PracticalDermatology

Since the introduction of gel nail manicures, there has been much debate about the safety of nail dryers that use ultraviolet (UV) light to dry and cure gel nail polish and this concern has increased as gel manicures become more popular.

Researchers from the University of California, San Diego, and the University of Pittsburgh tested UV-emitting, nail-drying devices using cell lines from humans and mice and found that chronic use of the machines can damage DNA and cause mutations in human cells that could increase the risk for skin cancer. The findings were published in Nature Communications.¹

Alexis Livingston Young, MD, a dermatologist at the Hackensack University Medical Center in Hackensack, NJ, discussed the findings and their implications with Practical Dermatology.

What does the new study add to the literature about the risks of UV-emitting, nail-drying devices?

Alexis Livingston Young, MD: Up until now, there have not been any actual scientific studies looking at the effects of UV radiation from manicure lamps on mammalian and human skin cells on a cellular level. Most of the studies have just measured the amount of ultraviolet A (UVA) radiation emitted by these lamps. There have been a handful of reports suggesting a link between skin cancers and precancerous sun spots on the hands related to the use of UV nail lamps. This is the first study to actually expose mouse and human skin cells to the UVA radiation from nail lamps and evaluate for the presence of cell and DNA damage.

Is the jury in or still out on this issue?

Dr. Young: Yes and no. I think the evidence is growing that this UV exposure could cause cumulative damaging effects, but until we actually have long-term studies performed on humans, we cannot definitely say that there is a link. Intuitively, it makes sense that the UV from these lamps should be minimized for a variety of reasons primarily because of the risk of skin cancer.

Have you ever diagnosed a skin cancer on the hand that is believed to be related to gel manicures/UV light?

Dr. Young: Not that I know of … yet. Since gel manicures only came into fashion in the past decade and skin cancers develop from repeated exposure to UV radiation over a long period of time, it could take a number of years to see the cumulative effect on skin cancer risk/incidence of skin cancers on the hands. I have definitely diagnosed skin cancers on the hands and fingers, but I am not completely certain of a direct link with UV lamps.

Are there other risks of gel manicures for nails?

Dr. Young: Gel manicures are performed by applying a plastic resin composed of acrylates onto the nail, which is then cured (ie, polymerized) under a light source (either UVA or light-emitting diode (LED). Acrylates are a common cause of allergic contact dermatitis. Allergy to acrylates could present as eyelid, facial, or fingertip dermatitis, pain and numbness of the fingers, nail weakening, and disfigurement of the nail. If someone becomes sensitized or allergic to acrylates in gel nail polish, the patient could then become allergic to acrylates found in other medical and nonmedical exposures such as the glue used to place false eyelashes, the resins used to hold diabetic glucose sensors in place, Super Glue, dental work, orthopedic exposures.

Gel nail polish is also removed by soaking the nails in harsh chemicals and/or physically debriding the polish from the nails. All of this severely weakens the nail and leads to disfigurement, breakage, ridges, and infection.

Another issue with UV lamps for gel manicures is the risk of photoaging. UVA radiation not only can cause skin cancer, but it is also responsible for causing wrinkles. Repeated exposure could age the skin of the hands prematurely. UVA radiation is what is used in tanning beds leading to an exponential risk of both skin cancer and aging.

What type of manicure is safest for nail and skin health?

Dr. Young: A regular manicure with polish that doesn’t have to be cured under a light source would be the least damaging to the skin and nails.

What advice would you give patients regarding nail art and gel manicures?

Dr. Young: If someone wants to do gel manicures, the individual should seek a salon that uses LED light to prepare the polish as opposed to UV. If the patient starts to develop a rash or any other skin symptoms when receiving a manicure, they should avoid it altogether. Avoid at-home gel manicure kits, which usually come with a light source. These could be overused and used incorrectly. If UV cannot be avoided in the salon, then either wear gloves with the fingertips cut off and/or apply a broad-spectrum sunscreen to the hands prior to placing the hands under the light source.

1. Zhivagui M, Hoda A, Valenzuela N, et al. DNA damage and somatic mutations in mammalian cells after irradiation with a nail polish dryer. Nat Commun. 2023;14(1):276. Accessed April 14, 2023. doi: 10.1038/s41467-023-35876-8.