After month of receiving enhancements with no problems, your client develops redness and then swelling around her cuticles.
We all know that beauty has its price. And attractive, well-groomed nails are an integral part of a woman’s overall appearance. But what happens even blisters around the cuticle area?
Mrs. Smith’s lips began to itch and blister. After testing, her dermatologist said she was allergic to nickel. The problem? Holding nickel-plated hairpins in her mouth when fixing her hair. When she stopped, so did the itching.
Tom Jone’s big toe was read and sore. His dermatologist diagnosed an allergy to rubber against the rubber lining. When he stopped wearing the shoes, his toe got better.
In its earliest stages, allergic contact dermatitis presents as mild redness and itching, symptoms easily overlooked during busy times or the dry, cold weather of winter when skin, especially on the hands, tends to be dry and chapped anyway.
As contact dermatitis worsens, the itching and redness may intensify and spread, localized welling may develop, and small blister may appear. The skin may begin to crack, bleed, and become infected. Onycholysis (separation of the nail plate from the nail bed) can also occur, leaving the nail vulnerable to infection.
Contact dermatitis is the skin’s reaction to a substance that either irritates the skin (called an irritant) or triggers an allergic response of the skin’s immune system.
“With an irritant, you get an immediate reaction due to local damage to the skin cells,” explains Doug Schoon, vice president of science and technology for Creative president of science and technology for Creative Nail Design in Vista, Calif. “With allergic dermatitis, it’s a reaction of the immune system. The immune system for some reason mistaken identifies the allergen as an invader and builds up defenses against it.”
Why some individual’s immune system overreact and attack otherwise harmless substances - like your skin - isn’t quite understood, say doctors. However, with each exposure to an allergen, the immune system builds up more and more defenses against it, hence the body’s increasingly severe reactions to subsequent exposures.
A rate symptom of exposure to acrylic monomer is a distressing burning sensation, tingling, and slight numbness in the fingertips, notes American Contact Dermatitis Society co-founder Dr. Alexander A. Fisher. Called paresthesia, these sensations ,y persist for several weeks after the dermatitis has subsided.
When dermatitis is present usually the skin gets red, swollen, and blisters appear. The blisters may form and break, leaving crusts and scales. Later the skin may darken and become leathery and cracked. Allergic contact dermatitis can be difficult to distinguish from other rashes, says Fisher.
These allergic reactions can also occur in the facial area. “We all touch our faces a million times a day, even if we don’t think we do,” explains Dr. Phoebe Rich, clinical associate professor of Dermatology at Oregon health Science university in Portland, Ore.
The vast majority of client allergies are caused by the nail technician repeatedly exposing the client’s skin to the enhancement product.
The most common allergy-causing agents found in nail products are formaldehyde and, to a lesser extent, methyl methacrylate (MMA).
“MMA can cause an allergic reaction so severe that the entire nail can be lost,” explains Rich. “The industry is responding very appropriately to many of the complaints that have been rightfully leveled against it.”
Surprisingly, fragrance ingredients are the most common cosmetic allergens. In fact, sensitivity to preservatives (necessary for proper shelf-life) and fragrance account for most cosmetic related skin allergies.
More Often, It’s Irritants
Harsh chemicals that can produce a reaction on anyone’s skin are known as “irritants.” An irritant reaction from nail products occurs when the hands and nails are exposed to irritant substance such as chemical solvents. While acid-based primers are the most common cause of irritant reactions, detergents and even excess exposure to water can cause chapped skin and dry, peeling nails. Irritant reactions can include the loss of the cuticle, allowing bacteria and fungus to invade the space around the nails. Some chemicals are both irritants and allergens.
Differentiating between an irritant and allergic reaction to a nail product containing an allergen is challenging even for physicians because the symptoms are the same, but the National Institute for Occupational Safety and Health (NIOSH) estimates that, in general, four out of five cases of contact dermatitis are caused by irritants.
“Allergic reaction can occur with any type of enhancement products,” says Schoon. “Prolonged or repeated skin contact is most often can cause. Allergies usually occur after four to six months or repeated exposure. The result is often dry, red, or irritated skin around the cuticle. Area.”
Schoon warns, if ignored, the symptoms can progress to form small water blister.
The second most common cause of client allergies is using too wet of a mix ratio, says Schoon. “If your bead is too wet, clients can become allergic. Too wet of a mix ratio usually causes the nail bed beneath the plate to itch or feel warm.” says Schoon. “Using too large of a brush is sometimes that culprit. Larger brushes increase the chance of accidentally contacting the skin. A very larger brush also holds excessive amounts of monomer, which can cause nail technicians to work too wet.”
UV-cured gels and liquid and powder are among the most likely to cause an adverse reaction, so it’s essential to change UV bulbs regularly to ensure the products cures thoroughly, cautions Schoon. “The light may stay blue, but that doesn’t mean it’s curing the product completely. Most UV-gel users should change their bulbs twice a year, and them four times pre-years.”he says.
Work smart - for Everyone’s Sake
In general terms, the first rule of preventing allergies is to avoid or reduce exposure to potential irritant and allergens.
This is essential not just to deter allergic reactions in clients, but to make sure the same thing doesn’t happen to you - regardless of how long you’ve been working without problems.
Nail technicians and their clients are exposed to a wide variety of potential allergens in the salon. “We wipe our monomer-soaked brushes on the table towel and then rest our arms in the same spot,” says Marti Preuss, a nail industry educator who is currently writing a manual on nail enhancements. “We use our fingers or wet brush to clean off any product that has overrun the clients cuticle or sidewall lines. These type of practices can result in sensitive and allergic reaction.”
“Over exposure that result in allergic reaction can be prevented,” says Preuss. “It all starts with paying specific attention to our preparation, application, and finishing techniques, and knowing our products.”
The following healthy work habits will benefit both you and your client’s skin.
- Avoid skin contact with uncured gels, monomers resins, and adhesives.
- Never apply product too wet or to an unprepared nail plate.
- After applying product, don’t go back and dip your brush in pure monomer to smooth the nail.
- Use plastic-backed pads when wiping your brush, and discard them after use and before filing.
- No matter which type of enhancement product is used, it must be cured properly and fully.
- Leave a tiny margin all around the eponychium and sidewall lines free of product. This will prevent overexposure and allow for air-tight retention of the product to the nail plate.
- Wear a long-sleeved smock to prevent dust from settling on your skin.
- If you do have a sensitivity to some of the products you use, wear nitrile gloves (latex is ineffective against monomer_.
- Use a dispenser bottle that has small openings only large enough for the brush to enter.
- Monomer-soaked pads should be placed in a sealed bag before being placed in the trashed can.
- l Monomer-soaked or dust-laden towels should be removed from the table top and laundered separately from other salon laundry.
- Trash can liners should be changed daily.
- Never pour more liquid into your dappen dish than is needed for the type of application you are performing.
- Always keep MSDS on all products used in your salon.
- Read and follow the product manufacturer’s application instructions and the warning labels on all products.
Keep ‘em Coming
We’ve all seen clients who insist on having enhancements applied regardless of the health of their nails or skin. But if your client does show symptoms of exposure to an allergen or irritant, should you comply with her wishes? Dr. Phoebe Rich advises strongly against it. “In no situation should products be used on or around an inflamed and irritated eponychium and nail fold because that could excerbate any type of dermatitis,” she says.
Doug Schoon agrees, suggesting that after condition has cleared up, you might change to a different type of service and try it on one or two fingers. “The services with the highest likelihood of creating a sensitivity are UV-cured gels and liquid and powder products, followed by odorless products,” says Schoon. If your client has problems with these, avoid odorless systems and try low-odor system, which are less likely to cause a reaction. “Wraps have the least likelihood of causing adverse skin reaction,” says Schoon.