UvA dentist and dermatologist warn against artificial nails
More and more young people are opting for artificial nails, but this is not without risks, warn dentist Albert Feilzer and dermatologist Thomas Rustemeyer. “An allergy to gel nails can mean having to go through life toothless.”
With gel nails, acrylic nails, or gel polish, getting your nails pimped at a nail salon is hip. You can find a nail salon on every corner in town, and the number is growing rapidly. “Artificial nails have advantages,” says dermatologist Thomas Rustemeyer at Amsterdam UMC. “They last much longer than normal nail polish and they’re not very expensive. But few people are aware of the risks.”
Not only can you become allergic to the acrylates in artificial nails, the same plastics are also found in all kinds of medical devices such as hearing aids, fillings, dentures, and hip or skull implants. Patients who turn out to be allergic to these are referred to the allergy clinic of former dean and professor of dentistry Albert Feilzer (ACTA) or to dermatologist Rustemeyer (Amsterdam UMC), who performs the allergy tests.
And that group is growing. Whereas in 2020 there were just 14 patients in the AMC diagnosed with an acrylic allergy from artificial nails with high certainty, in 2022 there were 35. The allergy is most often found in nail technicians who work with acrylates daily, but it also occurs in wearers of artificial nails. Feilzer says: “Every year at least one dentist in the Netherlands becomes so allergic to acrylates that they have to quit the profession.”
Complaints range from itching, bleeding fissures or blisters on the fingers, to eczema and breathing problems. In the worst cases, the symptoms can spiral out of control. Last month, a woman came to the emergency dentist because she had lost a tooth. Because she had experienced complaints from fake nails 25 years earlier, the dentist's procedure led to inflammation and swelling in her mouth cavity, which landed the woman in the emergency room at Amsterdam UMC. Says Feilzer, “As a dentist, you have your back against the wall. You can pull a tooth, but you can't fill teeth or make dentures. An allergy lasts a lifetime, so it can mean that may wind up having to go through life toothless.”
Rubber is the culprit
The allergy is often caused by the adhesive lacquer 2-hydroxyethyl methacrylate (HEMA) that nail technicians apply under artificial nails or gel polish. At issue are the acrylic monomers, the smaller, individual molecules contained in the liquid lacquer that can easily penetrate the skin. When the nails harden, the monomers string together to form long chains called polymers. Polymers are somewhat safer because they are larger and cannot penetrate the skin as easily.
In principle, the monomers are virtually unable to penetrate nails, but there are some points where things go wrong, Feilzer says. “The nail technician first pushes your cuticles back, which breaks the barrier between your nail and skin and allows the monomers to enter more easily. To remove the nails, the fingertips are held in trays of acetone so that the plastic softens and can be removed more easily. The skin of the fingertips is degreased by contact with acetone, releasing residual monomer that can penetrate the degreased skin.”
There are also cheap, do-it-yourself kits for artificial nails on the market that are particularly popular among teenagers. Rustemeyer says: “There should be European regulations for them. As it stands now, there is no warning on the kits that the substance should not get on your skin.”
Thorough training
Unlike dentists and orthopedists who also work with acrylics, nail technicians are often unaware of the dangers. For example, they often don’t know that monomers can also pass through rubber gloves. Nail technicians also work with these plastics on a daily basis and in much larger areas than dentists or orthopedists. That's why Feilzer and Rustemeyer advocate thorough training for nail technicians so that every stylist knows that acrylics should not get on the skin but only on the nail. Such training is currently provided usually only by the companies that develop the acrylics.
Feilzer and Rustemeyer think a ban on artificial nails goes too far. Feilzer says: “I advise students against getting artificial nails. Just use old-fashioned nail polish; there you don't have these problems.” The professors argue mainly for more awareness. Rustemeyer comments: “A sustainable gel nail polish I would welcome, but it is not yet available - contrary to what some manufacturers and beauty sites claim.”
