Fingernail : Nail Infections, Allergies and Other Hazards

by Food and Drug Administration (FDA)

(Page 2 of 3)

Nail Infections

More common nail problems, dermatologists report, are infections from bacteria, such as Staphylococcus; fungi, such as Candida (also known as yeast); and skin viruses, such as warts.

Bacterial and fungal infections frequently result from artificial nails, whether applied at home or in a salon. A bump or knock to a long artificial nail may cause it to lift from the natural nail at the base, leaving an opening for dirt to get in. If the nail is reglued without proper cleaning (with rubbing alcohol, for example), bacteria or fungi may grow between the nails and spread into the natural nail.

Also, as the natural nail grows, an opening develops between the natural nail and artificial nail. If this space is not filled in regularly, it can increase the chances for infection.

A fungal infection can take hold when an acrylic nail is left in place too long — such as three months or more — and moisture accumulates under the nail.

Bacterial, fungal and viral infections also can occur from using insanitary nail implements, especially in a salon, where the same implements are used on many people.

Unclean implements are especially dangerous if the skin around the nail is broken. This can occur with overzealous manicuring — if, for example, too much of the cuticle is cut or pushed back too far. If the cuticle is cut or separated from the fingernail, infectious agents can get into the exposed area. This is why dermatologists recommend leaving cuticles intact.

Symptoms of an infection include pain, redness, itching, and pus in or around the nail area. Yellow-green, green, and green-black nail discolorations are signs of a Pseudomonas bacterial infection. A blue-green discoloration signals a fungal infection.

If an infection appears while wearing artificial nails, they should be removed and the area cleaned thoroughly with soap and water. If symptoms persist, the person should consult a doctor, who may prescribe a topical or oral anti-infective medicine.

There are no approved nonprescription products to treat fungal nail infections, and over-the-counter products to treat other types of fungal infections should not be used for nail infections. In a review of OTC antifungal products, FDA found that fungal infections of the nails respond poorly to topical therapy, partly because of the nail's thickness. So, in 1993, the agency ruled that any OTC product labeled, represented or promoted as a topical antifungal to treat fungal infections of the nail is a new drug and must be approved by FDA before marketing. This rule, which went into effect in 1994, does not include prescription antifungal products.

Despite the rule, some companies continue to sell unapproved OTC nail products, such as nail glues, with antifungal claims. FDA has warned these companies it might take legal action if they don't stop selling the products.

Allergies and Other Hazards

Other common problems associated with nail products are allergic reactions, such as contact dermatitis, a skin rash characterized by redness and itching and sometimes tiny blisters that ooze.

Certain nail ingredients are known for their tendency to cause allergic reactions. Residual traces of the basic building blocks of acrylic resins ("acrylics") used in artificial nails, for example, can cause redness, swelling and pain in the nail bed. In some cases, the reaction is so severe that the natural nail separates from the nail bed, and although a new nail usually grows in, it may be imperfect if the nail root has been damaged.

Nail strengtheners that contain "free formaldehyde" may cause an irritation or reaction, as can certain other chemicals in nail glues and polishes.

In the late 1970s, use of methyl methacrylate, then a common ingredient in artificial nail products, resulted in FDA receiving a number of reports of injuries and allergic reactions, including damage and deformity of fingernails and contact dermatitis. The ingredient now is rarely used because of legal action against a former manufacturer of methyl methacrylate-containing products and numerous seizures and recalls of such products. Methyl methacrylate has since been replaced with other chemicals, such as ethyl methacrylate. However, according to John Bailey, Ph.D., acting director of FDA's Office of Cosmetics and Colors, the replacement chemicals have never been fully studied for safety, and they may be as harmful as methyl methacrylate.

"Our current guidance is that products containing ethyl methacrylate should be used only by trained nail technicians under conditions that minimize exposure and skin contact because of their potential to cause allergies," he said.

Whatever the cause, allergic reactions usually take place where the product has been applied or where it has inadvertently come in contact with other skin surfaces, such as the face, eyelids and neck.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.