Preventing contact allergies

With gel polish allergies making headlines, Ellen Cummings asked two top nail techs for their tips on how to prevent contact allergies and what to do if you think one has developed

In April, the Government launched an investigation into reports that gel nail products are causing users to develop allergies. It comes after the British Association of Dermatologists (BAD) reissued a warning, following media coverage about increasing reports of allergies. The BAD first issued a warning in 2018, after a study titled Epidemic of (meth) acrylate Allergy in the UK Requires Routine Patch Testing found that 2.4% of people tested had an allergy to at least one type of (meth)acrylate chemical – an ingredient found in acrylic, gel and gel-polish.

The Government’s Office for Product Safety and Standards is overseeing the investigation, and has asked anyone developing an allergy to report to their local trading standards department.

Although the DIY at-home gel kits popularised by consumers during the pandemic are being blamed for many of the cases of allergies, they can still occur in professional settings – with the BAD saying that nail technicians are most at risk of developing an allergy.

“Gel polish is safe when used by a professional nail technician who is competent and knowledgeable in all areas of nail technology,” says Katie Barnes, award-winning nail tech and owner of Katie

Barnes Tool Range and Training Academy. “This knowledge needs to include health and safety, and the nail tech needs to follow Health and Safety Executive (HSE) guidelines including Control of Substances Hazardous to Health (COSHH), wear PPE and follow manufacturing instructions. As with any chemical ingredient, including our household cleaning products, when this is not used correctly or the above is not followed, issues will arise.”

What causes allergies?

There are several ingredients often found in gel polish that are known to cause allergies, especially when they are found in high concentrations within products. Common culprits include hydroxyethyl methacrylate (HEMA), which is used as an adhesive, and isobornyl acrylate (IBOA) – you can see whether gel products contain these by checking their SDS.

Barnes says the reason HEMA might be reporting more allergies than other ingredients is that its molecular size is very small, so it can be absorbed into the skin and nail plate more easily than others – although HEMA has been used safely in nail products for years without issue when health and safety guidelines are followed correctly.

When it comes to what to look out for with HEMA concentrations in polishes, Suzanne Clayton, interim head of education at Louella Belle, and founder of the Nail Tech Awareness Facebook group, says, “The recommended guideline is 35% but most brands have way less than that. There are gels on the market that are HEMA-free but we have to be careful about which ingredient has been used in its place for adhesion.” Barnes adds, “Having an adhesive property in the product, such as HEMA, is important to prevent surface breakdown. When alternative ingredients are used, a coarser-grit file can be necessary to ensure adhesion, in turn having its own issues and causing potential damage to the nail plate.” Barnes says awareness of ingredients isn’t the only factor in preventing allergies – nail techs also need to be vigilant about the way they’re working. “You can change to a product without HEMA or other allergens if desired, but if you don’t change the working technique, an allergy will just occur to another ingredient and it will become a vicious circle,” she explains. “Once an allergy develops, the immune system goes into heightened alert, so it becomes much easier and faster to develop allergies to other ingredients in future – so switching to HEMA-free brands and rebranding is not the answer.”

Symptoms of allergies

It’s important to identify whether symptoms are caused by an irritation or an allergy to a substance. Contact dermatitis occurs when a product causes an irritation, with skin usually becoming red, blistered, dry and cracked.

Barnes explains, “This usually improves if the substance causing the problem is identified and avoided, preventing it from developing into an allergy. An irritation reaction usually occurs within a few hours or days of exposure to an irritant or allergen.”

Allergic contact dermatitis is an allergy that builds up over time from overexposure to an allergen over days or weeks through it coming into contact with the skin – in the case of gel polish allergies, this allergen is usually one or more of the ingredients in nail products. “The first time you come into contact with an allergen, your body becomes sensitised to it, but doesn’t react to it,” Barnes says. “Only when you’re exposed to the substance again does your immune system react and cause the skin to show signs of irritation. Itching, redness, swelling, burning, peeling or blistering are all ways that your body is telling you something is wrong.”

These symptoms might not always appear on the nails and hands, with puffy eyes and an irritable nose or breathing problems also possible indicators, especially when dust particles are involved. As for direct symptoms on the hands, there is a range of indicators Clayton explains, “Symptoms on the nail plate can look like the white free edge has moved down half or more of the nail plate (oncholysis), there may be blood splinters (splinter haemorrhaging) or bruising and discolouration on the nail plate. Underneath the nail, we might see a thickness growing between the nail bed and the nail plate (hyperkeratosis). This can appear from the first appointment, or months or years later. Nails can take months to heal properly, and nasal problems can take much longer.”

Once an allergy has developed, it will never go away because the immune system won’t forget that specific allergen – but symptoms can be stopped by ceasing contact with the allergen. “If an allergy is suspected [with a client], cease treatment immediately and do not apply any further nail products until the client has had an allergen test with a dermatologist,” says Barnes.

It’s also important to make the brand aware of any allergic reactions to their products. Clayton explains, “Report [the reaction] to the brand you are using, who have to legally keep a record, and to Trading Standards and the Office for Product Safety and Standards (OPSS).”

While an allergic reaction can prevent future application of certain gel polishes, allergies can also affect other aspects of life. Clayton says, “It can affect medical treatment because the same adhesive ingredients [like HEMA] are used in dental treatments, hip and knee replacements, diabetic patches, artificial cataracts and more, so you may have trouble when needing medical treatment. You have to have a dermatology test to find out which ingredient you have reacted to. You may or may not be able to have gels again.”

Since allergies are caused by products coming into contact with the skin, it’s important to understand how this contact is happening. Improperly cured gel is a common cause of contact allergies. A full cure can be ensured by using lamps from the same company as the gel polish you’re using, and by making sure the bulbs in the lamp are clean and functioning properly.

Prep work can also lead to skin contact: “Skin contact can occur from overaggressive filing of the natural nail with a coarse-grit nail file such as a 150 or 100 grit,” Barnes explains. “A 240 or 180 grit file is all that is required to file the natural nail and remove the shine. If you use a coarser grit, you will remove layers of the nail plate, making the nail thinner and more susceptible to absorbing nail ingredients and causing an allergy.”

Safe working practices

Of course, accidents happen, and skin contact might occur from dropped product. Barnes says, “It is essential to remove this product immediately with IPA or gel cleanser, and get the client to wash their hands. Do not dry wipe or use fingers or a nail tool to tidy this up because uncured product will still be present on the skin, albeit not visible, and will contribute towards an allergy or irritation.”

Other factors Barnes recommends taking into consideration to keep clients safe include avoiding overly large brushes and the one-bead method, always using the correct mix ratio, following manufacturer instructions, and keeping work areas clean and dust free.

The use of correct PPE is important in protecting yourself from developing allergies when carrying out treatments on clients. “To keep yourself safe, wear gloves when working and change them for each client,” advises Clayton, adding, “If you are with a client for a few hours, change the gloves several times because thinner gloves will not last for long.”

Barnes elaborates, “While many nail techs wear gloves, often they are not wearing the correct PPE and gloves that actually protect them. Not all gloves are made the same, and gloves are made for different industries to protect against numerous different chemical ingredients. It is essential to ensure that your gloves give chemical resistance against the ingredients you use in your nail services and that you are changing these gloves regularly by calculating the chemical resistance time for your brand – you can obtain the thickness and glove chemical resistance time from your manufacturer.”

If you have developed an allergy to nail products, it’s important to get to the bottom of the cause – it might not be as simple as flooding cuticles or dropping product onto bare hands. “If symptoms occur on your face, it is likely that you are touching your face unknowingly,” Barnes explains. “This then identifies that the transfer of allergen is coming from your hands and likely contamination of product transferring to your face. Consider things such as a visor or mask to help break the habit of touching your face in order to protect the area in question.

“Even if you are wearing gloves, if you get uncured gel on them accidentally, think of where this could transfer to – gel bottles and pots, switches, UV or LED lamps, nail tools… by transferring this product to high-contact points that are likely to be repetitively touched, you’re more likely to transfer uncured product to the skin.”

Dangers of dust

Sometimes, it may not be direct contact of the product causing issues – dust particles from gel products can also cause allergies. Barnes recommends investing in a dust extraction unit, rather than a dust collector, to help to remove particles from the air and prevent them coming into contact with skin.

“What you wear is also important if you suspect dust particles as the cause of the allergy,” she adds. “Ensure all areas of your skin and your client’s skin is covered by wearing long sleeves, visors and masks. I recommend wearing long-sleeved and high-necked tops that you can tuck into your gloves, avoiding skin contact points for allergens and dust.

“It is also important to consider the material your uniform is made from and how absorbent it is; if some product comes into contact with the material, it will soak through. Choose a uniform that isn’t very absorbent, and add wipeable, removable layers, such as an apron, that can be removed should contact occur. Always have a spare uniform at work if product gets on your clothes.”