Adverse Skin Reactions Within the Salon

Why do adverse skin reactions happen in the salon industry, who is most susceptible and how can these reactions be prevented?

Adverse skin reactions occur in every area of the professional salon industry. Nail, skin, and hair services can all cause problems for sensitive clients and for beauty professionals themselves. When it comes to nail salons, the vast majority of adverse skin reactions can be easily avoided, if you understand how. Adverse skin reactions come in two varieties; irritation and allergy. When something irritates the skin reddening, inflammation and itching are often the results. When the irritating substance is eliminated or removed, the skin returns to normal and the irritation heals. Allergies are very different. One main difference is that irritations go away once the irritant is removed.

Allergies last a lifetime; they never go away

Their symptoms can worsen over time or may seem to subside, but they can be triggered again at any time, sometimes even with the slightest skin exposure. The medical term for a skin allergy is “allergic contact dermatitis”. These types of skin allergies account for approximately 80% of all cosmetic related skin problems. It is very important to understand that people don’t become allergic to cosmetic products; they become allergic to certain cosmetic ingredients. Usually, fragrances or preservatives are the culprits. These types of ingredients are beneficial for the vast majority of people and most of them will never experience any problems. However, a small number of people may develop skin allergies when significant skin overexposure occurs. Any substance or ingredient that causes skin allergies is called an “allergen”. In other words, allergens are substances, which upon exposure can cause an allergy. It is a common myth that just about any substance can cause allergies. This is completely false. Only certain substances can cause allergic reactions. Water or acetone for instance does not cause skin allergies. Excessive exposure to either of these may cause irritation, but neither is capable of triggering allergic reactions. Not everyone is allergic to a specific allergen; that often depends on that individual’s immune system.

Allergies to cosmetic products

The second important point to understand is that allergies to cosmetic products do not suddenly develop. Symptoms may take months or even years of repeated skin contact before they will appear. The process of developing an allergy to a particular substance is called “sensitization”. For this reason, allergens are often referred to as sensitizers. The substance causing the allergy is usually called either a sensitizer or an allergen. Tree pollen is a common allergen, and so is cat hair, dust mites, bee stings, molds, nickel, and latex. What else do these all have in common? They are all naturally occurring substances. That’s not a coincidence!

Most allergies are caused by naturally occurring substances. Our immune system is designed to protect us from nature. Nature is not the La-La land that many mistakenly believe it is. Nature is a dangerous place filled with all types of naturally occurring and potentially harmful substances. Our immune system is designed to protect us from naturally occurring dangers such as viruses and bacteria. It is a common myth that allergic reactions are caused by synthetic substances. The facts are, when a synthetic substance triggers an allergic reaction, it happens because the immune system was fooled into thinking the offending substance was natural. The immune system has no way to distinguish between natural and synthetic substances. Problems occur when the body mistakes synthetic substances for natural substances that are potentially harmful. The immune system sometimes overreacts to a harmless synthetic substance when they are mistaken for a potentially dangerous natural substance.

The immune system is like an army that never forgets

It’s a massive fighting force that has the ability to wage a full-scale war against any foreign aggressor. Like any army, the immune system army has privates and generals, spies and assassins, sentries and scouts. Certain parts of the immune system act as spies- roaming the body and constantly on the lookout for potentially dangerous invaders. The immune system spies memorize details about the attacker and describe it in detailed messages they send back to the “generals”. These spies even bring back prisoners for inspection. The “generals” then send messengers to alert the immune system army of a possible invasion and provide a description of the invading substance so the army can be on the lookout. Once the substance is under control and the threat is eliminated, the immune system strengthens its defenses and patiently waits for the next attack. When or if another attack comes, the immune system will be ready and prepared. In medical terms, this is called an “immune response”.

The body has two separate immune systems, one that protects the inside of our bodies, and we have a second immune system in our skin that protects us from the outside world. Let’s look at some examples so that we can better understand irritants and allergens and avoid their potential to harm the skin. Cleansing agents used in shampoos or hand and body washes contain ingredients that remove oil from the skin. These types of ingredients are called “surfactants”. Washing the hands too often can remove excessive amounts of surface oils and give the skin a whitish appearance which will eventually cause the skin surface to flake or peel. The hands may even become red and inflamed, which are additional signs of skin irritation. In this case, if the hands are washed less often then they would not be so irritated and the appearance of the skin would improve. Usually, irritations will quickly reverse themselves when exposure to the irritating substances ceases. Surfactants can be irritants for some people.

Water can also be an irritant

When hands are always wet, they can become irritated. Interestingly, some claim that constant water exposure dried out their skin, which of course makes no sense. Water makes things wet, not dry. This goes to show how many people don’t pay attention to the words they use and this just adds to the confusion. This also makes it more difficult for them to find a viable solution if they don’t understand the source of their problem. Skin allergies cause many of the same symptoms as irritation. Irritation and allergies can both cause skin redness, swelling, itching, tiny blisters, even nail onycholysis, and painful growths of pterygium under the free edge of the nail. The symptoms may appear similar, but the difference is that once you become allergic to a substance, you will be allergic to it for life. Your skin’s immune system will always remember that it is allergic to that particular substance and will rapidly react when direct skin exposure occurs. We don’t become allergic to vapors, but instead only via direct prolonged and/or repeated contact with specific liquids or solid substances.

Prolonged and or repeated contact

Only very potent allergic sensitizers such as certain poisonous plants can trigger immune responses after just a few exposures. Potent allergens are not used in salon products, in fact, they are carefully avoided by those who manufacture and supply cosmetic ingredients. Some ingredients (monomers and oligomers) used in nail enhancement products can be weak sensitizers for some individuals. This means that these ingredients are unlikely to cause allergic reactions under normal conditions of use; even so, prolonged and/or repeated skin contact with these products can cause some sensitive people to become allergic. I keep mentioning this because “prolonged and/or repeated contact” is the number one cause of allergic reactions to nail enhancements. Prolonged contact happens when some ingredients are allowed to sit on the skin for long periods of time, for example, sticky UV gels on the skin all day long would be considered prolonged contact.

Repeated contact occurs when the same area of skin is touched many times with the nail coating product. An example of this is a contaminated nail brush handle that is held between the same fingers, day after day or a contaminated table towel exposing the arm to monomer or UV gel or dust or filings of improperly cured UV gel products, or using bare fingers to pick at the hairs on the UV gel or monomer liquid application brush, or repeated touching the sticky inhibition layer that sometimes forms on certain UV gels. Artificial nail coating products do not cause clients to become allergic after a single exposure. Sensitization to nail coatings typically takes four to six months or even years of direct skin exposure.  One of the best ways to avoid skin allergies is to avoid prolonged and repeated skin contact.

Certain client’s skin may be more sensitive than others

Pale skin is usually more sensitive to allergens than darker pigmented skin. Some clients or nail technicians may be overexposed for many years before eventually becoming allergic, while others develop initial symptoms after just a few months. Usually, symptoms will worsen with each continued exposure. Eventually, even the slightest contact with the allergen can trigger a major outbreak of visible symptoms.  Determining the cause of the allergic reaction can be tricky. Unlike irritant contact dermatitis, the symptoms are not always restricted to the contact area.  Sometimes, swelling and other signs may occur far from the point of contact, i.e. face, eyelids, armpits, and glands in the throat or groin. In rare instances, some people develop hives (aka welts). Hives can appear on the wrist, arms, face, or neck and are usually caused by direct skin exposure to the dust from improperly cured nail coatings. Important reasons why products must be properly cured and dust in the salon should be cleaned up and not allowed to accumulate. Hives are smooth, slightly elevated areas on the skin. The area is either redder or paler than the surrounding skin and is often accompanied by severe itching. Hives may change size or shape or even disappear within a few hours.

Many other things are much more likely to cause hives, i.e. foods, medications, plants, clothing, etc. Do not automatically assume hives are related to cosmetic ingredient sensitivity. Typically, allergic contact symptoms are restricted to the site of skin contact and that should be your first clue. Look for what repeatedly contacted the site of the reaction over the past several months or years.Most are surprised to learn that an allergic reaction usually appears after several months or years of exposure. This can fool nail technicians into believing that the cause was something new or recent, i.e. a new polish or lotion. They don’t realize it’s probably something they’ve been using or doing for a long time.

Tracking down the source of an allergy

Fortunately, tracking down the source of an allergy becomes a lot easier if you know what to look for. The first symptoms noticed are a temporary reddening or warming sensation that occurs directly at the site of contact. If overexposure continues the skin may appear dry, tight, flaky or itchy. In later stages, tiny water blisters or raised, red bumps are often seen around the proximal nail fold or at the fingertip. There may appear to be an overgrowth of tissue underneath the free edge. When overexposure continues these symptoms will worsen. Water blisters may develop into open sores, the fingertips may become cracked, and feel numb or an annoying itch may develop underneath the nail plate.

The nail professional is exposed

The nail technician’s wrist or arm may also develop similar symptoms if the arm is repeatedly exposed to monomer, UV gel, or improperly cured dust. When this occurs, it would be wise to discontinue the use of the product and to immediately change work practices to eliminate overexposure to the skin. All artificial nail enhancement products, including UV gels, gel manicures, wraps, adhesives, and monomer/polymer systems can cause allergic reactions in sensitive individuals, but none of them need to cause problems. Adverse skin reactions are completely avoidable. By ensuring that uncured OR improperly cured nail coating and adhesive products don’t contact any living skin, including your own. Each skin exposure increases the potential risk for irritation or allergy. Since at first there are no obvious negative effects when skin exposure happens, many nail technicians don’t realize the risks they are taking. This is one reason why it is extremely important that you always leave a small margin between the product application and the client’s skin. Responsible and safe nail professionals will never intentionally touch any nail enhancement product on the skin.

Important tips to remember

In order to avoid adverse skin reactions: monomer liquids should only be used with the correct polymer powder, which is the one designed specifically for use with that particular monomer liquid. There is no such thing as a universal powder that works with any monomer liquid or vice versa. Also, using too much monomer liquid and not enough powder can create dust or filings that are only partially cured and will increase the risks of allergic reactions. Beads should be of medium consistency, never wet, since this can lead to under-curing. Using an overly large brush can cause the skin over exposure to clients, so avoid using them. Large brushes also hold too much liquid monomer and this can lead to enhancements that contain too much monomer, which makes the dust and filings more likely to cause an adverse skin reaction.

All UV-cured nail coatings must be properly cured using the correct UV nail lamp by exposing the nail coating for the proper length of time.  If not done, adverse skin reactions become more likely. The correct lamp is the one specified by the UV gel manufacturer. If no lamp is specified, I’d recommend finding and using a system that provides users with this information. Always remember, it’s easy to avoid adverse skin reactions if you take the proper steps to protect yourself and your clients.

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An interesting read Oil penetration and allergies