Paul Kechijian, M D, is a dermatologist who practices in New York. He is also chief of the nail section and clinical associate professor of dermatology at New York University Medical Center. Dr. Kechijian has written numerous articles and given many presentations on nail diseases and disorders. He is currently writing a chapter on nails for a medical textbook
In the two years since I changed brands of acrylic liquid and powder, I have had tour clients suffer from tender nail beds and separation of the nail plate from the nail bed. Two of the clients are mother and daughter. For the most recent client with these symptoms, I removed the acrylic and began doing natural manicures on her. Do you know what causes these symptoms? Did I do the right thing?
Dr. Kechijian: Acrylics max cause allergic contact dermatitis in some individuals. The allergic reaction can occur within days of the first application or it may occur years after the client begins wearing acrylic nails. A tendency to develop allergies can be indented, which may be the case with your clients who are mother and daughter. It is probably just a coincidence that the reactions occurred after you changed brands of acrylics. While formulations vary from brand to brand, the basic chemical makeup is the same in most brands.
Cutaneous allergic contact dermatitis is an allergy that manifests as a skin reaction. Poison ivy is a familiar example of allergic contact dermatitis. Affected people are allergic to a chemical in the poison ivy plant. The allergy appears as an itchy skin rash, which can vary in severity from a mild, pink skin discoloration to a severe blistering eruption with widespread inflammation.
Likewise, acrylics can cause an allergic reaction in people who are sensitive to chemicals in the product. Because the nail plate and bed are involved, however, the allergic reaction to the acrylic product is different from the typical allergic skin rash associated with poison ivy. The most common allergic reaction to acrylics is separation of the nail plate from the nail bed (onycholysis). Some persons also develop an itchy, inflamed rash on the lateral and proximal nail folds. If the allergic individual touches her eyelids with her nails before the acrylic hardens, she max develop a rash there, as well. A burning sensation in the fingertips and nail beds is also common: in rare instances this burning sensation can be permanent. If the reaction is severe enough, permanent loss of the nail plate can occur.
Not everyone will develop an allergy to acrylic, just as not everyone is allergic to poison ivy. Individuals who are allergic to acrylic commonly react in I he manner you do scribe. You were correct to remove the product when you first noted the adverse reaction. The symptoms usually disappear once the product is removed. If a client complains of any of the above-mentioned symptoms, have her conic in immediately – today not tomorrow – to have the product removed. The longer you wait to remove the product, the more severe the reaction can become.
If a client is allergic to acrylic, she will no longer be able to wear acrylics or gels (which are acrylic-based). This doesn’t mean, however or that you can’t apply other, non acrylic-based products, such as wraps or nail polish, but before applying another product to the nails, wait until the reaction has cleared and a new nail plate has completely reattached to the nail bed. Then apply the product to one nail only and wail at least 14 days. If the client has no reaction at that time, apply the product to her other nails.