Working Healthy

Are You Allergic to Work in the Salon?

Understand your risk of allergic and irritant reactions to the products you work with and you can probably prevent problems before they start.

Understand your risk of allergic and irritant reactions to the products you work with and you can probably prevent problems before they start.

A nail tech since 1980, Nancy King, owner of Nail Care in; Laurel, Md., switched most of her clients over to ultraviolet (UV) light-cured gels in 1991. Six weeks later she noticed that file cuts on her fingers were red, swollen, and sore, but she didn't make a connection then between the irritation on her fingers and the fact that she was using a new product.

“The cuts would get worse as the week progressed, begin to heal over my days off, and then get worse again when; I went back to work,” she recalls. By May the condition had worsened to the point that a friend's child commented that her fingers looked like “hot dogs that had split in the microwave.” King sought out a dermatologist, who told her she had eczema.

“One day I laid my arm down on my table and I got some gel on it,” she says. “I wiped it off and washed the area, but: an hour later the area on my arm looked like my fingers.” She called the product manufacturer, who told her that she had very likely developed an allergy to gels, and recommended that she avoid all contact with them. Back she went to the; doctor, who this time diagnosed allergic\contact dermatitis. She heeded the manufacturer's and doctor's advice to switch; products and went back to acrylics. The rash eventually cleared, but 10 years later she still breaks into hives even when she breathes the vapors from a UV system. Happily, King reports she's developed no problems with other products she uses.

Less fortunate is Cheryl Dietz, a salon owner of 25 years. A year ago one of her pinkies became swollen and started peeling. She just happened to be going on vacation, but over the following week the condition worsened and spread to other fingers. "It went all through my hands; I couldn't peel a potato or fold laundry. I thought, 'I am in deep trouble here,"' she says. What was ultimately determined to be allergic contact dermatitis forced Dietz to cut her work schedule to live hours a day and necessitate double-gloving her hands. Those accommodations worked until a few months ago, when guilt led her to start working more and more clients back into her schedule, stretching time in the salon from five to six to seven, sometimes eight hours.

“When my hands broke out in January I thought I had slipped up with gloves, perhaps got a little hole,” she explains. “But the doctor says the reaction now is systemic and is caused by breathing the vapors.”

After 25 years of sculpting acrylics, Dietz isn't sure she's able or willing to try switching to a different system or going to natural nails only. “I don't think I can stay in my salon because just breathing the product makes me react,” she says. “And I'm 12 years old and I've owned my salon for 25 years. I've never had a boss! I don't think I could start over with a new system in a new salon trying to get a whole new clientele. I'm going to cut my hours back again, but I think I will end up having to leave the salon.”

Could It Happen to You?

King and Dietz share their stories not to scare their peers, but lo alert others to the very real, but controllable, risk of allergic reactions to nail products. While not “hazardous” or “unsafe” in normal salon usage with proper work practices, the products nail technicians work with do contain chemicals that are known allergens and irritants. According to the National Institute of Occupational Safety and Health (NIOSI1), acrylates— such as ethyl methacrylate in monomers and cyanoacrylate in nail adhesives—can cause contact dermatitis, asthma, and allergies in the eyes and nose.

If you are already genetically predisposed to developing an allergy, the odds that you will do so increase each time an allergen comes in contact with your skin. Even those who aren't at risk of developing an allergy may develop an irritant reaction from overexposure to products commonly found in the salon.

Even more to the point, there's no way to tell in advance whether or not you're likely to develop an allergy to the products you use. “We think there is some genetic susceptibility to allergies, but... it also has to do with the quantity of contact and the inherent protection of the skin,” explains Jonathan Bernstein, M.D., an associate professor of medicine at the University of Cincinnati College of Medicine, division of immunology and allergy.

Nor is it just your skin at risk: Asthma is on the rise in the United States, with occupational asthma (so-called because it's triggered by substances most often found in the work environment) accounting for 5%-15% of all reported cases. While the experts we consulted emphasize that nail technicians are in a lower-risk category, Dr. Bern stein notes there have been at least a few cases reported of nail technicians who developed asthma triggered by exposure to MMA and EMA. Too, NIOSH's 1997 study of ventilation in nail salons was triggered by a request by the Colorado Department of Health because of a surge in reported cases of occupational asthma in nail technicians.

Your work products are no more a threat to your health than the products you use to clean your home, fertilize your lawn, wash your clothes... but just as you take care to protect your skin and lungs from coming into contact with chemicals in your personal life, so too should you in your work. You probably don't wash the tub out with cleaner without wearing gloves; you should be as cautious in handling chemicals at work. You should not only understand the causes and symptoms of contact dermatitis and occupational asthma, but you should know how to minimize your risks for developing them as well.

Avoid Rough and Red-y Hands — Contact Dermatitis

In its earliest stages, contact dermatitis appears as mild redness and itching, symptoms easy to overlook during busy times or the dry, cold weather of winter when hands tend to be dry and chapped anyway. As contact dermatitis worsens, the itching and redness may intensify and spread, localized swelling may develop, and small blisters may appear. Ultimately, the skin may crack and bleed. While there are no statistics on contact dermatitis in the beauty industry, Boris Lushniak, M.D., medical officer and dermatologist for NIOSH, says when it comes to contact dermatitis, doing nails is a high-risk industry.

Contact dermatitis is the skin's reaction to a substance that either irritates the skin (called an irritant) or triggers an allergic response of your immune system.

“With irritant contact dermatitis you get an immediate reaction due to local damage to the skin cells," explains Debra Marr-Leisy, director of R&D for IBD (Gardena, Calif.). "With allergic contact dermatitis, it's a reaction of the immune system where the allergen binds to a protein in the body's cells. The immune system for some reason identifies the allergen as an invader and builds up antibodies against it.”

Why some individual's immune systems overreact and attack otherwise harmless substances isn't quite understood, say doctors. However, with each exposure to an allergen, the immune system builds up more and more antibodies against it, hence the body's increasingly severe reactions to subsequent exposures.

NIOSH estimates that, in general, four out of five cases of contact dermatitis are caused by irritants. Differentiating between an irritant and allergic reaction to a nail product containing a known allergen (in the salon these would include acrylics, gels, cyanoacrylates, and nail polishes containing formaldehyde) is challenging even for physicians because the symptoms are the same.

Nor does the test of time apply: “You can become allergic after 10 or 20 years,” Dr. Lushniak says. “Your immune system changes as you age, so cells may be more sensitive. You may have spent 15 years working with a product and then 'suddenly' develop allergic contact dermatitis because of severe dry skin that allows the allergen to get into your body in a large enough amount.”

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