Abstract
Keywords
To the Editor,
Gel nails are composed of acrylate and methacrylate monomers that undergo polymerization with ultraviolet light. 1 Certain acrylates in gel nail polish, including 2-hydroxyethyl methacrylate (2-HEMA), methyl methacrylate, ethyl acrylate, and ethyl-2-cyanoacrylate are known sensitizers, and acrylates were designated the contact allergen of the year in 2012. 2 In a case series, there were 8 reports of allergic contact dermatitis (ACD) secondary to 2-HEMA, di-hydroxyethylmethacrylate, (HEMA)-trimethylhexylcarbamate, and urethane acrylates from at-home gel nail kits. 3 Since gel manicures and at-home gel nail kits have surged in popularity in recent years, we aimed to quantify and characterize skin reactions to gel nails on social media.
The TikTok social media application was queried for videos tagged #gelallergy on September 6th, 2023. Total views and likes, upload date, video content type, and clinical symptoms were recorded and quantified. Videos were excluded if they were irrelevant, duplicate from a content creator, or not in English.
There were a total of 366 videos for #gelallergy, of which 214 were included in the final analysis, with a total of 100,293,657 views and 4,627,621 likes. One hundred twelve videos were personal anecdotes detailing alleged ACD to acrylates from gel polish. Eighty-six videos were educational, explaining gel allergy prevention and management, and of those, 11 were created by board-certified dermatologists. Two news outlets including “This Morning” featured segments discussing the dangers of at-home gel nail kits (Table 1).
Analysis of #gelallergy Videos on September 6th, 2023: Insights, Video Content Quantification, and Clinical Findings.
Among videos with personal anecdotes, 94 explicitly mentioned developing allergies associated with at-home gel nail kit use, and 4 were associated with gel nails at a salon (Table 1).
We found that there were almost 100 reports of ACD associated with at-home gel nail kits on TikTok, suggesting an epidemic of sensitization from acrylates. In a retrospective analysis of 35 cases of suspected nail-related acrylate allergies, 28 patients had positive patch testing to acrylates, with 71% in licenced salon nail technicians with training on artificial nail application, and 29% in non-licenced users. 4 Untrained users may inadvertently allow uncured polish to overflow onto the skin or use non-commercial UV lamps with insufficient wattage to fully cure the gel polish, which might cause sensitization. 5
In our analysis, there are 33 mentions of acrylate allergies secondary to applications beyond nail cosmetics, which has broader implications since these same acrylates present in gel polish are also utilized in dental fillings, joint and vertebral replacements, insulin pumps, medical adhesives, intraocular lenses for cataract surgery, adhesives for EKG electrodes, eyelash or hair extensions, and wood and metal coatings (Table 2). Once sensitization occurs from gel polish, there is risk for life-long cross reactivity.
Common Compounds in Gel Polish and Their Use Beyond Cosmetics.
TENS: transcutaneous electrical nerve stimulator.
Limitations include single-hashtag analysis, and inability to verify whether reported ACD cases were confirmed with patch testing.
In sum, at-home gel nail kits appear to be a risk factor for the development of acrylate allergies and might contribute to rising prevalence of these allergies. Our study highlights the need for dermatologists to counsel patients on the risks of gel nails and how to prevent the development of acrylate ACD.
Footnotes
Declaration of Conflicting Interests
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Eden Axler and Dr. Shari R. Lipner have no conflicts of interest to declare. No sources of funding were received for this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Disclosure Statement
Authors ENA and SRL have no conflicts of interest to declare.
Financial Disclosures
Author SRL has served as a consultant for Eli Lilly, Ortho Dermatologics, Moberg Pharmaceuticals, and BelleTorus Corporation.
