Nail Clinic: Allergy Or Irritation?
The nail products you use every day can trigger unexpected adverse reactions in clients. Here’s why, and what you can do about it.
Nail techs are expected to be well-versed on issues of sanitation and sterilization, and meticulous about employing protocols to ward off infections. But there’s another health risk that often gets short shrift: that of adverse or allergic reactions to commonly used nail products. Even when you perform every step by the book, a client can develop an uncomfortable and even dangerous physiological reaction to the chemicals in products that techs use every day. Fortunately, you can minimize damage to your clients (and your business!) by understanding how and why reactions happen.
Allergy or Irritation?
Any adverse response to a nail treatment is cause for concern, but there’s a difference between allergic reactions and irritations. “It can be challenging to distinguish between the two, but it’s important to do so,” says Dana Stern, M.D., board-certified dermatologist and founder of the dermatologist-developed nail care line, Dr. Dana. “Allergic reactions are much less common than irritations and tend to be lifelong, whereas anyone can develop an irritant reaction to a nail product if enough of the chemical comes in contact with the skin.”
An allergy to nail and/or skincare products develops in stages through a process called sensitization, the result of prolonged or repeated exposure to a particular substance over days or weeks. Ultimately the skin’s natural protective barrier is breached, enabling that substance to combine with skin proteins and be carried via white blood cells through the body. Those cells, whose job it is to work within the immune system, react by releasing chemicals that produce the symptoms we commonly see with skin allergies, generally referred to as atopic dermatitis or eczema.
An irritation occurs quickly, within minutes or hours after brief but heavy exposure or repeated low exposure. As with allergies, the outer layer of skin has been penetrated, but the response is acute and localized. Symptoms, typically a pink hue and blisters that might turn into sores that become scaly or crusty, tend to peak in about 24 hours. The condition is usually called, simply, contact dermatitis.
Suppose you have a long-time client who is slowly building up an allergy to one of your products. What are you likely to see? “The reaction to the allergen can appear as redness, swelling and blistering of the skin surrounding the nail,” says Stern. “Sometimes the nail will burn and then separate or lift off of the nail bed (onycholysis).” Other common symptoms include dry and bumpy skin, and even nail plate discoloration.
You might be mystified by this unprecedented reaction, and wonder whether the product has gone “bad” or changed formulations. Or, you might dismiss an allergy because you’ve been seeing this client and using the same products on her for several years. However, that’s exactly why you should suspect an allergic reaction. “Nobody develops an allergy upon first exposure; it takes repeated exposures for this to happen,” stresses Stern.
Sometimes allergic reactions to nail products behave so mysteriously that it takes a dermatologist to draw the connection between the symptoms and their cause. Remember, once the dermal barrier is violated, the reaction can show up anywhere on the body. Allergies to topical products can manifest as dermatitis on the neck, in and behind the ears, and even around the eyelids. More rarely, there are flu-like symptoms and/or dark circles under the eyes caused by swollen neighboring tissue. Pre-existing skin conditions may also flare up at the same time. Although this is less common, nail product-related allergies can even lead to serious secondary infections of the nail, such as paronychia (soft-tissue infection), onychia (nail bed inflammation) and paraesthesia (numbness or prickling sensations). Ultimately, the best way for a client to determine whether an allergy is causing her symptoms is to have a patch test administered by a dermatologist. As her nail tech, your knowing the results of that test can help you tailor future treatments so as to avoid using products that contain the allergen(s). Keep in mind, says Stern, if a client has a true ingredient allergy, she will likely be allergic to any product with that ingredient, or those with a similar chemical structure.
Recognize and Respond
A nail tech’s best opportunity for preventing a client’s adverse reaction occurs before a service begins, with a close evaluation at the start of every appointment, says Janet McCormick, M.S., educator, author and co-owner of Nailcare Academy, an online education site that offers programs for advanced and medical-level nail care. In artificial nail clients, for instance, “a developing allergy will give the technician an early warning: There will be an ever-so-slight puffiness of the skin in and outside the sidewalls of the nail, and the oponychium will be thinning or gone,” she explains. “It won’t be red or painful yet, but there’ll be a shininess due to the edema.” In such an instance, it’s time to recommend removal of the enhancement, McCormick says, because an allergic response has already begun. “Otherwise, the symptoms will worsen with each application. Next there’ll be redness and itching, and tiny blisters will occur after each application of the product,” she says. “If the nails aren’t taken off immediately, the skin will [develop] a raging reaction with severe pain and high edema. The client may even feel feverish.”
Should a client call you hours after a service to report a reaction, it is more likely to be an irritant-induced response, says Stern. “Salon technicians should have relationships with local dermatologists to whom they can refer such clients,” she recommends.
Finally, make sure that you are just as vigilant about your own potential for developing a product allergy. “It’s essential to understand the chemistry of the ingredients you work with, and to handle them properly, to prevent a lifelong, occupation-induced allergic dermatitis from developing,” says Stern. “Wear gloves—nitrile gloves are preferred as clients may be latex-sensitive—and maintain strict operational protocols, such as keeping tools, containers and working surfaces clean and dust-free.” Be alert to symptoms, and take care of any allergy or irritant issues asap for healthy (and happy!) clients and techs, alike.
-Linda Kossoff is a health and beauty writer in Los Angeles.
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[Images: Getty Images/BSIP/ Universal Image Group, Getty Images/S-ANIAOSTUDIO/ISTOCK]