I LOVE my Gel Manicures! But should I worry?

I LOVE my gel manicures!  Lasting at least two weeks, gel manicures have finally made my pincers look pretty!  Like many of you, I had been wondering about the safety about the UV lamps that are used to cure the gel manicures.  They seem fairly benign, but there has been some press questioning its safety. nail polish

When I read a recent issue of JAMA Dermatology, I was relieved to read that the authors concluded that the risk of skin cancer was very very low with gel/UV manicures, even with regular use.  This is what I suspected, so I stopped worrying.  Additionally, my salon recently introduced an LED nail lamp, which also seemingly solved the issue of the UV lamp.

Well, imagine my surprise when this topic came up again at the most recent American Academy of Dermatology Annual Meeting.  Nail expert Dr. Chris Adigun reopened my concerns about the safety of UV lights. She argued that the lamps are notoriously variable in their UV exposure, nail salons hardly ever follow manufacturer recommendations, and that the UV exposure is more than we previously thought.

This really left me conflicted, since I adore my gel manicures, and I really hadn’t prepared myself to abandon them anytime soon. So I took it upon myself to read through all the relevant articles on the subject (I hate taking someone else’s word for it).  Luckily, several groups have studied a variety of nail lamps, with a variety of hand positioning and exposure times.

Here’s the summary:

The amount of UV exposure is WAY below anything close to skin-cancer-causing levels.  

Here are a few other important take-away points:

  • Out of 72,709 women getting regular manicures for 60 years (assuming generous exposure times), only one woman would develop skin cancer who wouldn’t otherwise (in statistics, this is called the “number needed to harm”).
  • It would take 250 years of weekly gel manicures to equal that of a therapeutic phototherapy session that I commonly prescribe for psoriasis (15–30 treatments over 5–10 weeks).  (Yes, phototherapy is often UVB, rather than UVA, but this JID study measured UV dose in J/cm2, and gives a risk comparison to something we already know to be safe).

From a skin cancer perspective, the risk of skin cancer from nail curing lamps is very low.  However, it is important to note that ALL lamps used to cure gel manicures emit UVA radiation, even the LED lamps.  Despite the lack of “UV” in the name, LED lamps are actually more intense than UV lamps and emit more UVA.

As a quick review: UVB rays cause sunburn and skin cancer, while UVA rays penetrate deeper into the skin, causing skin aging, cell damage, sun spots, and wrinkles by breaking down collagen and elastin (and to a lesser degree than UVB, also contribute to skin cancer).

UVA UVB infographic
UVA penetrates deep into the skin to affect collagen and elastin, causing wrinkling, blotchiness, and poor skin tone.
UVA radiation is responsible for the brown spots (“liver” spots or “sun” spots) on your grandmother’s hands, as well as the wrinkles and crepiness of the skin.

There’s nothing worse than a youthful face that has been preserved with good skin care, but “old” looking hands.  

While the risk of skin cancer is much less than ambient exposure to natural sunlight, the cumulative effects of UVA exposure can result in discoloration and premature aging of the skin.

 

Aging hands
The typical appearance of a photoaged hand.  Note the blotchy appearance of the skin, brown spots, and thinned skin overlying the veins and tendons of the hand.  This occurs with regular exposure to UV light, especially UVA, which is emitted in all nail curing lamps and penetrates windows.
So your gel manicure won’t significantly increase your risk for skin cancer, but why risk any UV exposure?

For the very sake of preserving the youthful appearance of your hands, I recommend at least the application of a broad-spectrum sunscreen with an SPF of 30+ (see here for recommendations), or sun gloves while having your hands in the lamp.  My feeling is the gloves are better.

  • I use these sun gloves made by BloxSun– I wear them driving and bring them to the salon. 
  • Screen Shot 2016-02-08 at 1.14.25 PM
  • YouVee sunshields are currently crowdfunding – they are very cheap disposable hand protectors that block 99% of all UV radiation.  Wouldn’t it be great if salons started carrying these?
    2e0973_49bb9c8432144cb7809de96894bdcdf2

 

In summary, I’m going to keep getting my gel manicures (thank goodness)!

For many of us women on-the-go, the gel manicure is here to stay!  Just be sure to protect those hands! And as with anything, it’s good to take a break once in a while from manicures to give your nails a breather.

Dr. Jackie Dosal is a practicing dermatologist in Miami, FL at the University of Miami and Skin Associates of South Florida.  

 

References

Shipp et al.  Further investigation into the risk of skin cancer associated with the use of UV nail lamps.  JAMA Dermatology 2014;150(7):775-6.
Diffey BL.  The risk of squamous cell carcinoma in women from exposure to UVA lamps used in cosmetic nail treatment.  British Journal of Dermatology 2012;167:1175-1178.
Markova A, Weinstock MA.  Risk of skin cancer associated with the use of UV nail lamp.  Journal of Investigational Dermatology 2013;133:1097-1099.
Macfarlane DF, Alonso CA.  Occurrence of non melanoma skin cancers on the hands after UV nail light exposure.  JAMA Dermatology 2009;145(4):4479.
Curtis J, Tanner P, Judd C, Childs B, Hull C, Leachman S.  Acrylic nail curing UV lamps: High-intensity exposure warrants further research of skin cancer risk.  J Am Acad Dermatol 2013;69(6):1069-70.
Dowdy JC, Sayre RM.  Nail curing UV lamps: Trivial exposure not cause for public alarm.  J Am Acad Dermatol 2015;6(64):e185-6.
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