OVERVIEW: Women are discovering that gel manicures offer long-lasting and durable results in a quick manner. Yet dermatologists are concerned that they can cause nail problems – such as nail thinning associated with brittleness, peeling and cracking – with frequent use and can camouflage nail disease if done repeatedly.

AMERICAN ACADEMY OF DERMATOLOGY EXPERT Information provided by Chris Adigun, MD, FAAD, a board-certified dermatologist and assistant professor of dermatology at The Ronald O. Perelman Department of Dermatology at New York University School of Medicine in New York, N.Y.

HOW GEL MANICURES WORK • Gel nail polish is more durable than other nail polishes and can last two weeks or more without chipping.• Ultraviolet (UV) lamps are used to “cure” or seal the polish to the nail.• Gel nail polish is hard to remove as nails must be soaked in acetone for at least 10-15 minutes in order to rid the nail of the polish.

CONSEQUENCES OF GEL MANICURES • In one study, five women who had reported nail weakness, brittleness and thinning from gel manicures were examined by dermatologists, who attributed these symptoms to the gel manicures. In addition, one woman underwent ultrasound and reflectance confocal microscopy (RCM) measurements of the nail plate before and after one gel manicure, which showed thinning of the nail plate.¹ • Dr. Adigun noted that it is unclear whether the brittleness from gel manicures is attributed to the chemicals in the gel nail polish or from the acetone soaks needed to remove the polish.• Acetone, which is needed to break down the chemical bonds of gel polish, is very drying to the nails and irritating to the skin surrounding the nail. In some cases, an allergic reaction to acetone could cause contact dermatitis.• Women who frequently get gel manicures should consider their skin cancer risk since the UV light needed to cure the gel manicure is a risk factor for skin cancer. In addition, photo damage from UV lamps could result in cosmetic changes to the exposed surrounding skin.• Nails continually covered with polish obscure any problems occurring under the nail, such as an infection or tumor, and could delay diagnosis and treatment.

THE GEL MANICURE “DIET” Dr. Adigun noted that while occasional gel manicures do not pose a serious threat to nail health, she did advise women who frequently receive these manicures to be aware of the potential risks with repeated use. For women who experience nail problems due to gel manicures, Dr. Adigun offered the following gel manicure “diet” tips: • Pay attention to your nails and allow nails to re-grow and repair. Consider getting these manicures occasionally rather than every two weeks to decrease the consequences of chemical and physical trauma.• If you get gel manicures, wear a broad-spectrum sunscreen on your hands to minimize photodamage as a result of the UV exposure during the curing process.• Be very proactive with the manicurist. Tell her not to push or manipulate the cuticle because that will increase the risks of inflammation and infection and also dry out the nail. • Use traditional nail polish instead of gel nail polish if you experience recurring nail problems. Women with a known allergy to acetone also should use traditional nail polish, as acetone is required to remove gel polish.• Rehydrate nails several times a day with a moisturizing product, such as petroleum jelly, to reverse any signs of brittleness, thinning or chipping.• Don’t chip gel nail polish with other nails or tools to remove polish.• To decrease irritation to the skin, only soak nails, not the whole hands or fingers, in acetone while nail polish is being removed. If you get gel manicures frequently, consider buying finger wraps that expose only the nails and protect surrounding skin.• If you notice any unusual changes to the nails, see a board-certified dermatologist.

AMERICAN ACADEMY OF DERMATOLOGY EXPERT ADVICE:“In general, any manicure left in place for an extended period of time is not a good idea because you are not seeing what is going on underneath the nail polish,” said Dr. Adigun. “As is the case with most things, moderation is the key when it comes to gel manicures. If you get them regularly, you need to be aware of the possible consequences and see a board-certified dermatologist if a persistent nail problem develops.”# # #

Celebrating 75 years of promoting skin, hair and nail healthHeadquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 17,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org. Follow the Academy on Facebook (American Academy of Dermatology) or Twitter (@AADskin).

¹Chen, Andrea F, MD, et al Nail damage from gel polish manicure. Journal of Cosmetic Dermatology 2012; 11 27-29.

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