Love That Gel Nail Polish, But Know It Doesn't Come Risk-Free

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Just last week a friend told me about a gel polish manicure that stayed flawless through two weeks of mucking out stables and dish washing. Since I'm lucky if I get through a day without ruining polish, this seemed like a technological breakthrough.

Then I saw a report in Wednesday's JAMA Dermatology investigating whether the ultraviolet light used to dry gel nails causes skin cancer. I decided I'd better find out a bit more before I paint.

This isn't a totally loony question. In 2009, the same journal reported that two women got skin cancer on the backs of their hands; they both used UV nail lights. But there's no evidence that the lamps caused their cancers.

"No one had actually studied the lamps themselves," Dr. Lyndsay Shipp, the lead author of this week's report and a dermatologist at Georgia Regents University in Augusta, told me. "We thought we could add something to the puzzle."

Shipp measured the amount of UV coming out of nail dryers at 16 different salons. Overall the amount of UV was very low, but it varied a lot from one machine to another. It also varied within the devices. "My pinkie finger might be getting a different amount than my thumb."

Her conclusion: Because of the low UV levels, the skin cancer risk even from repeated salon visits remains small.

But that doesn't mean the polishes get a free pass, according to Dr. Chris Adigun, a clinical assistant professor of dermatology at NYU Langone Medical Center.

"The problem is there's no regulation of nail lamp exposure," Adigun told me. "For patients who aren't concerned about the melanoma risk, do know about the photoaging that comes from UV exposure."

In other words, my nails might look great now, but extra UV exposure speeds my hands toward wizened lizard status.

Adigun knows that even the threat of lizard claws probably won't discourage women from gel manicures. Last year she gave a lecture on health issues with gel nails at the American Academy of Dermatology meeting, and the nail industry was not amused. "It caused a whole hullabaloo." Her mother wasn't amused, either; it turns out she's a major gel polish fan.

To protect the hands, Adigun recommends wearing sunscreen during UV nail sessions, as well as photoprotective gloves with the fingertips snipped off. "That's what I gave my mom for Christmas."

UV exposure is a bigger issue for people who work in nail salons, because they're there all day. And that applies not just to skin but also to eyes.

Ultraviolet exposure is a main cause of cataracts, and probably contributes to macular degeneration, which is a leading cause of blindness in older people.

That's why Dr. Zoe Diana Draelos, a consulting professor at the Duke School of Medicine and a dermatologist in High Point, N.C., thinks that when you're at the salon, you should wear "appropriate eye protection," such as sunglasses that provide protection from ultraviolet.

Then there's what happens after that superdurable polish comes off, which requires soaking in acetone for 15 minutes. The polish blocks oxygen transfer through the nail, and nails can emerge discolored and thin. Draelos says she has seen cases where a person's nail has separated from the nail bed, or has turned green due to infections that were hidden by the polish.

That's true for artificial acrylic nails, too, Draelos says.

"I tell my patients to never wear them for more than three months consecutively," she says. "That allows oxygen transfer to be re-established and improves the health of the nail."

Once the polish comes off, the doctors recommend using protective ointments to help nails recover.

Still, none of the dermatologists said that gel manicures should be avoided completely. Rather, they said, be sure to take breaks and be prepared to give nails some extra love.

"It's the manicure for the working woman, it really is," Adigun says. "I'm very sympathetic to making this manicure work in women's lives."