Working Healthy

When Your Body Betrays You

What happens when the job you love becomes the source of your ill health? Rather than giving up nails, make some adjustments when you become “allergic to your job.”

It’s a gamble every nail technician takes. Working with chemicals over a long period of time increases the chances of developing an allergy. Years pass and we see clients react to the formaldehyde in polish, the primer of a particular nail manufacturer, or the chemicals of the acrylic. Yet we usually attribute the problem to a change in the client’s habits or lifestyle. We ask questions: Has she started a new medication, or is there stress in her life that makes her skin more sensitive? Instead, we should question what we are doing: Are we carefully applying the product? Are we taking steps to limit contact with an uncured product?

The instances of reaction are so few compared to the number of clients we see each day and each year that it’s easy to forget we are working with chemicals that are known to cause reactions. The products we use contain ingredients that not only may be the cause of allergies; they are proven to be the cause of allergies. It is always good to remember that while our job allows us to work in a great environment, that environment is exposing us to a variety of chemicals, and we are responsible to do all we can to keep that exposure at a minimum so we don’t cause an allergic reaction in clients — or in ourselves.

Symptoms of Allergic Reaction

We’ve all had a client or two who has complained about itching after an appointment. By the time she is back in our chair it’s been two or three weeks since the application of product. The itching is gone and if there was swelling, it has subsided. Since there is no evidence of irritation on her nails, we may think it was due to dry skin, a new moisturizer she sampled at our desk, or a new polish we tried, but what about when our own hands begin to itch and react? Because techs are always in contact with nail products and they haven’t had a previous reaction, most techs aren’t likely to assign the nail products blame, and they continue to work. However, once the reaction is visible, there is no mistaking an allergy to the chemicals found in the products we use every day.

The allergic reaction first presents as red and swollen cuticles. With continued exposure to the allergen (in this case, the nail product) technicians will develop severe itching and swollen cuticles and fingers. The reaction can worsen until the skin cracks and small blisters form around the cuticles. Cindy Wentzel, owner of Nails at the Carriage House in Newmanstown, Pa., says before she realized what was causing her allergy, the reaction was so severe she would wake up bleeding from scratching her cuticle area. Even a visit to the doctor didn’t diagnose the problem, and Wentzel was sent home with simple instructions to soak her fingers in cold water. “I never had allergies or sensitivities in my skin before this,” says Wentzel. Because of this it took her longer to receive the diagnosis of an allergic reaction to nail products.

Wentzel’s understanding of allergies is a common problem that explains why most techs who develop reactions wait so long to have them diagnosed. Since techs are around the chemicals with little or no reaction for years, it is hard to imagine an allergy would develop, so they assign blame to something recently introduced into their lives. However, it is because they are around the allergen that they are more likely to develop a reaction.

“The more you are exposed to a product that is known to cause allergic reactions, the more likely you are to get an intense reaction,” says

Dr. Joseph Newmark, a dermatologist who specializes in diseases of the skin, hair, and nails in Johnson City, N.Y. Nail technicians need to be proactive about preventing contact with chemical allergens in order to protect themselves against developing an allergy to nail products.

Minimize Exposure

The best way for techs to prevent a reaction is to minimize their exposure to irritants and allergens. Let’s define the terms. An irritant is a substance that causes a reaction on the surface of the skin. An allergen is a substance that is known to cause an allergy, which is a systemic reaction (throughout the body), not a surface reaction. An irritant would be a harsh wool sweater against dry winter skin; this would cause a person to scratch and may leave red marks. An allergen is a foreign substance that comes in contact with the body that the immune system identifies as an invader. Immediately the immune system reacts in an attempt to eliminate the substance. The reaction produced by an irritant is known as irritant contact dermatitis, while the reaction to an allergen is termed allergic contact dermatitis.

At work, an example of an irritant would be if a nail tech spills primer and hastily wipes it up. Her hand or arm will rest on the spot and within moments a slight red mark will be on the spot that was in contact with the chemical. This would disappear after washing the area (and the desk) with soap and water. An allergen is far more serious. In the case of an environmental allergy at work, the body does all it can to fight against the product being applied to it. When the product comes in contact with the skin around the cuticle, the body gives warning signs such as itching and redness. When that is ignored, the body fights harder, and blisters develop. Eventually, if a nail tech continues to come in contact with the product that the body has identified as an invader, the body will go so far as to begin to shed its fingernails; this is one cause of onycholysis.

“Nail technicians need to be very aggressive to avoid repeated direct contact with nail products,” warns Dr. Newmark. The reason for this is that once the body has determined the product is an invader, it will react more severely with each contact. The substances that are most often the allergy-causing culprits are products that contain acrylates. This could be the liquid used during acrylic application, or the gel used to form gel nails. Because of this, techs should be especially careful of contact during the application process of the nail appointment. If gloves pose too much of an inconvenience, techs should follow a few suggestions that are easy to implement:

• Never dip a brush directly into monomer and then clean the bristles with your ungloved fingers.

• When doing fills on yourself, don’t dip the brush into monomer and then directly touch your skin to remove excess product around the cuticles.

• Don’t work with product that is too wet. This puts excessive monomer in contact with the skin, and it allows the product to remain uncured on the skin too long before drying.

One way a tech can tell if there is too much liquid being applied is that when the product begins to cure, there is an uncomfortable heat felt underneath the nail. The body is reacting to the product in its liquid state. “Many of the products, once they harden and dry, no longer cause allergic reactions,” notes Dr. Newmark.

Because an allergy is developed as a response from the immune system, techs need to take extra steps to avoid contact with the acrylates in monomer when their immune system is already irritated. If techs have a pre-existing rash due to home cleaning products or poison ivy, or dry skin from winter weather or eczema, their immune systems will be on high alert and will be more likely to react adversely to nail products. “A tech is more likely to become allergic to product if she is exposed to the product when her skin is already inflamed,” Dr. Newmark explains.

Nail technician Lauren Cawley confirms this statement. Cawley suffers from a severe case of ulcerative colitis. When her colon is inflamed, she is very susceptible to contact dermatitis. It is at this time that her skin reacts to the monomer at work. “When I am not in remission from my colitis, I wrap my hands with Coban [a self-adhering elastic wrap], I wear a mask, and I avoid filling my own nails,” says Cawley. Her precautions have paid off; a colitis and dermatitis sufferer for eight years, she is still able to do nails full time at Volpe Nails and Hair, the salon she owns in Johnson City, N.Y.

Avoid Contact

Once your body has developed an allergy to nail products, there is no way to get rid of the allergy. Dr. Newmark remarks that barrier products don’t work as a treatment, so the only recourse a tech has to treat or eliminate the reaction to the allergy is to be very aggressive and deliberate about avoiding contact. This means firstly following the preventative suggestions listed above. Even if you have developed an allergy, there are some additional steps you can take so you aren’t forced to relinquish your post behind the desk.

One suggestion is to switch products. Wentzel switched to gel nails once she realized she was allergic to an ingredient in the acrylic product she was using. She also switched her primer from an acid primer to a protein bonder. These two changes, along with wearing gloves at work any time she applies product, have allowed her to control her allergy so she can continue in the business. Wentzel suggests techs purchase nitrile gloves through a medical supplier, or possibly a beauty distributor. “They cost more,” she says, “but are thicker than latex and have no powder.”

In general a person is more likely to develop a reaction to the resin of gels than the powder-and-liquid combination of acrylic. Doug Schoon, vice president of science and technology for Creative Nail Design in Vista, Calif., explains why: “In order for something to cause an allergy, it has to penetrate the skin.” Schoon says that if a molecule is too large, it can’t penetrate the skin. The molecules in the liquid monomer used in acrylic application are at a size where they can penetrate the skin, but when they cure (dry) the molecules increase in size and are unable to enter the body through the skin. The molecules in the ingredients of gel applications are smaller than the molecules in the monomer, which is why gels are more likely to cause a reaction — they make it into the body more easily. To protect against these molecules entering the body, techs need to be extra cautious when the skin is broken or cracked around the cuticle area. Techs should wait for the area to heal before risking contact to allergens, or at the very least wear gloves while applying product if they have a scratch, a burn, or a cut that could come into contact with any acrylates.

Techs will be happy to learn that there are new products on the market created from ingredients that are less likely to cause reactions. Experimenting with newer products may produce good results.

A second suggestion is to take steps to avoid contact with the dust or filings from a newly applied nail. Schoon warns nail techs that just because the product has cured enough to shape and file the nail, it isn’t completely cured. It could take up to 24 hours to complete the polymerization process. If a tech is careless about creating the correct ratio, the product could take weeks to cure, which allows the product plenty of time to sit on the nail and seep through to the nail bed. Potentially, the tech could be giving herself another fill before the polymerization product is complete. Because the curing process takes this long, techs should avoid contact with nail filing and dust. Those filings still contain molecules that are small enough to penetrate the skin. If techs rest their arms on the filings for an extended period of time, they are more likely to develop a reaction.

A final suggestion to treat, or limit, an allergic reaction is for techs to avoid exposure to vapors. Schoon is quick to point out that “allergic reactions are not from the vapors,” and used the illustration that if he were to take an emery board and brush it across his finger with enough force, it would cause an irritation. “That doesn’t mean I’m allergic to emery boards,” he explains. Schoon says techs need to come into direct contact with the product for the ingredients to cause an allergic reaction. However, as Dr. Newmark notes, if the vapors are acting as an irritant, the tech’s body will respond to the vapor by kick-starting her immune system. When the immune system is sensitized, it is more likely not only to fight off the offensive irritant of the vapors, but also to develop an allergy to the foreign molecules that are penetrating the skin.

Techs can take precautions against the vapors produced by the monomer by being careful to limit the amount of time it is exposed to the air. Suggestions for storage include using a pump-and-release dispenser (such as a Menda jar) that allows only the amount of liquid needed to be exposed to the air and has a top that locks into place when techs are not applying nails. Also, place used towels in a basket with a covered lid. At night, place the monomer container in a second sealed container. This may seem extreme, but techs have reported a noticeable difference with the smell of the salon on mornings when this step was taken. Each night, remove the garbage bags containing liquid-soaked towels from the salon. These steps can soon become habits for any tech. Prevention is always less costly than treatment.

Michelle Pratt is a freelance writer and licensed nail tech based in Johnson City, N.Y.

Keywords:   allergic contact dermatitis     allergic reactions     healthy working     overexposure     workplace allergies  

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