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  • Jenny She, Rajani Katta MD

Warning on Allergic Rashes from Gel Nails, Acrylic Nails, and Shellac Nails


As a dermatologist who specializes in allergic skin reactions, I’ve noticed more allergic skin rashes to all types of fake nails, including shellac nails, dip nails, solar nails, gel nails, and acrylic nails. All of these types of artificial nails contain a category of chemicals called acrylates. With this type of allergy, you need to be very careful, because acrylate allergies can cause severe skin rashes.


Allergic reactions to fake nails are sometimes on the skin around the fingernails. However, these rashes are also commonly seen on the face, neck, and eyelids. Also concerning is the fact that if you are allergic to acrylates, you have to be careful about exposure to dental procedures and joint implants. That's because those same acrylate chemicals are used in dental fillings and adhesives, as well as bone glue.


To learn more about allergy to fake nails like gel nails, shellac nails, and acrylic nails, keep reading. I’ll share more about what gel nail allergy looks like, why some people develop an allergy to acrylate chemicals, and what you can do when you are allergic to your fake nails.



How do I know if I am allergic to gel nails?


  • You can be allergic to gel nails

  • You can be allergic to shellac nails

  • You can be allergic to solar nails

  • You can be allergic to dip nails

  • You can be allergic to acrylic nails

  • You can be allergic to silk wrap nails

  • You can be allergic to gel nail polish


In fact, you can be allergic to all types of fake nails. That’s because all of these types of fake nails usually use the same set of chemicals: acrylates.


One other point. When we’re talking about this group of nail products, you might hear different words being used. We might call them fake nails, artificial nails, nail cosmetics, or acrylic nails.


Keep reading for more about the symptoms of allergy to fake nails, what the allergic skin rash looks like, and what testing can be used to confirm this allergy.



What are the symptoms of fake nails allergy?

What does allergy to acrylates in acrylic nails, gel nails, and shellac nails look like?


One of my friends sent me a photo of a rash that was around her nails. This rash would also occasionally show up on her upper eyelids. It was red, flaky, and very itchy. These are all common symptoms of allergy to fake nails.


  • Some people with fake nail allergy will develop rashes around their fingernails or on their fingertips.

  • Some people will never develop the rash around their nails. Instead, the rash will show up only on their eyelids, face, or neck.

  • The rashes can sometimes be red, swollen, and blistered.

  • Sometimes the rashes can be red and very flaky.

  • Sometimes the rash is painful, and sometimes it is itchy.

  • These rashes may last for days, although sometimes the rashes will last for weeks, especially if they’re not treated.



Red flaky rashes around fingernails and on fingertips due to fake nail allergy
Allergic reactions to fake nails have symptoms that include red, flaky, itchy rashes around the fingernails. Some people may also have red itchy rashes on their face, eyelids, or neck.


What are acrylates (acrylic chemicals), and why are they used in artificial nails?


Acrylic chemicals have some pretty amazing properties. They start in the form of a liquid, a powder, or a gel. Once they undergo a special chemical process called polymerization, these chemicals change form. They will harden and form a solid material. This solid material may be a hard plastic fake nail, a strong dental crown, or a strong yet soft hearing aid.


  • During this chemical process, the acrylate chemicals transform from small compounds called monomers to a final product called a polymer.

  • The initial monomers, once subjected to a process called "curing", will form really strong cross-linked bonds with other monomers.

  • Once that process is complete, you get the final product: a strong polymer.


From an allergy standpoint, understanding this process is important.

  • The final product, once it is fully polymerized, does not cause allergic reactions.

  • Allergic reactions are due to the monomers.



Acrylates such as methyl methacrylate, ethyl acrylate, hydroxyethyl methacrylate, and others are found in all types of artificial nails


These chemicals are used in acrylic nails. They are also the chemicals used in shellac nails, gel nails, dip nails, and solar nails.


Many people don’t realize that the same chemicals are used in all of these types of nails.




Why am I allergic to fake nails all of a sudden?

Why do some people develop an allergy to acrylates?


We do not know why some people may suddenly develop an allergy to their artificial nails. There are several potential reasons, although in many cases we simply don't have a clear explanation for why someone would develop an acrylate allergy.


  • It’s important to realize that allergy to fake nails can start at any time. For some people, it starts with their first exposure to fake nails. I’ve also had patients who’ve been getting fake nails applied on a regular schedule for years… and then suddenly one day develop an allergy.

  • Some people have more sensitive skin and are more likely to develop allergic reactions in general.

  • Some individuals are exposed to a higher dose of the acrylate chemicals. For example, when the nail technician was applying the powder, perhaps that acrylic powder got on the skin around their nails.

  • Other people may have touched their eyelids, face, or neck right after their artificial nails were applied. In this case, the process of polymerization may not yet have been completed. This means that they may have transferred some acrylate monomer to their eyelids, face, or neck.

  • Some individuals have an impaired skin barrier.

  • When your skin barrier is damaged, it is easier for chemicals to penetrate into the deeper layers of the skin where the immune system cells are present. If the immune system “sees” these chemicals, it might start to consider them a threat and start the process that triggers an allergic reaction.

  • There are different reasons for an impaired skin barrier.

  • Sometimes people have atopic dermatitis.

  • Sometimes people have dry, red skin from excessive handwashing or excessive use of hand sanitizer.

  • Sometimes people pick their nails or bite their nails, and that can cause damage to the skin around the nails.



Is manicure allergy the same thing as acrylate allergy?


I have treated patients who developed rashes after a manicure. Manicure allergy can be due to several different causes.


  • For some people, their manicure allergies are indeed due to the acrylates in their specific type of fake nails, such as gel nails or shellac nails

  • Other people are allergic to chemicals in nail polish. For example, some brands like OPI and Essie use a chemical called toluene sulfonamide formaldehyde resin, also known as tosylamide formaldehyde resin. This particular chemical can cause allergic rashes in some people.

  • Some people may also be allergic to other items in the nail salon environment, such as hand lotion or hand sanitizer or cleansing chemicals



If I’m allergic to fake nails, why didn’t it burn when they were put on? Understanding allergic contact dermatitis to acrylic nails


Allergic contact dermatitis is a type of allergic reaction. This type of reaction is known as delayed-type hypersensitivity because it doesn’t happen right away.


In fact, it often takes 2 to 3 days for the rash to show up. This can make it challenging to figure out what has caused your allergic reaction. It’s not as though your shellac nails are applied, and in the process, you experience burning of the skin.


Instead, you might have your shellac nails put on on a Saturday morning before a big party. You won’t experience any problems at the time. However, on Monday or Tuesday, you might start to notice a red itchy rash around your fingernails or on your neck or face. Over the next few days, the rash might worsen and intensify.



If I’m allergic to my artificial nails, why do I have a rash on my face, eyelids, and neck?


In some severe cases, people who are allergic to their fake nails will have severe rashes around their fingernails. But I found that it’s actually more common to have rashes on the face, neck, eyelids, and other parts of the body.


There are probably several reasons for this.

  • One is that it takes a while for the acrylate chemicals to fully polymerize. So even if the nail technician is extremely careful and only applies the chemicals to your nails, you might accidentally transfer some of those chemicals to your face or neck in the hours afterward. Even a small amount of the monomers can be enough to trigger an allergic reaction on somebody who is sensitive.

  • In some cases, I’ve suspected that people have had exposure in the nail salon itself. For example, if a small amount of acrylate powder has gotten on the counter, and you have accidentally touched that or rested your arm in that powder, you can develop an allergic reaction at any spot where that acrylate powder has touched your skin.

  • It’s also important to know that certain parts of the body are far more sensitive than others. The eyelids are some of the most sensitive areas of skin on the body. The face is more sensitive than the hands. So a small amount of acrylate powder might trigger a reaction on the eyelids, while it won’t on the skin around the fingernails.



How long does an allergic reaction to acrylic nails last?


Even if you completely avoid all acrylic nails starting today, it can still take up to eight weeks for your skin to recover. It may take less time than that if you see your dermatologist and are treated with prescription medicated creams or ointments. But I always warn my patients that even if they are religious about avoiding these chemicals, it may still take up to two months for their rashes to improve.



If I am allergic to acrylic nails or gel nails, do I need to be careful with other types of fake nails?


It is extremely important to understand that the same type of acrylic chemicals are used in almost all types of artificial nails. If you are allergic to acrylic nails, you need to avoid gel nails, shellac nails, dip nails, and solar nails. These types of fake nails all use acrylates, although the process of using them is slightly different in the different types of nail products.


If you would like to learn more about the process of crafting artificial nails and using acrylates for nail cosmetics, I thought this article in Vox was a deep and thoughtful explanation.



Whether they are gel nails (right), acrylic nails, shellac nails, dip nails (left), solar nails, or silk wrap nails, any type of fake nails can cause allergic reactions.




If I am allergic to artificial nails in the salon, can I use home nail products?


A few years ago, my patients started telling me about home fake nail products that are available on Amazon. I do not recommend these. A review of the ingredient list on some of these products indicates that they also use different types of acrylic nails.


In fact, the home products are even more worrisome to me, because if you have not had training on how to use these chemicals properly, you may accidentally expose yourself to a higher dose of chemicals than is safe.



If I’m allergic to artificial nails, do I need to tell my doctor? If I’m allergic to fake nails, are there other products that I need to avoid or be careful with?


This is such an important question, and it’s one of the most important parts of my counseling for people with artificial nail allergies. Many of my patients are fine with stopping their trips to the nail salon. They start to use nail polish instead.


But it’s really important that if you have an allergy to fake nails, you tell your doctor and your dentist.



The acrylates in artificial nails are also used in dental and medical procedures


The same acrylate chemicals that are used in artificial nails are also used extensively in dentistry, to make crowns, bridges, and fillings, and as dental adhesives.


If you are allergic to acrylates, then you need to tell your dentist. The same chemicals are used in many different dental procedures. They might be supplied in the form of a powder, liquid, or gel, but when they harden, they can take the shape of a crown, filling, or bridge. They are used to make some types of retainers. They are also used in many types of dental adhesives and veneers.


If you are allergic, you’ll have to have a discussion with your dentist on the best way to proceed if you need any of these dental procedures.



Acrylates are also used in bone glue and may be an issue if you are having a joint implant


Because of their fantastic shape-changing properties, acrylates are used in many joint implant procedures as a bone glue.


In fact, I have treated orthopedic surgeons who have developed an allergy to acrylates because they touch bone glue at work on such a frequent basis.


We actually do not know how often people with an acrylate allergy might have a problem with the bone glue in their joint implant, but it’s important to have that conversation with your orthopedic surgeon before the procedure.



How do I treat my allergic reaction to artificial nails?


The red, itchy rash that can occur from skin allergy is usually treated with anti-inflammatory medicated creams or ointments. Please speak with your dermatologist about the best treatments: some mild rashes can be treated with over-the-counter ointment, while more severe rashes require prescription medicated creams or ointments, and in some cases might even require medication by mouth.



If I’m not allergic to acrylate chemicals yet, how can I prevent an allergy?


When I was growing up, I didn’t know anybody who would get acrylic chemicals. But in the last few decades, and especially in the last decade, nail salons have proliferated across the United States. Many of my friends and my daughter's friends now get fake nails applied regularly.


While a manicure with regular nail polish is unlikely to trigger an allergic reaction (although some people do develop an allergy to nail polish), a manicure with shellac nails, gel nails, dip nails, or powder nails needs to be taken very seriously.


Although I’ve found that many of my patients know that acrylic nails can cause an allergic reaction, they don’t seem to be as aware of the fact that shellac nails and dip nails can cause allergies that are just as severe.


First of all, make sure you’re paying attention to the practices of the nail salon and the nail technician. Are you making sure that all garbage is disposed of properly and that the counters and table tops are cleaned in between patrons? Observe technique: is the technician making sure that the powder, liquid, or gel is only touching your nail? Are they extremely careful to protect the skin around the nails? Are they extremely careful and making sure that none of that powder, liquid, or gel touches the counter or tabletop?



If I’m allergic to gel nails, what can I use instead?

If I am allergic to gel nails, shellac nails, solar nails, or dip nails, are there other nails that I can safely get?


Although the easiest way forward would be to give up all types of fake nails completely, I understand that some people would still like to use these nails.


Unfortunately, there are very few options. Silk wrap nails that are created using cyanoacrylate may or may not be an option.


  • Some salons will use what are known as silk wraps.

  • Some silk wrap nails use acrylates, but there are some silk wrap nails that are created using a nail glue [an adhesive] called cyanoacrylate.

  • This is a type of acrylate chemical, but its chemical makeup is different than the other acrylates.

  • Some people will be able to use this as an alternative, but not all.

  • If you’re thinking about this option, you would need to get patch testing done to confirm whether or not you are allergic to cyanoacrylate.


In general, though, I recommend that patients who are allergic to acrylate chemicals avoid all types of artificial nails.


  • Nail polish does not make use of these chemicals, so you can still continue regular manicures (as long as you’re not allergic to the chemicals in nail polish).



Am I allergic to fake nails? How can I find out?


The same procedure is used to diagnose an allergy to shellac nails, acrylic nails, and all types of fake nails. This testing procedure is called patch testing. In patch testing, a specialist will apply tiny amounts of different chemicals to your back. The chemicals stay in place for 48 hours, and you will return to the doctor's office at 72 or 96 hours to have the doctor examine your back for the presence of any allergic reactions.


*If you would like to learn more about patch testing for acrylate allergy, please see this medical journal article written about one of my patients who developed a severe allergy to her acrylic nails. The article shows photos of her patch testing results, showing strong reactions to several acrylate chemicals.



If I think I might be allergic to my gel nails or shellac nails, what should I do next?


  • If you suspect you might be allergic to your fake nails, then it’s important to stop getting new nails placed.

  • You should then see your dermatologist to discuss the best medicated creams or ointments to treat the rash that you have.

  • Following that, you might have to wait up to eight weeks to see if your rash improves.

  • If your rash does not get better, then we usually recommend seeing a dermatologist or allergist who can perform patch testing. You’ll want to make sure that they can perform patch testing on the chemicals that are used in nail cosmetics.

  • Sometimes, even if the patient improves after stopping their fake nails, we will still recommend patch testing to confirm the allergy. That is so that they can go forward and let their dentist and orthopedic surgeon know about the allergy.



If I think I might be allergic to my gel nails, do I need to get them taken off?


If you’ve already had the nails placed, let’s say a week ago, you do not need to remove your nails. If you remember the way these chemicals work, once the acrylate monomers have fully polymerized (and have taken the form of a hard plastic substance), then they will not cause an allergic reaction anymore.


It can, in some cases, take a few days for this process to fully occur. That’s why you need to be really careful in the few days following application of your gel nails. But, if it’s been over a week or so, then you don’t need to move your hard nails. You can just let them finish up, without getting any new ones.



The Bottom Line


Whether you’re worried about gel nails, acrylic nails, shellac nails, dip nails, or other types of fake nails, it’s important to realize that they all make use of the same types of chemicals, and all of them may trigger allergic reactions. These allergic reactions may show up on the skin around your fingernails, but the rashes are also commonly seen on the face, neck, and eyelids. The chemicals that trigger these allergic reactions are called acrylates, and if you become allergic to these chemicals, it’s important to let your dentist and your orthopedic surgeon know prior to any procedures.




 


Dr. Rajani Katta is the author of Glow: The Dermatologist's Guide to a Whole Foods Younger Skin Diet. To receive future updates on preventive dermatology and the role of diet, sign up here.


Jenny She is a student at Rice University who is majoring in Health Sciences. She is passionate about dermatologic topics and will be entering Baylor College of Medicine in 2024.

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