You Gellin'?

Rihanna's 2013 Grammy Nails. Photo courtesy of xojane.com.

When we asked NYC dermatologist Dr. Dana Stern about everything nails – her specialty – we got way more than we bargained for. One could say... she nailed it! We learned so much from the good doctor, and we will be sharing our newfound wisdom periodically on our blog. Today, we want to shed some light on gel manicures.

What is it?

Gel technology is unique because it paints on like traditional nail lacquer but the gel has a chemical composition that enables it to harden or cure to a glossy finish with a UV light, thus preventing the need to sit and dry. These manicures and pedicures can last 2-3 weeks.  There are close to a dozen gel polish brands marketed and there are several hundred UV nail lamp devices on the market.  Salon and newer at-home do-it-yourself products are also now available.

What’s the controversy?

A slew of recent negative press indicates that there seems to be a backlash brewing against gel polish.  Cosmetics do not have to go through a rigorous approval process with agencies like the FDA and so consumers are rightfully questioning the health implications and potential consequences of this new pervasive trend. There is a lot of confusion in the both the press and even the medical literature – lets set the record straight! There are two categories of concerns about gel manicures.

UV Concerns (skin, eyes, and phototoxicity):

• Skin: the light emitted is in the UV-A spectrum or if it is an LED-device (most of the at-home devices are LED), then it is the short wavelength visible spectrum. UVA can contribute to signs of skin aging such as brown spots and wrinkles. A new study quantified the skin cancer risk of these devices and determined that even if you were to have a gel manicure every week, your chances of developing skin cancer would not be increased. We dermatologists tend to be cautiously optimistic people.  Although this is one study, and more research needs to be done, I am optimistic that these devices do not pose an increased risk of skin cancer.  However, I do advise protecting your hands or feet with either a broad spectrum sunscreen applied 15 minutes before exposure or a piece of fabric or fingertipless glove or pedicure sock in order to protect the skin on the hands and feet from the aging effects of UV light. 

• Eye: UV-light can potentially damage the eye.  Be sure that the light is not anywhere near your visual field.  If you can see the light then you should wear a broad spectrum sunglass.  For LED devices, protective eyewear with a yellow/orange lens is ideal.

• Phototoxicity/Photo-onycholysis/Retinal photosensitizers: If you are taking certain medications, when combined with light they can cause an increase risk of sunburn, lifting/separation of the nail or increased risk of damage to the retina in the eye.  Common ones include Doxycycline (used for treatment of acne and infections.)  If you are taking medications ask your doctor if you any of your medications can cause photosensitivity or phototoxicity.

Nail Concerns:

Many people express concern that after having gel manicures their nails become dry, thin and peel.  A new study out of Miami School of Medicine used ultrasound to demonstrate that that gel manicures cause nail thinning.  The authors concluded that it was unclear whether the source of the thinning is due to the acetone soaking required to remove the gel or the actual chemical composition of the gel polish. Another cause may be if the gels are incorrectly removed.

Be sure to ask how the product will be removed and make sure that they won’t be using a gritty file, sander or other implement to vigorously scrape the product off.  These methods can cause tremendous and sometimes irreversible damage to the nail as well as the cuticle and matrix.  The companies that make these products have very little control over whether their products are being removed properly.  Gel polish should come off easily after soaking in acetone.  If it is not easy, something is wrong.  Remember time is money in a nail salon.  You need to be your own advocate, armed with information.

Are Gels a No No?

No! When done safely, gels are a great way to get a chip free, long lasting manicure or pedicure.  In order to minimize nail damage that can occur from a bi-weekly gel application I suggest gels only occasionally before a big trip or a special event.  Gel manicures can also be an incredible tool to help nail biters to “bite the habit.”  After spending time and money to get your nails manicured in the latest color for spring, a long lasting manicure can help those who pick and bite to refrain from these habits.  Usually if my patients can avoid biting for 12 weeks then they are successful at overcoming this habit, gels can be a great tool for these patients.

Any Tips?

• Enjoy the occasional gel manicure or pedicure before a big trip or special event where chips are going to be a big bummer!
• Be sure to use sun protection before going under the UV light.  Sunscreen should be broad spectrum and applied 15 minutes prior to exposure or alternatively, drape a fabric or use a fingertip-less or pedicure sock to protect the surrounding skin.
•  If you can see the light, then your retina is potentially being exposed to harmful UV rays.  Wear a broad spectrum sunglass.
• Ask your doctor about your medications and if they have photosensitizing risks as certain medications combined with UV light can cause nail lifting, sunburn and eye damage.
• Make sure that your cuticles are not removed or cut in preparation for your manicure/pedicure.  Instead, they can be gently pushed back after soaking.
• Make sure the gel polish is not removed too vigorously with an implement.  It should never hurt.  Gel polish should scrape off easily after the nail has soaked effectively in acetone.

Dr. Dana Stern is an assistant clinical professor at The Mount Sinai School of Medicine. She is in private practice in NYC.  Dr. Stern can answer all your nail-biting questions on Facebook and twitter! @DrDanaStern / http://facebook.com/danasternmd