Nail Salon Safety: Expert Tips

When you go to a salon for a manicure or pedicure, you’re probably thinking about how nice your nails will look. However, these treatments can cause problems, some of which are serious, disfiguring, and long-lasting.

Your best bet? Keep things simple.

“There are so many types of manicures, and they’re constantly coming up with new things. But for the long-term health of your nails, regular polish is the safest bet,” says Brian Morrison, M.D., a dermatologist with the University of Miami Health System. “I recommend that my patients stick with a classic coat of polish because other more complex techniques are more likely to provoke allergic reactions or damage your nails.”

Choose your nail salon carefully.

“Use common sense. First, look at the cleanliness of the place. If the floor is a mess, they are probably not maintaining their equipment either,” says Dr. Morrison. You should see clean workstations, clean uniforms, and correct sterilization techniques used with the tools. Salons need to wash instruments and treat them with steam to sanitize them. Some people bring their own instruments to the salon.

Clean your feet and wash your hands before treatment. Make sure your nail tech washes their hands too. Check the salon’s reviews and ask friends for recommendations. 

A nail problem is only sometimes a fungus.

With nails, everyone thinks that when something goes wrong, it’s a fungus. Often, that’s not the case; it’s something else. Many things can make a nail ugly.
– Dr. Brian Morrison

At least once a week, he says, a patient comes in thinking they have a fungus when it’s something else, such as an allergy to the chemicals in a gel manicure.

It can be an allergy, an inflammatory response, or a problem caused by manipulation of the nail that was too forceful. Rough handling can lead to the hard, top part of the nail lifting. “Technicians sometimes dig and dig under the nail, thinking they are cleaning but there is zero benefit to that,” he said. 

To correctly address any problem, see a dermatologist. They can give you an accurate, specific diagnosis. The doctor can scrape a little bit of material under the nail and study it under a microscope to identify it. Or they can send a clipping to a lab.

“You want to be sure you’re treating the right thing, not treating fungus when it’s not a fungus,” Dr. Morrison says.

If you have a nail fungus, be warned: available treatments have low success rates.

“There are several different treatment options. But the best thing we have, a pill that you take every day for three months, only works around 60% of the time,” says Dr. Morrison. The medication, terbinafine, is only available by prescription. 

If you take terbinafine, don’t stop at the first sign of the fungus clearing. Continue treatment for the whole period for which it was prescribed, or the fungus may re-emerge.

“If the medicine doesn’t work the first time, you can do a repeat treatment. Every time you take it, there’s still a chance the fungus will clear up,” says Dr. Morrison.

There are two other often-prescribed antifungal pills, itraconazole and fluconazole (although the latter is not FDA-approved to treat nail fungus).

Many patients hesitate to take a drug orally. There are externally applied fungus treatments as well. Ciclopirox is one often-used topical treatment. Efinaconazole (brand name Jublia) is another. “Jublia is very expensive, and it works around 15 to 20% of the time. The topical therapies just aren’t very efficacious,” says Dr. Morrison. 

Applying vinegar, a simple home remedy for discolored nails, often works for bacterial infections.

“I recommend vinegar all the time,” says Dr. Morrison.

Some approaches involve soaking the nail in vinegar or a vinegar solution. Another less tedious approach is to put on thick, clean white socks and moisten the area above the damaged nail with plain white vinegar. Wear them until the moist area dries up.

Gel manicures can provoke severe allergies.

Speedy drying and durability are advantages of gel manicures. In contrast, a traditional nail polish takes about 30 minutes to air dry initially (Completely dry in 1-2 hours). During that time, the polished nails can still be smudged or nicked. Gel polishes dry quickly by exposing the nails to bulbs that produce ultraviolet (UV) radiation or light-emitting diodes (a specific bulb type).

To create a gel manicure, the manicurist applies usually three different products. There’s a gel base coat, the actual polish containing the color, and a gel topcoat.

“Gels look really nice. They last a long time, but they contain a chemical called methacrylate. This is a common allergen, and if you are allergic to it, your nails will become a disaster,” says Dr. Morrison. In these situations, the nail plate will often lift up from the nail bed, creating a problem called onycholysis.

“I often see patients who are allergic to the gel polish,” he says. The first time it happens, he prescribes anti-inflammatory creams, and the nails return to a healthy condition. “But these people should not get gels ever again,” he says.

If a person keeps getting gels applied and they provoke an allergy, the nail can stay lifted. This will leave it vulnerable to infection. The nail may fall off.

Regular nail polishes also contain chemicals that can provoke allergies, such as formaldehyde. However, the reactions to formaldehyde tend to be fairly mild, such as redness, itching or peeling skin in the area around the nails or on the hands or feet.

Dips can do damage too.

“Dip manicures have also become very popular,” Dr. Morrison says, but he warns against them. For a dip manicure, the nail technician brushes your nails with glue. Then, you dip your nails into colored powder, or the powder is sprinkled on. You shake off the excess powder, and the steps are repeated several times.

One problem is “double dipping,” which happens when several people dip their hands into the same powder. One way to avoid this unsanitary practice is to request that the powders be sprinkled on instead.

Another big problem with dips involves the preparation and removal techniques. Nail technicians often use e-files. These tools use a spinning, round abrasive end that is run over the nails to rough them up so the glue will adhere firmly to them. After the electric roughing, the nail tech will use manual files to roughen the nail surfaces further, which can thin and weaken the nails.

“Removing a dip manicure is also very damaging. You wind up with thinner, rougher nails after a dip,” says Dr. Morrison.

UV light promotes skin cancer.

Exposing your hands to UV radiation during the drying phase is another problem with gels. Although UV rays do not penetrate the hard part of the nail well, the radiation damages your DNA and increases your risk of cancer in the exposed areas of the skin.

The Skin Cancer Foundation lists getting a gel manicure as one of the top five “sneaky” situations in which people are exposed to high levels of UV rays without thinking about the risk. They advise skipping or minimizing how long your hands are exposed to UV or LED drying lamps.

If you do still opt for a gel manicure, put sunscreen on your hands 20 minutes before the drying begins.

If you forget to apply sunscreen in advance, be aware that mineral sunscreens that contain zinc and/or titanium start working faster than products without minerals. Another option is to wear fingerless sun-blocking gloves while the gel dries.

With a regular manicure, the safest approach is to allow nails to air-dry naturally or use a mini-fan, which many salons have available.

Acrylics involve potential problems as well.

Acrylics are fake nails created from a chemical paste made of powders and liquids. The mixture adheres to your natural nail, and the technician molds it into different shapes. After the fake nail dries in the air and hardens, the technician can file and polish it.

Like gels, acrylic nails involve risks, including damage to your skin, nails and overall health. Chemicals in acrylic nails can make your natural nails thinner and weaker. Plus, the chemicals used to apply and remove the nails can irritate your skin or provoke allergies.

Acrylic nails can cause a common allergic reaction called contact dermatitis.

This can be triggered by many products. It’s common, affecting up to one in five people.

“If you’re allergic to the chemicals in acrylics, the skin around your nails may peel or crack or become dry, itchy or red,” says Dr. Morrison. Sometimes, contact dermatitis leads to problems far away from the site of the initial exposure. For instance, the thin skin on your eyelids may be affected before the thicker skin surrounding your nails.

“The steps that the technician takes to apply and remove the acrylics can also cause harm,” he says.  To attach the fake nail, the technician will rough up your own nail, which can weaken it. Removal involves soaking your nails in acetone, a strong chemical that can leave your nails brittle, dry and more prone to crack and break.

Your cuticles: the unsung protector of your nail health

The cuticle is a thin band of clear skin running along the bottom edge of each fingernail and toenail. The delicate cuticles have an important job. “The cuticle is there to create a seal that doesn’t allow anything underneath the nail fold, to protect the growing nail,” says Dr. Morrison.

The nail folds are the areas of skin that border your nail on the sides and bottom. The folds are connected to the cuticles, which in turn are attached to the nails. The bottom cuticle overlaps the hard nail and often touches a whitish crescent at the base of the nail called the lunula, because it resembles a little moon. These “little moons” are not always visible, and some people can only see them on their thumbs, but they are there even if hidden.

The folds hold the nail in place and protect it while it grows. The folds and cuticles work as a team to keep bacteria and fungi from infecting your nails. They also protect the nail from outside irritants which could inflame it. 

“Your cuticles also prevent the deposit of things like preservatives and other chemicals in soaps and lotions, things you don’t want under your nails,” says Dr. Morrison. If the cuticles become infected or damaged, the healthy growth of your nails can suffer.

Ensure your nail technician uses reasonable restraint in handling your cuticles. Although manicurists often cut clients’ cuticles, this is a bad idea. Have the technician gently push back your cuticles with an orangewood stick instead.

Nail cleaning? Gentle is better.

“I discourage cleaning aggressively under the nails which can lift the nail plate and start a cascade of problems,” says Dr. Morrison. 

Also, if you have brittle nails, he suggests that you ask the technician to use a glass file rather than a metal one since glass files are somewhat less abrasive. “You don’t want to break the already brittle nails,” he warns.

“At the nail salon, less is more; don’t do too much. Don’t overdo it. Everything in moderation. This is no different,” says Dr. Morrison.

Milly Dawson is a contributor for UHealth’s news service.

Tags: dermatology, Dr. Brian Morrison, fungal infection, polish is applied, top coat