Contact dermatitis is a form of allergy that is specifically related to skin. Skin allergies usually manifest themselves as small blisters, red and rough skin, and nail separation if the allergic reaction occurs on the nail. When these symptoms show up around the nail, however, they are often mislabeled as a fungal infection and treated with a topical preparation, when the best treatment would be to remove the offending agent instead.

The skin acts as a natural barrier to prevent potentially harmful substances from entering the tissue and causing an allergic reaction. However, small molecular compounds are capable of penetrating the skin and causing contact dermatitis with prolonged contact. In order to develop contact dermatitis around the nail, one’s exposure would have to be especially prolonged because the hard nail plate serves as an excellent barrier to prevent dyes, pigments, and adhesives form reaching the underlying nail bed.

Whether certain compounds cause a dermatitis reaction in a person depends on several factors, the most important of which is a genetic predisposition. Poison ivy rash is a classic example of contact dermatitis. When an individual is exposed to the plant, she may have no reaction or she may develop the well-known itchy, weepy, uncomfortable rash often associated with poison ivy. How long someone is in contact with the substance and her prior exposure to it also determine whether a person will develop contact dermatitis.

Generally speaking, the first exposure to a potential allergen is known as the sensitization phase and doesn’t cause a reaction at all. It is at this time that the individual is rendered allergic. After being exposed to the substance a few more times, a person will usually notice a reaction about 48 hours later.

The two basic allergies that will confront nail technicians most often involve acrylic nails and nail polish and hardeners that contain formaldehyde resins. As most nail technicians know, acrylic nails are formed using a process that combines a methacrylate polymer powder with a liquid methacrylate ester. When mixed together, the powder and liquid polymerize, hardening to form an artificial extension. Unfortunately, the liquid usually contains methacrylate monomers that do not polymerize. These monomers remain free in the hardened acrylic, which means these small molecules can penetrate the nail plate and cause an allergic reaction.

Nail technicians who don’t wear gloves can also become sensitized to products and have allergic reactions on their hands and arms due to contact with nail products.

Treatment for these symptoms, or any others for that matter, is immediate removal of the artificial nails. A dermatologist can intervene using anti-inflammatory medications if the problem persists.

The most common complaint will probably be pain and swelling of the nail tissues. If the condition is left untreated long enough, the swelling can irritate the nerves in the nail bed and cause tingling or a loss of sensation in the fingertips. Extensive and prolonged inflammation can cause a permanent loss of the affected fingernails.

Clients can also have allergic reactions to nail hardeners and nail polishes. Nail hardeners and polishes contain a resin that dries to a shiny, hard finish. However, toluene-sulfonamide formaldehyde resins, which are found in some polishes and hardeners, are very allergenic when wet. If they are not allowed to dry thoroughly, any contact with another body part, especially the eyelids and mouth, on the appropriately sensitized individual can cause itching, redness, and blistering.

Any person who is allergic to toluene-sulfonamide formaldehyde resin can wear nail polish containing the resin as long as she doesn’t touch any other part of her body with her hands until her nails dry. There are also many manufacturers who have substituted formaldehyde resins with alkyd or other resins to lessen the chance of allergic reactions. Switching to a formaldehyde-free preparation may be all that is necessary to keep the client happy.

If contact dermatitis occurs with any nail preparation, the most prominent symptom will be itching and redness with possible swelling. If sufficiently sensitized, the client will become uncomfortable and may require medical treatment.

Prescription medications, of given early enough, prevent unnecessary discomfort and permanent nail damage. The easiest way for nail technicians to avoid developing an allergy to nail products themselves is to wear gloves. While it isn’t impossible for a nail technician to work with nail products once she’s developed an allergy, it can certainly make life at work more difficult if she’s not very careful.

[Originally published: February 1993]