the addition of skin directly underneath the tip of the nail can cause pain, especially when clipping or filing the nails.^[5]

Acrylic Nails

Some people choose to skip the natural nail polish altogether and move to fake nails in the form of acrylic nails. The typical process for the addition of the nails starts with gluing a nail prosthesis to the tip of the natural nail, cutting and shaping the newly added nail and continues with adding the acrylic solution to the nail with UV light to dry the sample. Finally, a top coat is applied. While the process results in longer lasting, perfectly polished, lengthy nails, the process can cause damage to the nail and irritation to the skin.

Skin Allergies

Skin allergies (allergic contact dermatitis) is a very common reaction to acrylic nails due to the chemicals in the adhesive and gel. The allergic reaction can occur in individuals with acrylate nails and even in manicurists.^[6] In several cases, allergic contact dermatitis manifested in severe onychodystrophy or abnormalities of the nail.^[7] These included separation of the nail from the finger (onycholysis) or thickening of the skin underneath the nail (subungual hyperkeratosis).^[7]

Facial Skin Allergies

Additional allergic reactions can occur on the face. We touch our faces so often with our hands and nails that our face may be the first place we see an allergy to nail products. One major side effect of the allergy is lip or eye swelling.^[8]

Risk for Injury to Real Nail

Once the nail is on, it firmly adheres to the natural nail. With the gluing of the nail and the addition of gel to the remainder of the nail, the fake nail adheres more firmly to the nail than the nail adheres to the finger. The fake nail is also stronger than the natural nail so it will not break as freely as natural nails. The strong bond between the real nail and the false nail sets up a recipe for disaster if the false nail were to take on impact. Injury to the false nail can cause injury to the natural nail underneath.^[9]

Acrylic Nail Recommendations

Just the act of wearing the acrylic nails damages the nails underneath. They become brittle, thin and weak. It is recommended that acrylic nails are not worn for longer than 3 months and includes a 1-month break in between applications to allow the nail to heal in between.^[1] Even after the removal of the false nails, damage can still occur during your manicure with additional buffing and nail filing.^[10] The nail filing can further thin the nail.

A Note on UV Exposure from Manicures

Manicures with gel polish or acrylic nails both require UV light to cure the polish. The UV light is the purple light in the box you place your hands (or feet, if it’s a pedicure) to “cure” the nails. The majority of this light is UVA light.^[11] UVA light overexposure poses a significant risk for skin cancers like basal cell carcinoma and squamous cell carcinoma. Studies have shown that the exposure our hands receive during these manicures does increase our risk of developing skin cancer on our hands.^[12,13] Individuals should be aware of this risk and should consider applying a physical sunscreen to their hands prior to a manicure to protect their skin or using fingerless gloves.