Recently I had a fascinating and important conversation with Prof. Albert Feilzer, affiliated as material expert at the dental (training) center ACTA in Amsterdam, about his increasing concerns in respect to acrylate allergy.
Irreversible complaints
Plastics based on acrylates are widely used in nail styling (gel polish, gel nails and artificial nails) and by the dentist for making white fillings and dentures.
Dermatologists internationally have already hit the alarmbutton that a tsunami of acrylate allergy is coming up. Also Professor Feilzer thinks that this is a worrying development.
The breathing problems and skin complaints are irreversible. An allergy to acrylates you cannot undo. So after you developed an allergy to acrylates, there is no space for gel nails, but also no more crowns, or even a cemented artificial knee. Increasing sensitivity to 2-hydroxyethyl methacrylate (HEMA) develops, which is used in fillings and crowns, and on an even larger scale in gel and artificial nails.
Substances from the petrochemical industry
In his office on the eleventh floor with a beautiful view over Amsterdam-Buitenveldert, he first sketches a more general picture. A doomsday scenario for our health that we owe to the emergence of at least 20 thousand new substances from the petrochemical industry during the great growth in prosperity in the 50s. ‘Our body, as Darwin puts it from his theory of evolution, has not had time to get used to it for thousands of years. It can make us sick,’ says Feilzer.
The relationship between disease and the mouth
He continues: ‘We are surrounded by modern chemicals that are often also toxic or allergenic. From perfume sprays in the toilet to flavor enhancers and much more.
‘As a professor of dental material science (he started his career as a dentist, ed.) I was increasingly confronted with questions from dentists about the relationship of materials in the mouth (such as amalgam) in relation to diseases.
‘This increased because people consulted alternative healers who had a focus on what goes on in the mouth, and the relationship with disease. It has led to an ‘allergy consultation hour’ at ACTA. Dentists and doctors refer their patients to allergy consultation hour when they suspect that the complaints are caused by materials present in the mouth.
Allergy consultation hour
‘At the allergy consultation hour, people come with a wide variety of health complaints such as dry mouth, mucosal problems, eczema, fatigue, and so on. Gradually, in collaboration with the Amsterdam UMC, we have been able to improve our tests more and more.
‘For example, we noticed that many patients with palladium in crowns had many complaints, but that the allergist’s test gave a false negative result. Together we have developed new better test salts. If crowns contain substances for which it has been shown that one is allergic are removed, very often, but not always, the symptoms decrease.
‘Think about the wire that you get behind your front teeth after orthodontics, which often contains 10-12% nickel and can give cycle-dependent pimples in your face when you are allergic to nickel. As soon as we removed those wires, those pimples didn’t come back. A crown with nickel in your mouth? That can give eczema to hands and feet. A doctor generally does not look into the mouth….. and they are often not aware of this process.
No more white fillings or crowns
‘And so during time, you broaden your view more and more when people come up with problems. In case of plastic allergy, acrylates play the leading role. If you used to be allergic to shellac, in regular nail polish, I was less worried about that. But acrylates in gel nails is another story that has major consequences for a number of medical treatments.
‘Once that allergy is a fact, you will never be able to have white fillings, but also no dentures. Not even a cemented knee prosthesis or an acrylic-based skull roof implant – should that be necessary after an accident. Think about it! As a young woman you only want to have beautiful nails, but that it can end in a situation where many types of medical treatments are no longer an option.
Non-healing fissures and asthma attacks
An acrylate allergy can manifest itself locally in bleeding fissures of the fingers, red fingers or cheeks, eczema symptoms with redness and systemic in asthma-like breathing problems.
Feilzer emphasizes that you can also get this with a dental treatment, but there is a micro-exposure because the dentist works as hygienically as possible and can also use a rubber patch around the tooth to prevent exposure in the surrounding tissue. So becoming allergic to acrylates via a dental treatment is therefore extremely rare.
The liquid is the worst
Albert Feilzer: ‘I am particularly concerned about the large amounts of acrylic that nail stylists use. They exposed themselves to it on a daily basis and their customers weekly or monthly.
‘The main topic is that they work with liquid that is applied directly to the nail and often also reaches the surrounding tissues. In addition, acetone is used to soften the gel on the nail during removal. This releases a lot of ‘residual monomer’, which can cause an allergy via the skin.
Female dentists with gel nails
Feilzer also sees a relationship between dentists and the nail industry, because more and more women are becoming dentists (it is estimated that in the near future 70% will be women) and they also wear gel nails in large numbers. If a dentist has become allergic to acrylates, he/she has actually become incapable for work. That’s a huge threat ……
Gloves do not protect
In order to be able to learn more about this problem, Albert Feilzer became a member of the private Facebook group for ‘nail technicians’ and learned that it was not easy to create awareness to this profession about health risks.
They think that if you have become allergic, you can easily switch to another brand. However, there is only one solution for the problem: stop using gel and sticky nails.
Feilzer: ‘Also the advice they gave each other is misleading. For example, wearing gloves. That hardly makes sense! Gloves are waterproof but not against plastics. The plastic material goes through it and your hands sweat in those gloves. So it softens the skin and makes the water-loving plastic fabric easily to penetrate.
‘Ultimately, it leads to the fact that you can become allergic even faster.’
1 out of 1000 dentists have it
To my question how many people are now walking around with an acrylic allergy, he cannot directly answer. But he knows that it happens regularly among dentists, and that they really have to stop their work. ‘My estimation is that 1-2 out of 1000 has become allergic. That’s quite a bit when you know that we have ten thousand dentists in the Netherlands. ‘
The biggest exposure gets the customer in the nail salon
‘We now advise dentists in training to change gloves immediately as soon as they are contaminated with plastic. That should also be the urgent advice to nail stylists. But the customers ….. they sometimes sit in the nail salon with their fingers wrapped in foil to soften the nail gel with acetone. For them, the exposure is inevitable!’
Once it was three a year, now it’s 1 per week
Albert Feilzer was used to see a patient with a plastic allergy two to three times a year and now it’s really every week. They are sent by the dentist or dermatologist because they get acute complaints as soon as a filling is made in the mouth. Half of these patients wear or wore gel or artificial nails.
Facts and fables
When I look for articles about acrylic allergy and gel or artificial nails, I notice that some advice is keep coming back: you have to be careful with damaged cuticles and make sure that the gel polish must be well dried and hardened. Feilzer looks at me shaking his head and says, ‘That paint has never really hardened properly. There are always residues of monomer in it, and that leaks out.’
Gel nails even worse than artificial nails
The message that gel nails are ‘healthier’ than artificial nails is also based on inaccuracy. ‘Gel nails are even worse because of the thick layer of plastic used for gel nails.’
Symptoms? Stop immediately…….
When I ask if there is no hypoallergenic material, the answers is negative. ‘It would be great of course but I once spoke to a director of a factory in nail polish materials. He told me that he couldn’t even walk into his own packaging department without having an asthma attack. If you have the symptoms, you really have to stop using these materials immediately. There’s nothing else on it and no escape.
After flu suddenly allergy …. how does that work?
Is there a trigger for the manifestation of this allergy? Feilzer tells me that it can go well for years, and then your immune system is suddenly heavily burdened. For example by a big flu and the chance increases that an exposure to allergenic materials ends up in a real allergy.
‘And I see that much more often: after an overwhelming or continuous stimulation of the immune system, all kinds of complaints can arise that you did not have before. Whether it’s nickel in crowns, gel nails, silicone breast implants or maybe even a Covid vaccination? …. we still do not know a lot in this area and a lot of research has to be done to get more insights.’
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1 reactie
I cant not react to this post:
“Dr Feilzer says “‘The main topic is that they work with liquid that is applied directly to the nail and often also reaches the surrounding tissues. In addition, acetone is used to soften the gel on the nail during removal. This releases a lot of ‘residual monomer’, which can cause an allergy via the skin.””
The ‘liquid’ applied to the nail, if applied properly should never reach the surrounding tissue, 35+ years ago when I started in this industry we trained and trained and trained with liquid and powder acrylic systems that contained MMA (now banned, but back in the day it was all we had to work with) – Day in day out, making little balls of product on plastic sheets, if we could not create the perfect acrylic bead, we were not allowed to apply the product to human nails. – Allergies were not a problem because we had complete control of our brush AND our product for color we used nail varnish.
Anno 2000 whatever when you tube became a thing, it all looked so easy on the video – so everyone thought they could do it – no practice, no knowledge about the nail unit and no knowledge about the chemical content of the products – Today I can still hear my instructor in my head – Education is hypoallergenic – not the products!
A soft gel product that needs to be soaked off was introduced as a revolution and that it was, amazing stuff – the company that started the trend worked hard on education – explaining that the health of the natural nail needed to be maintained and also the surrounding skin, that reduced the probability of an allergy significantly and the product was not available without training. We did however see a problem starting to happen, that was the development of White Superficial Onychomycosis on the surface of the nail plate, WSO is an opportunistic pathogen – if we damaged the upper layer of the nail plate during removal by scraping our product off of the nail with too much pressure while the nail was softened from the soak off process WSO had a surface to develop on and when we reapplied the product on those (sometimes still damp) nail plates we created a cozy place for it to develop. We learnt how to deal with that problem and now only if nail plate maintenance is neglected do we see it.
But in an 80-billion-dollar market the world wanted soak off products so – EVERYONE joined the ball game – and sold product to ANYONE who wanted it – imagine, in the Netherlands alone there are more than 20.000 nail techs, some pro’s, some hobbyist and some just because they don’t want to pay a pro to do their nails.
If soaking off gel products was not safe after a 90% cure it would be removed from the market, it hasn’t been, and it won’t be in the future but, convincing the industry that you cannot sell a product to a consumer without proper training is exhausting, when the money is in the bank it’s easy to wash your hands of responsibility. On the other hand, the consumer wants instant results, and no one ever told them that products that look so very pretty, pinks, blues, golds and glitters of all shapes and sizes could be harmful to their health even if there is a little sticker on the products that says ‘for professional use only’– the connection just isn’t there.
There is one more problem, when problems do occur, the client doesn’t want to ‘upset’ the nail tech, the nail tech doesn’t want to ‘upset’ the supplier and the same for the ‘consumer’ she doesn’t want to upset the supplier because she has professional products that she used at the kitchen table with no education and my working day is spent trying to help solve problems after the fact – its impossible, there is nothing I can do to reverse an acrylate allergy – I can only treat the symptoms. Every day one or two cases, everyday I say the same thing – Education, education, education.
How sexy is education? It’s not – Red Gel Polish is, spending money on new color collections is easy, we love all the new colors, spending money on education is like paying taxes, no one wants too!
Im losing the battle – and its heartbreaking!
Feilzer: ‘Also the advice they gave each other is misleading. For example, wearing gloves. That hardly makes sense! Gloves are waterproof but not against plastics. The plastic material goes through it and your hands sweat in those gloves. So, it softens the skin and makes the water-loving plastic fabric easily to penetrate.
While I agree that when hands sweat inside gloves and indeed, the build up of sweat in those gloves makes the skin more prone to monomer or fluid penetration, wearing gloves does make a difference, professional nail techs should be taught to change their gloves during the service. Again, the problem starts when the nail tech chooses not to wear gloves because no one can see their artificial nails, or the consumer that does it herself at home doesn’t even realize that there is a problem. Please do not outlaw the use of gloves – I wrote an article about them, choosing the right ones, when to change them, double gloving when needed, saying they are pointless takes 10 years of education and bins it! Gloves matter!
When I look for articles about acrylic allergy and gel or artificial nails, I notice that some advice is keep coming back: you have to be careful with damaged cuticles and make sure that the gel polish must be well dried and hardened. Feilzer looks at me shaking his head and says, ‘That paint has never really hardened properly. There are always residues of monomer in it, and that leaks out.’
I will quote Doug Schoon (https://schoonscientific.com/about/doug-schoon-bio/ – https://nailknowledge.org/)here:
“What’s Needed for Proper UV Curing?
In my scientific opinion, the best way is to ensure a proper cure is to consistently apply a thin layer of UV gel with the correct thickness and then cure that thin layer for the proper length of time, using a nail lamp that emits the correct UV wavelengths needed to efficiently activate the photointiators in the UV gel. ALSO, those wavelengths can have neither too high nor too low of an intensity for the UV curing product. Too high of an intensity causes over-curing; too low of an intensity causes under-curing.
Besides the wavelength and intensity, even the DESIGN of the lamp is very important. For instance, the distance between the nail plates and the bulbs makes a very big difference in curing. Very small changes in this distance can have big consequences on curing. Most people don’t think about the electronics inside the lamp. The electric components drive the bulbs to create UV. These components influence UV intensity and different lamps have different components. If the exact same UV bulbs are used in two different brands of UV nail lamp, the bulbs can produce widely different UV intensities. It’s important to note that old UV bulbs should be replaced with the same type and model of UV bulb. Fluorescent style bulbs should generally be changed 2-4 times per year depending on how often the nail lamps are used.
Too few understand how important the design of the nail lamp is in curing. The positioning of the bulbs and even type of interior reflector material used are VERY important factors that influence curing. This is why it is wrong to assume that only wattage is important, when it is the least important of the factors. The most confusing of all, is that many are fooled when the UV products harden. They incorrectly assume that hardening means properly cured, but in many cases they are not. UV nail coatings will harden when they cure more than 50%. However, to obtain the best properties and avoid causing skin sensitivities, these coatings should be sure to around 90%. So, there are many clients walking around with under cured enhancements, which are more prone to service breakdown and more likely to cause adverse skin reactions, especially for the nail technicians who are repeatedly exposed to partially cured UV gel dust and filings.
How do I know this information is correct? I have spent many years developing some of the leading UV nail products in the world and I am also one of the top scientific experts on UV nail lamps. These are the facts as I know them. This information is important because too many nail professionals don’t realize that many of their service breakdown problems are probably due to improper cure. Improper cure can cause everything from cracking, breaking, shattering, lifting, pitting, discoloration, bubbles, and onychosis to adverse skin reactions. In my opinion, improper curing is a leading cause of skin sensitivity, producing symptoms such as skin redness, itching, water blisters, etc. These are completely avoidable and would not happen if these coatings were properly applied and cured. In short, don’t use a UV nail lamp (either LED or fluorescent style) unless it is recommended by the UV curing product manufacturers and then always cure these products exactly as directed.”
Again, if a professional product is sold to either a nail tech or a consumer without the proper education, problems and allergies will continue to be a major problem. The bottom line is $!
“Gel nails even worse than artificial nails”
This just isn’t a correct statement – artificial nails are made from exactly the same ingredients but with a different % of acrylics. ALL artificial nail products that cure in the UV LED lamp contain acrylics and even if they don’t contain HEMA because it is now forbidden, they contain another acrylic resin, and even if that acrylic resin is less allergenic or less reactive than HEMA its still an acrylic resin and when used and or cured incorrectly its allergen – with some being significantly more allergen than others. Some are even ‘gateway allergens’ our body’s immune system doesn’t have a computer to determine exactly which allergen is causing the problem, it just recognizes the allergen as allergenic because its similar to the one we have developed a reaction to.
“The message that gel nails are ‘healthier’ than artificial nails is also based on inaccuracy. ‘Gel nails are even worse because of the thick layer of plastic used for gel nails.’ “
I agree:
ALL ARTIFICIAL NAIL PRODUCTS, CONTAIN ACRYLICS
ALL ACRYLICS CONTAIN ALLERGENS
HYPO ALLERGENIG PRODUCTS THAT CONTAIN MINDER ALLERGENIC ACRYLATES CAN STILL CAUSE ALLERGIES
Again, the problem is
1: Understanding the product
2: Curing the product as per instructions with the correct and matched UV LED lamp (the nanometer output needs to match the photointiators in the gel)
3: Controlling the amount of liquid monomer combined with the acrylic powder (the liquid monomer needs to match the powder exactly for a proper cure)
4: Controlling and applying the product correctly (takes time and money)
5: Regardless of what product it is – KEEP THE PRODUCT OFF OF THE SKIN – nail plates don’t have immune system sensors, skin does!
EDUCATION – EDUCATION – EDUCATION
“Symptoms? Stop immediately…….”
Agree but even then, the client just goes to another salon that knows not what they do, she wants pretty nails and doesn’t understand the consequences, or he/she does them him or herself and so the circle goes round. THE ALLERGY NEEDS TO BE INVESTIGATED, the realization that an acrylate allergy can affect you in the dentist’s chair or by the orthopedic surgeon is just too hard to comprehend when you have no understanding of the products used.
Also, the added complication of no knowledge and fielding the question on social media like ‘What can I use now?’ clients, consumers and nail techs believe anything and switch over to another brand because they don’t understand 1: how the immune system works 2: they believe that acrylate A is not the same as acrylate B even if A & B come from the same acrylate family 3: a brand or educator tells them the alternative product is ‘biological’ or hypoallergenic and they go ahead and use that and the problems just get worse – and again, the one selling the products is not held responsible for not teaching the salon, nail tech or consumer how to work with the product ensuring minimal risk.
“When I ask if there is no hypoallergenic material, the answers is negative. ‘It would be great of course but I once spoke to a director of a factory in nail polish materials. He told me that he couldn’t even walk into his own packaging department without having an asthma attack. If you have the symptoms, you really have to stop using these materials immediately. There’s nothing else on it and no escape.”
Fumes and odors – That’s a book in itself!
Fumes and odors can also cause problems, good ventilation, good table extraction that should be just common sense, if the salon you go to doesn’t have these things, go somewhere else! – health and safety is for clients and professionals – that’s why the products are called ‘professional’ – but take a drive to Eindhoven and you will find 2 brands selling professional products to untrained consumers in a shopping mall – shoot me now cos that’s a bunch of accidents waiting to happen!
All cosmetics contain allergens – nail coatings and artificial nail products included – they are all chemical – The industry needs to get its act together – we are causing major health problems for the sake of $ & € but no one cares – how can something as pretty as a UV LED or air-drying nail coating cause so many problems?
I love the nail industry, I have worked in it for 30+ years – I specialize now in medical hand and oncology hand care, registered with the IKNL & Kanker.nl I give classes about Anatomy & Pathology of the Natural Nail, I write and post and talk about all of these things all of the time – and less than 10% of the industry listens.
Tell me what I have to do to fix the problem – and I will do it.