Complications from nail adornments can range from infections to allergies, but fortunately, they're not all that common. Problems include nails with nail sculptures ripped from their nail beds, allergic reactions and exposure to caustic chemicals in cuticle remover.
Considering the potential for infection or injury, it's a small miracle that problems from nail adornments are relatively rare, says Richard K. Scher, M.D., a professor of dermatology at the University of North Carolina, Chapel Hill, who specializes in nails.
A common problem, however, is that artificial nails have been put to use not just as adornments, but as hand tools of sorts, says Zoe Draelos, M.D., a High Point, N.C., dermatologist specializing in nails and a Dermatology Times editorial adviser.
The resulting condition, onycholysis, joins other conditions such as paronychia and brittle nails as some of the potential problems that land in dermatologists' offices.
Allergens can be another problem with adornments. In addition to the most common allergen, for-maldehyde, allergens can include methyl methacrylate. Even the tiny beads that manufacturers put in nail polish bottles can be troublesome, Dr. Scher says.
"Many companies still use metal beads instead of plastic ones in the bottles to keep the polish smooth, because they're cheaper," he says. "But the beads have traces of nickel, and people can sometimes have allergic reactions to the nickel."
"The polish remover dries out the nail, and the nails then become brittle and can crack and peel," she says.
"When (patients) paint their nails, it's important to do a good job so they don't have to remove the polish more than every two weeks," she recommends. "You want to use a base coat, then a color coat and then a top coat."
Polish remover is also sometimes used to remove nail sculptures as well as polish, but, either way, patients should be advised to keep exposure to the polish remover as brief as possible.
Cuticle remover can present problems of its own, Dr. Scher says. "Cuticle removers usually have potassium hydroxide, which is caustic."
Patients who are on photosensitizing medications may face risks in using gel- sculptured nails, which need to be cured under light.
"If a customer is taking something like tetracycline, which can sensitize them to light, there could potentially be a phototoxic reaction in the nail bed if the sculptured nails are cured under a bright light," Dr. Draelos says.
Patients who have medical conditions such as HIV or diabetes can be more susceptible to infection from just a minor injury, and much more care should be used in terms of manicures or pedicures.
However, health problems stemming from nail adornments are simply not common enough to raise significant alarm, Dr. Scher adds.
"It's important to stress that, sure, problems may arise, but if sterilized instruments are used and technicians are careful, the statistical probability is very low," he says.