ArticlePDF AvailableLiterature Review

Nail cosmetics



The nail as an anatomic structure protects the terminal phalanx of the digit from injury. Historically, it has served as a tool for protection and for survival. As civilizations developed, it attained the additional function of adornment. Nail beautification is a big industry today, with various nail cosmetics available, ranging from nail hardeners, polishes, extensions, artificial/sculpted nails, and nail decorations. Adverse events may occur either during the nail-grooming procedure or as a reaction to the individual components of the nail cosmetics. This holds true for both the client and the nail technician. Typically, any of the procedures involves several steps and a series of products. Separate "nail-bars" have been set up dedicated to serve women and men interested in nail beautification. This article attempts to comprehensively inform and educate the dermatologist on the services offered, the products used, and the possible/potential adverse effects related to nail-grooming and nail cosmetics.
309Indian Journal of Dermatology, Venereology, and Leprology | May-June 2012 | Vol 78 | Issue 3
How to cite this article: Madnani NA, Khan KJ. Nail cosmetics. Indian J Dermatol Venereol Leprol 2012;78:309-17.
Received: July, 2011. Accepted: Septembar, 2011. Source of Support: Nil. Conict of Interest: None declared.
The earliest use of nail coloring dates back to ancient
Egypt and China. The first nail polish was made from
egg white, flowers, and wax. Natural henna was also
used as a nail colorant. Specific colors like red, gold,
and silver were chosen for royalty, and the common
folk had to use lighter shades. In ancient China, gold
and silver represented royalty. While red and black
represented strength and boldness, pale colors denoted
feebleness. Artificial nails date back as far as 600 BC
to the Chou dynasty in China, where nails were made
from gold, silver, and precious stones.[1]
Modern day nail polish was formulated in 1920 by the
Charles Revson Company, which today is known as
Revlon. They were inspired by the enamel paint used
on cars to formulate something similar for the nails.
The modern day nail polish became commercially
available in 1932.
Attractiveness of a nail is a subjective phenomenon.
A nail is generally considered aesthetically pleasing
if it has:
1. A smooth glossy surface.
2. No overhanging or ragged cuticle.
3. A tip extending beyond the nail.
4. An oval contour to the nail plate.
5. A gentle curve when visualized from the side.
6. Translucency so that the pink nail bed is clearly
The beauty of the nail can be further enhanced using
various shades and colors of nail polish.
The most popular nail‑grooming procedure is known as
a manicure (for fingernails) and pedicure (for toenails).
Prior to applying the nail polish, the hands/feet and
nails undergo the following:
Access this article online
Quick Response Code: Website:
Nail cosmetics
Nina A. Madnani, Kaleem J. Khan
Department of Dermatology,
P.D. Hinduja Hospital and
MRC, Veer Savarkar Marg,
Mahim, Mumbai, India
Address for correspondence:
Dr. Nina A. Madnani,
Department of Dermatology,
P.D. Hinduja Hospital and
MRC, Mumbai, India.
The nail as an anatomic structure protects the terminal phalanx of the digit from injury.
Historically, it has served as a tool for protection and for survival. As civilizations developed,
it attained the additional function of adornment. Nail beautication is a big industry today,
with various nail cosmetics available, ranging from nail hardeners, polishes, extensions,
articial/sculpted nails, and nail decorations. Adverse events may occur either during the
nail-grooming procedure or as a reaction to the individual components of the nail cosmetics.
This holds true for both the client and the nail technician. Typically, any of the procedures
involves several steps and a series of products. Separate “nail-bars” have been set up
dedicated to serve women and men interested in nail beautication. This article attempts
to comprehensively inform and educate the dermatologist on the services offered, the
products used, and the possible/potential adverse effects related to nail-grooming and
nail cosmetics.
Key words: Acrylic nail, gel nail, manicure, nail polish, sculptured nail
Nails-Part II
Madnani and Khan Nail cosmetics
Indian Journal of Dermatology, Venereology, and Leprology | May-June 2012 | Vol 78 | Issue 3310
1. The previous polish is cleaned off with
a chemical remover and the nails are cut
to the required length with nail cutters or
2. The hands/feet are soaked in warm water with
a mild detergent to soften the nail plate and
cuticle and to remove any dirt or grease from
the surface.
3. A foot scraper or a pumice stone is used to buff
away any rough skin or thick callus.
4. A cuticle softener (alkaline substances like 0.4%
sodium and potassium hydroxide) is applied
to the cuticles for 5–10 min. They dissolve the
di‑sulfide keratin bridges.
5. The cuticle is pushed back with a specially
designed metallic or wooden stick, and then
trimmed off with a cuticle cutter.
6. The surface of the nail is buffed with an emery
board to smoothen any ridges.
7. The hands/feet are rinsed and dried, and an
emollient cream is massaged to soften the skin
and trap moisture into the nail plate.
8. The cream is cleaned off from the nail plate.
Now, the nails are considered suitable for nail polish
The ideal nail polish application procedure includes
three layers:
1. Base coat: This is the first layer to be applied. It
is transparent with a strong adhering capability
due to higher resin content. It protects the nail
plate from staining.
2. Nail polish: A plethora of colors are available,
with or without a metallic finish. The
expertise of the nail technician provides
various styles of nail polish application, of
which the “French nail manicure” is very
3. Top coat: This transparent layer contains more
of nitrocellulose and less resin, so as to protect
the varnish from chipping.
Each product is applied consecutively with a 10‑min
gap in between applications [Figure 1].
Nail polish serves the purpose of:
1. Beautification.
2. Strengthening weak brittle nails.
3. Camouflaging surface irregularities or
discolorations. It can provide a youthful
appearance to aged ridged nails.[2]
Nail polish is a complex combination of:
1. Film‑forming agents (most commonly,
2. Resins (e.g., tosylamide–formaldehyde) for
3. Plasticizers (e.g., dibutyl pthalate) for flexibility.
4. Solvents (butyl stearate and acetate compounds)
for keeping the polish in fluid state and to help
in quick‑drying once applied.
5. Thixotropic agents (e.g., bentonite) for keeping
the ingredients uniformly suspended.
6. Various mineral pigments (calcium carbonate, zinc
oxide, titanium dioxide, iron oxides), synthetic
pigments (D and C red 6/7/19, FDC yellow).
7. Natural agents (guanine, bismuth, oxychloride,
and micatitanium) for the color and shine of
the nail polish.
The most common allergen in nail polish is tosylamide
formaldehyde resin (TSFR). Because of growing
awareness, “toxin‑free” nail polish is getting popular.
This variety contains cellulose, acetate, butyrate, and
polyester resin,[3] with plasticizers such as dibutyl
phthalate for softness and pliability, dissolved in
solvents (N‑butyl acetate or ethyl acetate). Some
manufacturers claim to have “toxic‑free nail polish,”
which is free of toluene, pthalate, and formaldehyde
and contains natural pigments in a water base. Argan
oil, which has a high content of amino acids, has also
been used as an important ingredient.
These are applied as a base coat for the purpose of
strengthening the nail plate. They may contain titanium–
silicone–zirconium polymers, polytef, nylon, calcium,
and biotin.[4] Those containing formaldehyde may cause
paronychia and irritant dermatitis, and are not in common
use anymore. Nail hardeners need to be cleaned off every
2–3 days to prevent onycholysis and chromonychia.[5]
With the innumerable color choices available, nail
polish is constantly changed to suit women’s moods
Madnani and Khan Nail cosmetics
311Indian Journal of Dermatology, Venereology, and Leprology | May-June 2012 | Vol 78 | Issue 3
and clothes. This involves cleaning off the existing one
with removers. The following varieties are available:
1. Acetone the most commonly available. It has
been reported to cause an irritant dermatitis.
2. Acetone‑free nail polish removers containing
ethyl acetate, butyl acetate, or ethyl lactate.
3. Nail polish remover pads containing
gammabutyrolactone, which are safe and
convenient to use. Rarely they get converted
to GHB (gamma‑hydroxybutyrate) resulting in
systemic toxicity.
This method is used to provide a “natural” appearance
to the nail. A pink color is applied to the main nail
plate, while a white color is applied to the free edge,
simulating a natural un‑painted nail, picturing good
health [Figure 2].
1. The cosmetic appeal of nail polish can be
enhanced with the application of ready‑use
plastic or metal artifacts immediately before the
polish dries.
2. The design pieces are skillfully lifted from a
template with forceps and placed on the freshly
applied wet nail polish, in a planned pattern
[Figure 3a and b].
3. This is then covered by a top coat, which
prevents it from getting dislodged.
4. Nail design can also be made, allowing the
first layer of color polish to dry completely
and subsequently painting a second contrasting
color on top of the first, with a design template.
Artificial nails evolved from the need for lengthening
or reinforcing soft, brittle, or damaged nails. These can
be partially attached as nail tips or used to reinforce the
entire length as sculpted nails (acrylic or gel based).
Ready‑to‑use plastic plates, shaped like nail tips are
available at nail salons. These are glued to the free edge
of the nails with adhesives containing methacrylate or
ethyl 2‑cyanoacrylate. The nail surface is filed roughly
prior to gluing the nail tip, in order to improve adhesion.
The glued‑on tips are then painted or decorated with
nail art and finally coated with acrylic or gel [Figure 4a
and b]. Entire plastic nails can be stuck on. The tips
can be removed with acetone.
These are either acrylic or gel based and are sculpted
over the existing un‑aesthetic nail. Both acrylic or
gel‑based nails involve a mix of a powder and a solution,
applied to the nail. A disposable foil with a printed grid
is used as a template for the application of materials.
Acrylic nails
A few drops of ethyl methacrylate mixed with powdered
poly‑methacrylate results in a polymerized mixture
that needs to be applied quickly due to the instant
setting potential. A uniformly thin layer is applied
to achieve the desired effect. The powder contains
benzyl peroxide, which acts as a catalyst, while
hydroquinone acts as an inhibitor of polymerization.
Individual brands may add titanium dioxide and
permitted colors. A further modification of the process
is the gluing of pieces of silk, linen, or fiber glass to the
nail, prior to the acrylic application. These are called
“nail wraps” and add strength to the nails. Acrylic
nails can be removed with acetone.
Gel nails
The powder and the liquid phase of gels is akin to dental
resin and requires specific UV‑light exposure to set
and cure (harden) the gel after application on the nail.
These nails appear glossy, are aesthetically appealing,
have greater strength for endurance to physical wear
and tear, and need less after‑care [Figure 5]. Gel nails
can be removed only by completely buffing them off
the nail plate. This results in physical damage to the
nail plate during each removal. “Touch‑up” procedures
are required for both acrylic and gel nails. As the
nail plate grows, a gap appears at the proximal end
between the nail fold and the artificial nail [Figure 6]
that needs to be filled up at regular intervals, usually
every 2–3 weeks.
These can be broadly categorized as those due to
the chemical components or complications during
or subsequent to the nail‑grooming procedure. Most
reported adverse reactions due to the chemical
components have been tabulated in Table 1.
Madnani and Khan Nail cosmetics
Indian Journal of Dermatology, Venereology, and Leprology | May-June 2012 | Vol 78 | Issue 3312
Procedural complications of a manicure/pedicure
These may occur in the periungual tissue, the nail plate,
or at distant sites due to an allergic contact dermatitis.
1. Cuticular cuts and “hang” nails are common
with the cuticle‑trimming procedure and can be
very painful.
2. Irritant reactions or chemical burns following
use of the cuticle softener are usually seen
around the proximal paronychial fold.
3. Clipping nails when dry can cause
onychoschizia, with horizontal splitting of the
nail plate in layers, making it brittle.
Figure 2: French Manicure – It stems from the idea of a healthy
nail where the free edge of the nail is bright white and the proximal
nail has a pink hue
Figure 1: Bright‑colored nail polish adds to the beauty of the hand
Figure 3: (a and b) Nail adornment
Figure 4: (a and b) Nail art – Decorative art along with sparkles add to the nal effect of the nail
Madnani and Khan Nail cosmetics
313Indian Journal of Dermatology, Venereology, and Leprology | May-June 2012 | Vol 78 | Issue 3
4. Over‑zealous buffing of the nail plate can thin
the nail plate and cause fragility.
5. Paronychias, bacterial, fungal, and viral
infections, especially verrucae, can be
inoculated or spread between patients with the
use of non‑sterile implements.
6. Pedicure tubs in which hands and feet
are soaked have been reported to cause
Mycobacterium fortuitum infections from a nail
salon in California.[38]
The physical process of nail beautification has its own
set of adverse events, as have been enumerated earlier.
Softening/pushing back/cutting of the cuticle, in nail
parlance, is a very important step. Anatomically,
the cuticle has a very important role in sealing the
potential dead space below the proximal nail fold.
A damaged cuticle exposes this walled‑off space to
external agents like detergents and bacterial, viral, and
fungal pathogens. Subsequently, acute‑over‑chronic
paronychia ensues, which, over time, results in nail
dystrophy. Cuticle softeners contain alkaline chemicals
that cause an irritant dermatitis. Dombrowski and
Llyod reported a case of chemical damage to the cuticle
and nail plate by application of a callus remover
instead of a cuticle softener, under occlusion, resulting
in arrest of cuticle formation.[39]
Separation of the nail plate from the nail bed can result
from over‑zealous clipping of the hyponychium or as
a consequence of a “lever effect” following minimal
trauma, especially in long “strengthened” sculpted nails.
Hapalonychia, the thinning of the nail plate
postbuffing, results in weak foldable nails.
Onychoshizia may be attributed to faulty trimming
when the nails are dry, leading to horizontal layering
of the nail plate.
Repeated use of nail polish, especially deep colors like
red, often stain the nail plate. Staining was reproduced
with D and C red no 7, D and C red no 34, D and C red
no 6 and FD and C yellow no 5 lake. The likelihood of
staining increases if the pigments are dissolved and
not suspended [Figure 7].
Patients may develop delayed hypersensitivity
reactions around the painted nail and rarely present
with acute contact dermatitis. Allergic contact
dermatitis from nail polishes has been seen to
affect distant sites like face and neck commonly,
especially on the eyelids and around the mouth.
Unusual involvement of other distant sites like the
genitals and perianal region have also been reported.[40]
TSFR was the seventh most common ingredient causing
contact dermatitis in patients with a cosmetic allergy.[2]
Baran described surface friability of the nail plate,
mimicking a white superficial onychomycosis,
following the use of nail products [Figure 8]. The
keratin granulations occurred more commonly when
Table 1: List of reported adverse reactions to individual
constituents of nail cosmetics
Nail cosmetic Component Reported side-effect(s)
Nail polish Nitrocellulose Allergiccontact dermatitis[6]
Formaldehyde Allergiccontact dermatitis[7]
Outbreakof contact
Allergiccontact dermatitis
Dibutylphthalate Allergic contactdermatitis[16]
Decreasedsperm mobility
Altereddevelopment ofthe
Butylstearate Contact dermatitis[19]
Dand Cyellow 11 Allergiccontactchelitis[20]
Nail polish
Withdrawaldelirium with
acuterenal failure[21]
Acutetoxicity in9 and15
Rapidonset ofcoma,
Fataland nonfatal
Nail adhesive Methylacrylate Skin sensitizer[26]
Ethyl2- cyanoacrylate Allergiccontact dermatitis[28]
Acrylicnails Methacrylate paresthesia[30]
Allergiccontact dermatitis[32]
Allergiccontact dermatitis
Benzoylperoxide Allergic contactdermatitis
Gelnails UV light Nonmelanomaskin cancer[36]
Allergiccontact dermatitis[37]
Madnani and Khan Nail cosmetics
Indian Journal of Dermatology, Venereology, and Leprology | May-June 2012 | Vol 78 | Issue 3314
the nail polish was kept on for several months or when
it was re‑applied without removing the first coat and
also when a primer base coat was not applied.[41]
Nickel‑sensitive patients may develop an allergic
contact dermatiis due to the adornments. In such
patients, adornments chosen may be of gold or may be
nickel free.[42]
Long fingernails harbor bacteria, and antimicrobial
soaps/gels may not be sufficient for complete
elimination. Long nails are cumbersome, reduce grip,
and tend to puncture gloves. Hence, they are best
avoided by medical professional in healthcare settings.
Wynd et al. in their study on 102 perioperative nurses
concluded that chipped nail polish or nail polish
worn for more than 4 days increased bacteria on
fingernails.[43] Opaque nail polish can mask nail signs
during a clinical examination. The possible role of nail
varnish in altering pulse oximeter reading has long
been debated. However, it has now conclusively been
seen that there is no effect in the measurements from
healthy or hypoxic subjects. Chan et al. suggest placing
the probe in a side‑to‑side position on the finger to
preclude any disparity in the measurements.[44]
Many dermatological diseases cause disfigurement of
the nail plate, which may be cosmetically unacceptable
to the patient and reduce his or her quality of life.
The duration of treatment for most intractable nail
disorders is long, with poor efficacy. While waiting for
the therapeutic response, cosmetic camouflage helps
Figure 7: Prominent staining of nail plate along with onycholysis
results from regular and repeated use of nail polish and nail
polish removers
Figure 8: Keratin granules simulating supercial onychomycosis
Figure 5: Gel nails These look similar to acrylic nails but are
stronger and appear more glossy
Figure 6: Development of a clear area at the proximal nail fold as
the nail grows out. Note also the onycholysis in the little nger
Madnani and Khan Nail cosmetics
315Indian Journal of Dermatology, Venereology, and Leprology | May-June 2012 | Vol 78 | Issue 3
the patients tide over the mental discomfort.[45] Nail
polish application may be adequate for camouflaging
dyschromias and mild dystrophies. Gel or acrylic nails
may be helpful in concealing moderate nail dystrophy.
For cases of anonychia or severe nail dystrophy, a nail
prosthesis may be the only option. This prosthesis
consists of a false nail attached to a silicone finger
glove molded to the specifications of the corresponding
finger of the opposite hand.[46]
Nail cosmetics are generally not recommended for use
in children. However, the author has seen mothers
using it on their children’s nails in order to break the
nail‑biting habit, the deterrent being the taste. This
is not advisable, as there is always a possibility to
develop adverse reactions.[47]
Nail technicians are at a risk of occupational hazards
due to constant exposure to chemicals used for
various nail cosmetic procedures. Increasing number
of technicians are sensitized to acrylate monomers
used on sculpted nails. Some are at risk for developing
occupational asthma due to the cyanoacrylates
used.[29] McNary and Jackson concluded in their study
that neither nail technicians nor consumers are at any
additional risk when exposed to formaldehyde and
toulene at their work place compared with exposure
from commercial products at home.[48]
Nail polish remover pads were reported to have caused
bilateral pneumothoraces, pneumomediastinum,
and respiratory obstruction in a 15‑month‑old child
who accidently sucked on them. Fortunately, with
medical treatment, the child recovered completely.[23]
Turgut et al. reported a case of bacterial endocarditis
developing as a consequence of a pedicure.[49] A series
of patients developing candidal osteomyelitis and
diskitis, narrowed down to a nurse who was wearing
artificial nails, was reported by Parry et al.[50]
1. Nail polish should be tested as it is.
2. A specific resin can be tested in 10% petrolatum.
3. Nail acrylate allergy should be tested with
2‑hydroxy methacrylate, ethyl cyanoacrylate,
and methyl methacrylate monomer 10% in olive
4. Patch testing for nail polish removers should be
an open patch test, at a concentration of 10%,
dissolved in olive oil.
5. Cuticle removers tested as a 2% aqueous
concentration as an open patch test.
1. The nail salon should have a clean environment.
2. The nail technicians should be neatly attired
and have clean nails.
3. Check how the nail implements are cleaned
and sterilized. Implements like nail clippers,
nail cutters, foot scrapers, callus removers, and
electric drills are sterilized best with autoclaving
or soaking in 7.5% stabilized hydrogen peroxide
for 6 h or in >2.4% gluteraldehyde‑based
formulations for 10 h to remove all pathogenic
organisms and spores. The trend at the parlors
is to soak the instruments for 10 min in
disinfectants like benzalkonium chloride.[52]
These may still harbor bacteria, fungi, yeast,
and viruses.[51]
4. Carrying one’s own implements is a wise
5. Nails should be cut only after soaking for 10–
20 min in water to prevent onychoschizia.[4]
6. Over‑zealous pushing back the cuticle or
nipping the cuticle by the technician should
be avoided, as it leads to infection and
inflammation of the nail folds.
7. Nail polish should be left on for few days only,
and cleaned off with acetone‑free cleansers.
Nail hardeners too need to be cleaned off every
2–3 days. Inform the patient about the probable
staining effect of dark nail polish. Avoid layering
on nail polish without cleaning off the old one.
8. Inform the patients about nail plate damage
with application of artificial nails.
9. Any swelling, pain, redness, and growths
around the nails should be attended to by a
medical practitioner.
Although nail cosmetics are advantageous for
“beautifying” or concealing various nail disorders,
adverse effects are a definite possibility. As
dermatologists, a complete knowledge of various
Madnani and Khan Nail cosmetics
Indian Journal of Dermatology, Venereology, and Leprology | May-June 2012 | Vol 78 | Issue 3316
nail products, nail‑enhancement procedures, and
anticipated complications and their management can
result in better patient care.
1. Nail polish. Available from:
polish. [accessed on 2011 Jun 10].
2. Rich P. Nail cosmetics. Dermatol Clin 2006;24:393‑9.
3. Schlossman ML. Nail enamel resins. Cosmet Technol 1979;1:53.
4. Dahdah MJ, Scher RK. Nail diseases related to nail cosmetics.
Dermatol Clin 2006;24:233‑9.
5. Helsing P, Austad J, Talberg HJ. Onycholysis induced by nail
hardener. Contact Dermatitis 2007;57:280‑1.
6. Castelain M, Veyrat S, Laine G, Montastier C. Contact dermatitis
from nitrocellulose in a nail varnish. Contact Dermatitis
7. de Groot A, Geier J, Flyvholm MA, Lensen G, Coenraads PJ.
Formaldehyde‑releasers: Relationship to formaldehyde contact
allergy: Metalworking fluids and remainder. Part 1. Contact
Dermatitis 2010;63:117‑28.
8. Moossavi M, Scher RK. Nail care products. Clin Dermatol
9. Staines KS, Felix DH, Forsyth A. Desquamative gingivitis,
sole manifestation of tosylamide/formaldehyde resin allergy.
Contact Dermatitis 1998;39:90.
10. Brauer EW. Onycholysis secondary to toluene sulfonamide
formaldehyde resin used in a nail hardener mimicking
onychomycosis. Cutis 1980;26:588.
11. de Wit FS, de Groot AC, Weyland JW, Bos JD. An outbreak of
contact dermatitis from toluenesulfonamide formaldehyde
resin in a nail hardener. Contact Dermatitis 1988;18:280‑3.
12. Koch P. Occupational allergic contact dermatitis from epoxy
resin systems and possibly acetone in a shoemaker. Contact
Dermatitis 2002;46:362‑3.
13. Jacob SE, Stechschulte SA. Tosylamide/formaldehyde resin
allergy: A consideration in the atopic toddler. Contact
Dermatitis 2008;58:312‑3.
14. Yokota M, Thong HY, Hoffman CA, Maibach HI. Allergic
contact dermatitis caused by tosylamide formaldehyde resin in
nail varnish: An old allergen that has not disappeared. Contact
Dermatitis 2007;57:277.
15. Stechschulte SA, Avashia N, Jacob SE. Tosylamide
formaldehyde resin. Dermatitis 2008;19: E18‑9.
16. Gach JE, Stone NM, Finch TM. A series of four cases of allergic
contact dermatitis to phthalic anhydride/trimellitic anhydride/
glycols copolymer in nail varnish. Contact Dermatitis
17. Pant N, Pant A, Shukla M, Mathur N, Gupta Y, Saxena D.
Environmental and experimental exposure of phthalate esters:
The toxicological consequence on human sperm. Hum Exp
Toxicol 2011;30:507‑14
18. Habert R, Muczynski V, Lehraiki A, Lambrot R, Lécureuil C,
Levacher C, et al. Adverse effects of endocrine disruptors on
the foetal testis development: Focus on the phthalates. Folia
Histochem Cytobiol 2009;47: S67‑74.
19. de Groot AC, van der Meeren HL, Weyland JW. Cosmetic allergy
from stearic acid and glyceryl stearate. Contact Dermatitis
20. Sasseville D, Joncas V. Allergic contact cheilitis from D and C
Yellow 11. Contact Dermatitis 2009;60:294‑5.
21. Bhattacharya IS, Watson F, Bruce M. A case of γ‑butyrolactone
associated with severe withdrawal delirium and acute renal
failure. Eur Addict Res 2011;17:169‑71
22. Savage T, Khan A, Loftus BG. Acetone‑free nail polish remover
pads: Toxicity in a 9‑month old. Arch Dis Child 2007;92:371.
23. Brown JJ, Nanayakkara CS. Acetone‑free nail polish removers:
Are they safe? Clin Toxicol (Phila) 2005;43:297‑9.
24. Rambourg‑Schepens MO, Buffet M, Durak C, Mathieu‑Nolf M.
Gamma butyrolactone poisoning and its similarities to gamma
hydroxybutyric acid: Two case report. Vet Hum Toxicol
25. Lenz D, Rothschild MA, Kröner L. Intoxications due to
ingestion of gamma‑butyrolactone: Organ distribution of
gamma‑hydroxybutyric acid and gamma‑butyrolactone. Ther
Drug Monit 2008;30:755‑61.
26. Kanerva L, Lauerma A, Jolanki R, Estlander T. Methyl acrylate:
A new sensitizer in nail lacquer. Contact Dermatitis 1995;33:203‑4.
27. Borak J, Fields C, Andrews LS, Pemberton MA. Methyl
methacrylate and respiratory sensitization: A critical review.
Crit Rev Toxicol 2011;41:230‑68.
28. Isaksson M, Siemund I, Bruze M. Allergic contact dermatitis
from ethylcyanoacrylate in an office worker with artificial nails
led to months of sick leave. Contact Dermatitis 2007;57:346‑7.
29. Jurado‑Palomo J, Caballero T, Fernández‑Nieto M, Quirce S.
Occupational asthma caused by artificial cyanoacrylate
fingernails. Ann Allergy Asthma Immunol 2009;102:440‑1
30. Freeman S, Lee MS, Gudmundsen K. Adverse contact reactions
to sculptured acrylic nails: 4 case reports and a literature
review. Contact Dermatitis 1995;33:381‑5.
31. Guin JD. Eyelid dermatitis from methacrylates used for nail
enhancement. Contact Dermatitis 1998;39:312‑3.
32. Baran R. Nail cosmetics: Allergies and irritations. Am J Clin
Dermatol 2002;3:547‑55.
33. Sauni R, Kauppi P, Alanko K, Henriks‑Eckerman ML,
Tuppurainen M, Hannu T. Occupational asthma caused by
sculptured nails containing methacrylates. Am J Ind Med
34. Andersen SL, Rastogi SC, Andersen KE. Occupational allergic
contact dermatitis to hydroxyethyl methacrylate (2‑HEMA) in a
manicurist. Contact Dermatitis 2009;61:48‑50.
35. Dejobert Y, Martin P, Piette F, Thomas P, Bergoend H. Contact
dermatitis caused by benzoyl peroxide in podiatrists. Contact
Dermatitis 1999;40:163.
36. MacFarlane DF, Alonso CA. Occurrence of nonmelanoma
skin cancers on the hands after UV nail light exposure. Arch
Dermatol 2009;145:447‑9.
37. Cravo M, Cardoso JC, Gonçalo M, Figueiredo A. Allergic contact
dermatitis from photobonded acrylic gel nails: A review of four
cases. Contact Dermatitis 2008;59:250‑1.
38. Winthrop KL, Albridge K, South D, Albrecht P, Abrams M,
Samuel MC, et al. The clinical management and outcome of
nail salon acquired Mycobacterium fortuitum skin infections.
Clin Infect Dis 2004;38:38‑44.
39. Dombrowski NC, Lloyd JR. Nail changes induced by application
of a callus eliminator during a manicure. J Am Acad Dermatol
2005;52: E4.
40. Lazzarini R, Duarte I, de Farias DC, Santos CA, Tsai AI.
Frequency and main sites of allergic contact dermatitis caused
by nail varnish. Dermatitis 2008;19:319‑22.
41. Brauer E, Baran R. Cosmetics: The care and adornment of nail.
In: Baran R, Dawber RPR, de Berker D, et al., editors. Diseases of
the nail and their management. 3rd ed. Oxford (UK): Blackwell;
2001. p. 358‑69.
42. Draelos ZD. Nail cosmetic issues. In: Hordinsky M, Sawaya ME,
Scher RK, editors. Atlas of Hair and Nails. 1st ed. New York:
Churchill Livingstone; 1999. p. 184.
43. Wynd CA, Samstag DE, Lapp AM. Bacterial carriage on the
fingernails of OR nurses. AORN J 1994;60:796
44. Chan MM, Chan MM, Chan ED. What is the effect of finger nail
polish on pulse oximetry? Chest 2003;123:2163‑4.
45. Iorizzo M, Piraccini BM, Tosti A. Nail cosmetics in nail
disorders. J Cosmet Dermatol 2007;6:53‑8.
46. Baran R. Nail cosmetology. In: Baran R, De Berker D, Dawber RP,
editors. Manual of nail Disease and Surgery. 2nd ed. London:
Blackwell Science Ltd; 1997 p. 50.
47. Ozkaya E, Mirzoyeva L. Tosylamide/formaldehyde resin
allergy in a young boy: Exposure from bitter nail varnish
Madnani and Khan Nail cosmetics
317Indian Journal of Dermatology, Venereology, and Leprology | May-June 2012 | Vol 78 | Issue 3
used against nail biting. Contact Dermatitis 2009;
48. McNary JE, Jackson EM. Inhalation exposure to formaldehyde
and toluene in the same occupational and consumer setting.
Inhal Toxicol 2007;19:573‑6.
49. Turgut F, Kanbay M, Uz B, Carlioglu A, Selcoki Y, Karanfil A,
et al. A forgotten but important risk factor for infective
endocarditis in patients with prosthetic valve: Pedicure. Scand
J Infect Dis 2007;39:274‑6.
50. Parry MF, Grant B, Yukna M, Adler‑Klein D, McLeod GX,
Taddonio R, et al. Candida osteomyelitis and diskitis after
spinal surgery: An outbreak that implicates artificial nail use.
Clin Infect Dis 2001;32:352‑7
51. Baran R, Dawber RP. The nail and cosmetics. In: Samman PD,
Dav F, editors. The Nails in Disease. 4th ed. Chicago: Year‑book
Publishers; 1986. p. 129.
52. Kurtzweil P. Fingernails: Looking good while playing safe. FDA
Consum 1995;29:20‑4.
New features on the journal’s website
Optimized content for mobile and hand-held devices
HTML pages have been optimized of mobile and other hand-held devices (such as iPad, Kindle, iPod) for faster browsing speed.
Click on [Mobile Full text] from Table of Contents page.
This is simple HTML version for faster download on mobiles (if viewed on desktop, it will be automatically redirected to full HTML version)
E-Pub for hand-held devices
EPUB is an open e-book standard recommended by The International Digital Publishing Forum which is designed for reflowable content i.e. the
text display can be optimized for a particular display device.
Click on [EPub] from Table of Contents page.
There are various e-Pub readers such as for Windows: Digital Editions, OS X: Calibre/Bookworm, iPhone/iPod Touch/iPad: Stanza, and Linux:
E-Book for desktop
One can also see the entire issue as printed here in a ‘flip book’ version on desktops.
Links are available from Current Issue as well as Archives pages.
Click on View as eBook
... Most antifungal nail lacquers not only treat the disease but also improve the condition of the nail plates [16,17]. It should be noted that some lacquers, which include amino acids (lysine, methionine) have pronounced regenerative properties [18,19]. Amino acids allow to strengthen nails, improve its protective properties, and the ability to resist fungal infections [18,19]. ...
... It should be noted that some lacquers, which include amino acids (lysine, methionine) have pronounced regenerative properties [18,19]. Amino acids allow to strengthen nails, improve its protective properties, and the ability to resist fungal infections [18,19]. ...
Full-text available
Onychomycosis is one of the most acute problems of modern medicine, which accounts for about 50% of all nail diseases. Fungi of dermatophytes of the genus Trichophyton are the most studied etiological factor of onychomycosis. Non-dermatophytes can also cause onychomycosis. Fungi of the genus Aspergillus is one of the main pathogens among the non-dermatophytes agents of onychomycosis. Antifungal nail lacquer is the most optimal dosage form for the topical treatment of onychomycosis. GABA derivative of 2-chloro-N-(9,10-dioxo-9,10-dihydroanthracen-1-yl)acetamide was used as a perspective antifungal agent in the form of lacquer. The antifungal action of the obtained lacquer containing compound 2 against fungus strain Aspergillus niger VKM F-1119 was compared with the known antifungal lacquer “Lamisil” containing terbinafine as the active agent. Investigation of the antifungal action was carried out at concentrations of 1%, 0.5%, and 0.1% of compound 2 and terbinafine using the diffusion in agar technic after 24 h and 72 h. It has been determined that derivative 2, as well as terbinafine at a concentration of 1%, caused fungicidal action after 24 h and fungicidal and fungistatic effect after 72 h.
... Nail cosmetics have been a mainstay of grooming and beauty since the 17th century, with the earliest findings of nail coloring and enhancements dating back to ancient civilizations in Egypt and China [1]. Today, millions of people worldwide utilize nail cosmetic products in order to achieve aesthetically pleasing nails, with the nail cosmetic industry growing from a USD 3 billion industry in 2007 to a USD 45 billion industry by 2012 [2]. ...
Full-text available
Many ingredients found within nail cosmetic products are capable of sensitizing patients’ immune systems and causing contact dermatitis (CD). These include but are not limited to tosylamide, (meth)acrylates, and formaldehyde. A clear temporal relationship between nail cosmetic procedures and an eczematous outbreak on the hands, face, or other ectopic body regions can be a key indicator of CD secondary to nail cosmetic exposure. Once an inciting allergen is identified through patch testing, elimination and avoidance becomes a mainstay of treatment alongside the use of emollients and topical anti-inflammatory therapies. Patients should be counselled to approach future nail cosmetic products and procedures with caution and careful attention to ingredients, regardless of whether or not it has a “hypoallergenic” label.
Nail in women assumes special importance, due to the aesthetic appeal and regular use of nail cosmetics and beautification procedures. Also, women are more prone to certain nail disorders like brittle nails and chronic paronychia due to increased household work and parlor activities. In this chapter physiologic changes in women nail, nail cosmetics and aesthetic procedures have been discussed in detail. The proper technique of commonly done nail procedures like manicure and pedicure has been highlighted. Also, conditions like brittle nails, paronychia, onycholysis, habit tic deformities, ingrown nail, onychomycosis, and glomus tumors which are more common in women, have been discussed.
Gel nail polish (GNP) has recently gained worldwide popularity. We have conducted a comprehensive summary of the complications of GNP through a literature search using PubMed, Scopus, and Google Scholar databases to identify eligible papers. Complications were divided into mechanical and traumatic nail disorders, allergic contact dermatitis (ACD), and UV-induced lesions. A total of 12 contributions were included, identifying 88 patients, all of whom were women. Six of the reports described ACD (62 cases, 70,5%), three concerned mechanical nail damage (23 cases, 26,1%), and three reported UV-induced skin lesions (3 cases, 3,4%). ACD developed an average of 30 months after GNP initiation. The most frequent culprit allergens were: 2-hydroxypropyl methacrylate and 2-hydroxyethyl methacrylate. Pterygium inversum unguis was the most frequent mechanical lesion (n=17). Squamous cell carcinoma was reported in 3 cases. The delay between UV exposure and the diagnosis of SCC ranged from 11 to 15 years. Scant literature and a lack of education among consumers and beauticians has lead to the uncontrolled use of GNP. The principle of managing nail cosmetic problems is prevention through education. There is a need for understanding the processes involved and the associated complications to facilitate appropriate treatment and safe use.
Artificial nails are an essential component of nail cosmetics. The artificial nails are either preformed and glued onto the existing nail plate or they are custom made by applying a polymerizing mixture to the existing nail plate and overlying the template with a paintbrush that is subsequently allowed to harden into an acrylic nail. Artificial nails require regular maintenance. Onychotillomania is a body-focused repetitive disorder in which the person is usually aware that they are picking at their nail and/or the surrounding soft tissue. A woman with onychotillomania affecting her artificial nails is described; although this may be a relatively common occurrence, additional reports of artificial nail-associated onychotillomania were not able to be retrieved from the medical literature. The woman was not only aware that she picked at her artificial nails, but also realized that the action might result in adverse events to her natural nails and the corresponding digits. She desired no interventions for her nail-associated repetitive behavior and continued to regularly visit the nail salon for the application of new artificial custom acrylic nails. The acronym ANASON is introduced to define the condition of artificial nail-associated onychotillomania.
Full-text available
The purpose of the present investigation was to formulate and evaluate anti-nail-biting lacquers consisting of bitter herbal extracts. The hydroalcoholic extracts obtained from Andrographis paniculata and Tinospora crispa were determined for phytochemical constituents, total phenolic contents, antioxidant activities, anti-inflammatory activities, and cytotoxicities. Anti-nail-biting lacquers were prepared by using herbal extracts (bittering agent), shellac (film forming polymer), ethanol (volatile solvent), and other indispensable additives with continuous stirring. Thus, attempts to enhance the film property and bitterness are accomplished by using polyvinylpyrrolidone (PVP K30) as a copolymer and varying concentrations of herbal extracts. Good accepted formulations were established for drying time, pH, viscosity, smoothness of film, film strength, water resistant, and solubility in simulated saliva and evaluated their bitterness in human volunteers. The results revealed that phytochemical constituents including tannins, glycosides, reducing sugars, alkaloids, terpenoids, and flavonoids were found present in both extracts while saponins were only detected in A. paniculata extract. Although T. crispa extract exhibited a significantly higher (p
Full-text available
Healthy nails are functionally and cosmetically important to the daily work of women. The globally increasing market for nail cosmetics reflects the importance of the appearance of nails. This article details the composition of a healthy nail, diagnosis and treatment of nail disorders, use of nail cosmetics and their risks, the impact of the aging process on nails, and the relative risks to nail salon workers. Knowledge of these issues will prepare health care providers and patients to maintain healthy nails throughout their lives.
Full-text available
Methyl methacrylate (MMA) is a respiratory irritant and dermal sensitizer that has been associated with occupational asthma in a small number of case reports. Those reports have raised concern that it might be a respiratory sensitizer. To better understand that possibility, we reviewed the in silico, in chemico, in vitro, and in vivo toxicology literature, and also epidemiologic and occupational medicine reports related to the respiratory effects of MMA. Numerous in silico and in chemico studies indicate that MMA is unlikely to be a respiratory sensitizer. The few in vitro studies suggest that MMA has generally weak effects. In vivo studies have documented contact skin sensitization, nonspecific cytotoxicity, and weakly positive responses on local lymph node assay; guinea pig and mouse inhalation sensitization tests have not been performed. Cohort and cross-sectional worker studies reported irritation of eyes, nose, and upper respiratory tract associated with short-term peaks exposures, but little evidence for respiratory sensitization or asthma. Nineteen case reports described asthma, laryngitis, or hypersensitivity pneumonitis in MMA-exposed workers; however, exposures were either not well described or involved mixtures containing more reactive respiratory sensitizers and irritants. The weight of evidence, both experimental and observational, argues that MMA is not a respiratory sensitizer.
Full-text available
There are great concerns about the increasing incidence of abnormalities in male reproductive function. Human sperm counts have markedly dropped and the rate of testicular cancer has clearly augmented over the past four decades. Moreover, the prevalence rates of cryptorchidism and hypospadias are also probably increasing. It has been hypothesized that all these adverse trends in male reproduction result from abnormalities in the development of the testis during foetal and neonatal life. Furthermore, many recent epidemiological, clinical and experimental data suggest that these male reproductive disorders could be due to the effects of xenobiotics termed endocrine disruptors, which are becoming more and more concentrated and prevalent in our environment. Among these endocrine disruptors, we chose to focus this review on the phthalates for different reasons: 1) they are widespread in the environment; 2) their concentrations in many human biological fluids have been measured; 3) the experimental data using rodent models suggesting a reprotoxicity are numerous and are the most convincing; 4) their deleterious effects on the in vivo and in vitro development and function of the rat foetal testis have been largely studied; 5) some epidemiological data in humans suggest a reprotoxic effect at environmental concentrations at least during neonatal life. However, the direct effects of phthalates on human foetal testis have never been explored. Thus, as we did for the rat in the 1990s, we recently developed and validated an organ culture system which allows maintenance of the development of the different cell types of human foetal testis. In this system, addition of 10-4 M MEHP (mono-2-ethylhexyl phthalate), the most produced phthalate, had no effect on basal or LH-stimulated production of testosterone, but it reduced the number of germ cells by increasing their apoptosis, without modification of their proliferation. This is the first experimental demonstration that phthalates alter the development of the foetal testis in humans. Using our organotypic culture system, we and others are currently investigating the effect of MEHP in the mouse and the rat, and it will be interesting to compare the results between these species to analyse the relevance of toxicological tests based on rodent models.
γ-Butyrolactone (GBL) is a popular drug of abuse which is easily available over the internet. Following a UK classification change to a class C drug in January 2010, internet supply has become difficult. Some of the effects have resulted in sourcing GBL from industrial solvents. We report a case of a 24-year-old man who was admitted for detoxification from GBL. He reported having sourced the GBL by diluting the contents of nail varnish remover pads with water. During his admission he developed a severe withdrawal delirium and acute renal failure. He required admission to the intensive care unit. Physicians and psychiatrists should be aware of toxic sources of GBL leading to renal failure and consider GBL in those presenting with agitation, psychosis or coma.
This is part of a series of review articles on formaldehyde-releasers and their relationship to formaldehyde contact allergy. Formaldehyde-releasers used in metalworking fluids (MWF) and a group of releasers not presented in previous articles are discussed. Here, in Part 1 of the article, there is a short overview of the composition and functions of MWF, the function of biocides in them, and adverse reactions to MWF. In addition, the releasers in MWF that have caused contact allergy are presented with CAS, synonyms, molecular formula, chemical structure, applications, patch test studies, and amount of formaldehyde released by them. In Part 2 of the article, the relationship between formaldehyde-releasers used in MWF and formaldehyde contact allergy is discussed as are data on miscellaneous releasers not previously presented, followed by a discussion of Parts 1 and 2 of the article.
Rapid industrialization and urbanization release several chemicals such as phthalates into the environment and cause adverse effects on reproductive system, mainly endocrine disruption, testicular injury and decline in semen quality in humans. There are no reports in extrapolating of the epidemiological data with in vitro findings. Our study show the correlations between in vivo studies and in vitro data for the effect of phthalate esters. Healthy human males, in the age group 21 to 40 years, visiting Chhatrapati Sahuji Maharaj Medical University (CSMMU), Lucknow, as part of infertility investigation, were recruited as volunteers. Semen analysis was performed according to the WHO guidelines. Phthalate esters were analyzed by high-performance liquid chromatography (HPLC) and cell viability by MTT assay. In the in vitro studies, sperms were exposed to highest concentration in semen samples (5-10 times higher) for a period ranging between 30 min and 96 hours. An inverse relationship with sperm motility in epidemiological studies was concurrent by significant dose-and time-dependent decrease in the sperm motility under in vitro environment after 12-hour exposure. Cytotoxicity was observed only with the highest concentration after 96 hours of exposure. There are a significant correlation between phthalate ester diethylhexyl phthalate, di-n-butyl phthalate (DEHP and DBP) and sperm motility both in vitro and in vivo conditions. Additionally, in vitro experiments conducted not only adjunct to the existing in vivo data but also specify the effect of specific toxicants (DEHP and DBP) on sperm motility and viability. Results show the decrease in motility of sperms under in vitro conditions at the maximum range of in vivo measured levels and 5- or 10-folds higher to that found in human semen samples.