At-Home Gel Nails Pose Underrecognized Risks

 Users of at-home gel nail kits are at an increased risk for adverse skin reactions, according to new data presented at the annual meeting of the American Contact Dermatitis Society.

Dermatitis associated with gel nail products has been documented in nail technicians, but the COVID pandemic accelerated the use of at-home gel nail kits, many of which contain 2-hydroxyethyl methacrylate, according to Samantha K. Ong, MD, a dermatology resident at Saint Louis University School of Medicine, St. Louis, and colleagues.

Previous studies of gel nail products have focused on professionals, and the risk for allergic contact dermatitis from these products remains underrecognized in nonoccupational users, Ong told Medscape Medical News.

“By focusing on at-home users rather than salon professionals, this study addresses a gap in the literature and highlights a growing public health issue that affects real-world consumer behavior,” she said.

Ong and colleagues posted a survey about at-home gel nail use on six Reddit subgroups focused on gel nails or contact dermatitis. The 163 respondents answered questions about demographics, manicure habits, dermatitis symptoms, allergen knowledge, help-seeking behavior, and financial impact.

Overall, 88 respondents (54%) reported adverse skin reactions associated with the use of at-home gel nail products; most were young women, and 98% were not nail technicians. The rates of skin reactions increased the more the products were used, with 80% of weekly users reporting some adverse reaction. Itching was the most common reaction, reported by approximately 75% of the participants. Redness and swelling occurred in approximately 70% and 60%, respectively.

Although the cost of an at-home gel nail kit is less than a salon manicure, users of the at-home kits faced additional expenses from seeking treatment for their reactions or from changing products, the researchers noted. A total of 20 respondents reported using prescription treatments to manage the adverse reactions.

Notably, users of the at-home kits who reported prior allergen awareness were significantly less likely to have adverse reactions than those who were unaware of possible problems (36% vs 88%; P < .0001).

“I was most surprised that knowledge of allergenicity was protective, regardless of knowledge of proper application, since most of our users were not professional technicians,” Ong told Medscape Medical News.

The findings were limited by several factors, including the cross-sectional design and lack of clinical assessment, as well as reliance on self-reports and the potential for selection bias given the recruitment through Reddit, Ong said. “Additional research would be useful in larger, more diverse populations, ideally with confirmatory patch testing and prospective designs to better define causality, risk factors, and long-term outcomes,” she noted.

However, the current study results highlight the underrecognized public health risk allergic contact dermatitis from at-home gel nail products and the need to raise consumer awareness of the possible risks associated with at-home gel nail kits, the researchers concluded.

“Ask specifically about at-home gel nail use when evaluating hand, periungual, or facial dermatitis, especially in younger patients and frequent cosmetic users,” Ong said. The findings also support counseling patients on the risk for acrylate allergy, recommending that they stop using the offending products if dermatitis develops, and considering patch testing when contact allergy is suspected, she said.

Frequent Users Don’t Have Fewer Problems

The new study provides perspective on the potential risk for acrylate allergy in people who use at-home gel nail kits, said Amber Atwater, MD, a past president of the American Contact Dermatitis Society and a dermatologist in private practice in Vienna, Viginia.

“We know the risk may be higher in this population because users are not trained professionals and because they are typically applying the product to themselves,” said Atwater, who was not involved in the study.

Atwater said she was surprised that more than half of the gel nail kit users reported skin reactions. “Also, I would expect weekly users to have more application expertise, and therefore fewer reports of reactions; instead, they had more reactions,” she told Medscape Medical News.

Atwater acknowledged that the findings were limited by the use of a single source for the survey (Reddit) but also said the study provides a heads-up to clinicians that their patients may be using at-home nail kits. “Prior allergen awareness was associated with fewer reactions, so counseling patients on the risk of acrylate allergy from home kits could be of value,” she added.

This study received no outside funding. Ong had no financial conflicts to disclose. Atwater had no relevant financial conflicts of interest to disclose.

https://www.medscape.com/viewarticle/home-gel-nails-pose-underrecognized-risks-2026a1000aco