Allergies from At-Home Gel and Acrylic Manicures Are On the Rise

Hardly anyone uses normal nail polish anymore, it seems. Now, gel and acrylic manicures are the thing—and you don’t even have to go to a salon to get them.

Gel and acrylic manis appeal to many because they can last for three weeks (or even longer) without chipping. In the last few years, the UV lamps required to harden or “cure” more chip-proof polishes have gone from specialty salon tools to household appliances, spurred initially by women seeking salon-style nails during lockdown. There’s a booming market for chemically-hardening products like powders, gels, and putties, often promoted by how-to social-media videos.

It’s also given rise to an expanding patient population: people who find out they’re allergic to an ingredient found in many of these manicure products. The more the DIY nail community grows, the more patients Dr. JiaDe (Jeff) Yu sees with the same irritated skin.

“A lot of people come in with rashes at a distant site,” says Yu, a dermatologist at Massachusetts General Hospital and president-elect of the American Contact Dermatitis Society. “So we’re talking neck, we’re talking eyelids, we’re talking somewhere in a remote location that’s not directly connected to their nail.” Through skin patch testing, Yu and other doctors have tracked many of these mystery cases back to a family of chemicals called acrylates, which are found in every type of UV-hardening nail product. There’s dip powder, which is glued to the nail like glitter onto a posterboard before being melted into a polish layer by an activating liquid. There’s poly gel—a more moldable form of standard gel polishes—which can be used to build a thick and rigid nail extension. Classic gel has acrylates, too. Though the steps differ, without an acrylate ingredient, your manicure just won’t cure. Even the glue used with press-on nails has it. And unlike the base coats and top coats for traditional nail polish—which do not contain acrylates—gel-curing base and top coats do.

Allergies to nail products aren’t new: Dermatologists and allergists have seen them for ages, most often among nail-salon workers. But the recent uptick in home use of these products has resulted in far more cases than normal—and acrylate allergies apply to far more than just beauty products.

What are acrylates?

Acrylates are the reason that gel nail polish hardens in seconds. When these tiny chemicals are exposed to UV light, they join together to create acrylate polymers, or larger, bonded collections of molecules. It’s the formation of these bonds that harden or “cure” the product. When acrylates become polymers, “the assumption is that they are no longer allergenic,” says Yu. Because of their smaller size, individual acrylates are easily able to enter the body through the skin and cause irritation—polymers simply can’t fit through those small channels.

Read More: Why ‘Natural’ Household Cleaners Can Make Allergies Worse

The problem is that curing is not an exact science. Even the most careful manicure can leave unbonded acrylates behind, and the risks of this increase when DIY-ers don’t pay attention to how long a product needs to be cured, or use cheap lamps with too-weak LED bulbs—both of which can lead to an under-cured manicure. That’s why Yu believes he sees so much acrylate irritation far from the hands. “Scratching and touching moves the allergen from your fingernails over to more sensitive places, like eyelids or your neck, where the skin is a bit thinner and more susceptible,” he says. Still, reactions do appear around the hands and nails, particularly in people who are more sensitive to acrylates. In the online nail art community, videos of blistered fingers and inflamed cuticles are common. Serious reactions can even lead to onycohlysis, or the separation of the nail from the skin beneath it.

Are acrylates avoidable?

Best practices are difficult here. Aside from the risk factors of improper use and repeated exposure, doctors don’t really know why certain people develop acrylate allergies. Some people paint their nails with gels every week for 10 years before suddenly developing an allergy; others might notice a reaction after just one or two uses. And it’s a true allergy: You can’t just wait for your skin to clear and go back to your nail routine. After just one negative reaction to an acrylate, says Yu, the skin is primed to react the same way with each repeated exposure. Switching to a different product isn’t likely to work, either. “A lot of the studies really show there’s a significant amount of cross reactivity”—meaning that an allergy to one acrylate usually means an allergy to all acrylates.

Gel manicures aren’t the only place you’re likely to encounter acrylates. “The bad news is that acrylics are used in a lot of different facets of life,” says Yu. Take the dentist’s office. The glue used to affix braces to teeth? Acrylates. The molds they use for orthodontic devices? Acrylates. And you better hope you never need a knee or hip replacement, says Yu, because many of the glues used in these types of orthopedic procedures have acrylates as well. Even Superglue and similar adhesives rely on acrylates to harden and stick. “I just saw a woman who had a horrible groin rash from popular feminine pads that contain acrylates,” Yu adds. Diagnosing that patient was easy, he says, once she told him that she’d had similar reactions in the past to some nail polishes and eyelash glue. “Acrylates are very sneaky,” Yu says.

A safer at-home gel manicure

Dermatologists know that it’s unreasonable to expect every nail hobbyist to abandon their pastime, but there are ways to minimize exposure to uncured monomers and reduce overall risk. When doing your nails, ensure that you’re curing each layer fully, and wear fingerless gloves to protect your hands from the UV exposure. “We often recommend putting a good barrier cream like Vaseline around the nail,” says Yu. This will prevent the uncured chemicals from making as much direct contact with your skin.

Be careful, too, when purchasing products, he says. When people were getting formaldehyde allergies from standard nail polish, manufacturers coined terms like “3-free” and “4-free” to indicate which of the top allergens their new formulas were free from. A similar labeling system doesn’t yet exist for acrylate-based polishes, but some do advertise that they don’t contain HEMA, one acrylate believed to prompt allergic reactions more easily than others.

A safer-than-gel bet is to stick with regular nail polish. While it may not last as long as a polygel extension set, it’s more stylish than a rash.