> SYMPTOMS: Allergic contact dermatitis to nail products usually occurs days after exposure and may show up as redness and swelling, blisters, crusting, lifted nails, fingertip tenderness and swelling, and/or eyelid, mouth, or neck rash and swelling.
> TYPES OF HYPERSENSITIVITIES AND ALLERGIES: When a chemical in a product comes into contact with the skin surrounding the nails, hypersensitivities can be immediate. Enhancement products that are not meant to contact the skin can cause instant burning or pain and subsequent inflammation at the surrounding nail fold. According to Dana Stern, M.D., board-certified dermatologist and assistant clinical professor of dermatology at the Mount Sinai Medical Center in New York City, these reactions are considered to be irritant reactions as opposed to true allergies and are due to damage to skin cells caused by overexposure to a harsh chemical. “In contrast, a delayed type of hypersensitivity reaction would occur in someone who has had repeated exposure to a chemical, and over time the person’s immune system learns to recognize and react to that chemical,” says Dr. Stern. “Certain people are more prone to having hypersensitivity reactions. For example, eczema patients tend to have sensitive, reactive skin. Eczema patients have a compromised skin barrier and are therefore more predisposed to reactions to products.” Dr. Stern says allergic reactions can be severe, necessitating lost work time or, rarely, hospitalization. These types of reactions can result in nail reactions and skin reactions, including fissures (deep openings). Any openings in the skin can predispose to skin infection.
> CAUSES: Toluene-sulfonamide-formaldehyde resin accounts for 4% of positive patch test results (skin allergy tests), according to The North American Contact Dermatitis Group. “The allergen in nail enamel is usually the resin component,” says Dr. Stern. “Even though the allergic reaction is most commonly due to wet nail enamel, investigators found that 11 of 59 patients who had positive patch test results to wet polish also reacted to the dried enamel.” It’s a good idea to have a client fill out an information sheet at her first appointment and to keep it updated. Be sure to have her list pre-existing allergies to specific chemicals and preservatives, fragrances (including essential oils), and products (including polishes, gels, strengtheners, and artificial enhancements). If the client has an allergy to a certain nail product but would like to try a different brand or type, proceed, but with caution. Monitor her skin closely for irritation or symptoms. If a client has a reaction to a nail product it’s important that she see a dermatologist to determine if the reaction is an irritant or allergic reaction; she may be a candidate for patch testing to determine which chemical is the trigger.
The Hyper-Sensitive’s Rx
Tips when performing nail services on hypersensitive clients:
> If a client comes to you with an allergic reaction, do not soak off her enhancements until she has seen a dermatologist for treatment to calm the reaction.
> Encourage hypersensitive clients to stick to basic manicures and to use a five-free nail polish brand.
> Avoid using heavily perfumed products such as scented hand creams on sensitive clients.
> If applying acrylics, use a protein bonder instead of an acid primer to avoid unnecessary irritation.
> Avoid touching the cuticles with product.
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