Why you shouldn’t have back-to-back gel manicures

All that’s glossy isn’t always glam as dermatologists warn regular treatments can cause problems. Here’s how to protect yourself

They’re a summer godsend: a glossy manicure that doesn’t smudge or budge no matter how often you go for a dip. Little wonder gel manicures – which can last for up to three weeks – are the most popular beauty treatment in the UK, according to the online booking system Treatwell.
But are they too good to be true? Last year, the British Association of Dermatologists (BAD) warned that gel manicures can potentially cause allergic reactions. They issued a similar warning in 2018 following a rise in reactions, including swollen fingers, infections, rashes, along with nail lifting, breakage, and brittleness, related to the chemicals in the products.
The polish used in gel manicures contains a chemical called methacrylate, which has been linked to these reactions. The gel is “cured” under a UV lamp to harden each layer of base coat, colour, and top coat. However, if the gel is not properly cured, a reaction to the chemicals can occur on the nails, skin, and any area they touch.
“It is important that people are aware of the potential risks of artificial nail products, whether they are having them applied in a salon or at home,” said BAD’s Dr Deirdre Buckley last year. “It’s important that people are aware of the potential risks of artificial nail products, whether they are having them applied in a salon or at home.”
“One of the most common issues with gel nails is with overuse, and a weakening of the nail plate,” says Dr Justine Hextall, a consultant dermatologist and fellow of the Royal College of Physicians. “Over time with persistent application of gel nails many individuals start to notice that the nail plate becomes dry, flaky and often softer and less robust.”
Dr Hextall says that if the surrounding skin, cuticles and or the nail plate becomes damaged, the natural protection afforded by our nails is lost. And when the nail area is damaged it becomes vulnerable to irritants and infection. “If you see any redness, dryness around the nails, or any sign of dermatitis, it could be an allergy,” she says. 
“A second potentially very serious complication is contact allergy to hydroxyethyl methacrylate (HEMA) and methacrylate, which is used to polymerise [bond] the gel and give it the shiny hard appearance,” she says. “Once sensitised there is a risk of eczema not only in the hands but also in the face and neck area where there is frequent contact with hands and nails. Not only can this reaction be severe and lead to nail loss, once sensitised to this substance, the individual has to avoid any contact with it in the future. However, methacrylate is found in dental appliances and hip replacements, so the implications can be far reaching.”
A 2023 study published in the journal Nature Communications found that exposure to the UV light of the gel dryers can cause damage to cells that may lead to cancer. However, it was a small study, not done on humans, and one of the study’s authors, Maria Zhivagui, a researcher at the University of California, said at the time of publishing the study: “At this point, I would recommend or advise people to just weigh the risk. There is damage at the DNA level. We don’t know if it’s carcinogenic [cancer causing]”.
“Research shows that it is very unlikely that someone would develop skin cancer as a result of using UV nail lamps, even on a regular basis,” says Claire Knight, Cancer Research UK’s senior health information manager. “This study on cells in the lab doesn’t change that. Although these lamps give out UV radiation, the dose is far less than when using a sunbed or spending too much time in the sun. Too much UV radiation from the sun or sunbeds is the main cause of most skin cancers, which is why we encourage people to protect their skin when the sun is strong by spending time in the shade, covering up with clothing, regularly applying sunscreen, and avoiding sunbeds.”
So, if you do get gel manicures, should you continue and can you make them a little healthier? “I would recommend having some periods where the nails are allowed to rest, and apply emollients that help to hydrate and soothe the nail plate and surrounding cuticles and skin,” says Dr Hextall. She also suggests avoiding back-to-back manicure or pedicure appointments, to allow you to examine your nails between applications: “If the nail plate appears damaged or discoloured, then use this time to condition and strengthen nails.
“Brands like Biosculpture focus on nail health and are sometimes suggested for those with nail plate damage. This brand seems to be easier to remove and as such may leave less damage to the nail and surrounding skin. If allergy or irritation is a concern I would also suggest looking for gels that are methacrylate- and HEMA-free. However, I would still suggest resting the nails if there is any visible damage.” 
Dip powder manicures, a technique where nails are brushed several times with a pigmented powder to create a layer of colour before being painted with a top-coat that hardens the powder for up to three weeks, are often cited as a healthier alternative. However, Dr Hextall says she’s not sure there is a significant difference: “Both can potentially cause allergies. The powder doesn’t require UV light though, which I would see as a benefit.”
Lastly, consider who is applying your gel. The BDA warning last year highlighted the fact that since the pandemic many of us have DIY gel kits and do our own gel manicures at home. They advised people to read instructions carefully, always use the recommended lamp for curing, and to avoid direct skin contact with the nail product whilst it is curing.
“It’s important to seek out a reputable salon or technician,” adds Dr Hextall. “How the gel is applied and which products are used is vital. For example, if each layer is not sufficiently hardened the potential allergens are much more available and likely to cause irritation and in some cases allergy. Even how gel is removed is important as mechanical damage can cause significant issues to the delicate nail plate and surrounding skin. Be cautious if using at-home systems by making sure the gel is sufficiently hardened, and seek out recommended brands.”
Ultimately, says Dr Hextall, it’s up to the individual whether they continue to have gel manicures. “If there are no issues and someone wants to continue, that is absolutely their decision. Although I suspect resting nails from time to time is probably a good idea for most.”
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