The Dermatologic Hazards of Nail Product Usage

October 2025 | Volume 24 | Issue 10 | 9039 | Copyright © October 2025


Published online September 8, 2025

doi:10.36849/JDD.9039

Emma Scott BSa, Dirk M. Elston MDb, Craig G. Burkhart MD MPHc

aDepartment of Medicine, University of Toledo Medical Center, Toledo, OH
bDepartment of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC
cOhio College of Osteopathic Medicine, Athens, OH

Abstract
The major dermatologic adverse effect of nail polish that has been reported is an allergic contact dermatitis. This can within the ungual and periungual region, but it can also be diffuse and spread along the face, chest, trunk, and arms. The purpose of this paper is to explore the dermatologic impacts, especially allergic contact dermatitis, secondary to nail product use. This paper aims to increase awareness of possible dermatologic risks of nail product use and encourage consumer safety.1

J Drugs Dermatol. 2025;24(10): doi:10.36849/JDD.9039

INTRODUCTION

Allergic contact dermatitis is a type IV delayed hypersensitivity. It is triggered by contact with an allergen by individuals who have been previously sensitized via allergen-specific T cell activation. If the allergen triggering allergic contact dermatitis is not found and eliminated, the dermatitis can become chronic, which can significantly decrease the patient’s quality of life. For example, allergic contact dermatitis can lead to long term workplace leaves of absence negatively impact the socioeconomic state of the patient. UV nail light radiation exposure and damage to the nail bed itself are also dermatologic concerns of nail product use.1

Composition of Nail Polish: Toxic Ingredients and Their Potential Effects

Dermatological Impacts of Nail Polish

Allergic contact dermatitis is the most studied adverse effect from nail polish. This has been documented as early as the 1940s and 1950s. Symptoms include paronychia, subungual swelling, severe pruritus, nail dystrophy, scaling, vesicular dermatitis,1 thickened and dried nail plates, and hemorrhagic onycholysis with complete nail detachment.2 Additionally, allergic contact dermatitis can lead to fingertip eczema, onychodystrophy, onycholysis, and leukonychia. Allergic contact dermatitis secondary to nail product use can also be seen in other anatomic locations including the dorsum of the hands, face, eyelids, and trunk3 due to hand transfer. In fact, a study on periorbital eczema found that 4% of the patients studied had periorbital dermatitis due nail polish use. Allergic contact dermatitis usually presents 7-10 after current exposure. Patch testing is the standard diagnostic and confirmatory test for allergic contact dermatitis-causing allergens.2

Allergic contact dermatitis from traditional nail polish may be due to the toluene/formaldehyde resin, formaldehyde, polyester resin, pigments, or nitrocellulose. The most common allergen being tosylamide/formaldehyde resin.3 In fact, 4% of positive patch tests involve sensitivity to toluene/formaldehyde resin.2 Allergic contact dermatitis due to toluene/formaldehyde resin can involve the head, neck, nose, ears, and eyelids. Allergic contact dermatitis secondary to phthalic and trimellitic anhydride/glycols copolymer, which is present in traditional nail polish typically presents on the head and neck but there are cases of the dermatitis affecting the face, neck, and periorbital area as well as swelling of the eyelids that can last several months.3 Additionally, allergic contact dermatitis is the most common cause of eyelid dermatitis, causing 46-74 cases of eyelid dermatitis.4

Methyl Methacrylate (MMA) is the monomer used with acrylic nails, but MMA has been found to cause severe contact dermatitis as well.1 In fact, there has been a global allergic contact dermatitis from (meth)acrylic monomers (ACDMA) epidemic over the past 10 years, and nail polish has been identified as a trigger to this epidemic. Nail technicians, nail salon patrons, and at home nail product users have been identified as having ACDMA. Methacrylates are also present in dental materials, prostheses, and glucose sensors and while data on the immediate and long