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Cite as: Archiv EuroMedica. 2026. 16; 1. DOI 10.35630/2026/16/Iss.1.022
,
Nina Kubikowska1 
, ,
Zuzanna Gąsior2 , ,
Małgorzata Landowska1 , ,
Patryk Krawczak1 , Gel manicure is widely used in professional and home settings. Concerns relate to chemical exposure from acrylate containing nail products, ultraviolet radiation emitted by nail curing lamps, occupational exposure among nail technicians, and potential microbiological implications.
To systematize published evidence on health effects associated with gel manicure use, with emphasis on allergic reactions, ultraviolet exposure related outcomes, occupational risks, and microbiological findings, and to identify gaps in the current evidence base.
A narrative review was conducted using PubMed, Google Scholar, and ResearchGate. Publications from January 2010 to March 2025 were considered. Only English language articles were included. Inclusion criteria comprised randomized controlled trials, cohort studies, case control studies, systematic reviews, meta analyses, and international or national guidelines reporting health effects or exposure characteristics related to gel manicure use. Exclusion criteria included single case reports, conference abstracts, non peer reviewed publications, animal studies, and articles lacking explicit data on gel manicure exposure or associated health outcomes. The initial search yielded 223 records, and 44 publications were retained for analysis.
Nail curing devices predominantly emit UVA radiation with peak wavelengths between 365 and 405 nm, with substantial variability across lamp types and designs. Under typical usage conditions, cumulative ultraviolet exposure during manicure sessions remains below levels associated with clinically significant dermatologic damage or increased skin cancer risk. Allergic contact dermatitis related to acrylate and methacrylate containing products is the most frequently reported adverse outcome, particularly among nail technicians and younger users. Evidence on microbial retention and reduced hand hygiene effectiveness with gel or artificial nails is heterogeneous and context dependent.
Available evidence indicates that allergic sensitization to acrylate containing nail products represents the primary clinically relevant health risk of gel manicure, whereas ultraviolet radiation related carcinogenic risk appears minimal under typical use. Standardization of exposure assessment and further research on occupational and microbiological outcomes are needed.
Keywords: gel manicure, gel nails, UV nail lamp, acrylates, bacterial burden
Gel manicure is one of the most widely used cosmetic nail procedures worldwide and is performed both in professional beauty salons and in home settings [1]. Its popularity is mainly related to long lasting aesthetic results and ease of application. At the same time, the increasing use of gel nail products has raised concerns regarding potential health effects associated with repeated contact with chemical components of nail cosmetics and exposure to ultraviolet radiation emitted by nail curing lamps. Recent dermatological publications have reported skin reactions and other adverse effects potentially linked to these exposures, indicating clinical relevance of the issue [2].
The widespread adoption of gel manicure has led to increased exposure to acrylate containing nail products and ultraviolet radiation in diverse patterns of use, including professional and home applications. Existing safety standards and recommendations do not consistently differentiate between device types, exposure duration, or frequency of procedures, while the available scientific evidence is often presented as isolated experimental studies or clinical reports rather than as an integrated body of data.
The relevance of this review is determined by the high prevalence of gel manicure use and the growing number of reported dermatological reactions, occupational sensitizations, and concerns related to cumulative ultraviolet exposure. The novelty of the present review lies in the structured integration of data on allergic reactions, ultraviolet radiation exposure, occupational health aspects, carcinogenic considerations, and microbiological findings related to gel manicure within a single narrative framework.
The aim of this narrative review is to systematize published evidence on health effects associated with gel manicure use related to chemical exposure, ultraviolet radiation exposure, and occupational factors.
A narrative review of the literature was conducted to identify studies assessing potential health risks associated with gel manicure use, with focus on dermatological, occupational, carcinogenic, and microbiological outcomes. The literature search was performed using the PubMed, Google Scholar, and ResearchGate databases. Publications published between January 2010 and March 2025 were considered. Only articles published in the English language were included.
The search strategy combined the following terms: “gel manicure” OR “gel nails” OR “UV nail lamp” AND (“skin cancer” OR “photoaging” OR “contact dermatitis” OR “allergy” OR “acrylates” OR “toxic exposure” OR “occupational risk” OR “nail salon workers” OR “health risk”).
Inclusion criteria comprised randomized controlled trials, cohort studies, case control studies, systematic reviews, meta analyses, and international or national guidelines reporting health effects or exposure characteristics related to gel manicure use.
Exclusion criteria included single case reports, conference abstracts, non peer reviewed publications, animal studies, and articles lacking explicit data on gel manicure exposure or associated health outcomes.
The initial search identified 223 records. After removal of duplicate entries and application of the inclusion and exclusion criteria, 44 publications were retained for analysis.
The included studies were categorized according to the primary type of reported risk, including dermatological reactions, photobiological effects of ultraviolet exposure, potential carcinogenic considerations, and occupational health aspects related to nail salon work.
Gel nails are very popular today, but they are associated with a significant risk of allergy to acrylic compounds (acrylates and methacrylates), especially when manicure is performed at home. The most common problem is allergic contact dermatitis (ACD)[6]. Symptoms include redness, itching, vesicles, and cracking of the skin around the nails, on the fingers and hands, and even on the face and eyelids[7]. Onycholysis (separation of the nail plate), nail dystrophy, periungual eczema, and psoriasis-like lesions may also occur [8]. In children and adolescents, cases of ACD after gel nail products have been reported, with severe eczema of the fingertips and periungual area[9].
2-Hydroxyethyl methacrylate (HEMA) has been identified as the primary allergen in nail products, eliciting a positive patch test in 97% of patients with allergic contact dermatitis (ACD) related to nail cosmetics[7, 10]. HEMA is present in approximately 60% of commercially available nail products[10]. Although allergy to nail acrylates is observed in only 1–2% of all patients undergoing patch testing, its prevalence is rising in parallel with the increasing popularity of gel nails and at-home UV manicure kits[11, 12]. The use of home kits and improperly cured gels further elevates the risk of sensitization, as the liquid monomer is more likely to come into contact with the skin and induce an allergic reaction[6, 13]. Occupational exposure is higher among professional manicurists and nail technicians[11, 14, 15].
Once sensitized, individuals may also react to acrylates present in medical products, including dental fillings, contact lenses, insulin pumps, and prostheses[4, 11]. Studies emphasize the importance of patch testing when an allergy is suspected, avoiding acrylate-containing products (particularly HEMA), ensuring professional application, thorough curing, and limiting the use of at-home manicure kits[10, 16]. Nevertheless, it should be emphasized that the current evidence is limited, as comprehensive data are lacking due to the absence of meta-analyses and the heterogeneity of available studies[17].
Exposure to ultraviolet radiation from nail curing lamps has attracted growing scientific interest due to its potential implications for photocarcinogenesis, photoaging, and photo-induced allergic and inflammatory skin conditions[18]. Nail curing lamps predominantly emit UVA radiation (320–400 nm); however, substantial variability exists between devices with respect to emitted wavelength, irradiance, uniformity of exposure, and the duration required for proper gel curing. Conventional UV fluorescent lamps typically emit within a wavelength range of approximately 300–410 nm, with a peak around 375 nm, and require curing times of 2–4 minutes per cycle, whereas UV LED lamps emit mainly between 375 and 425 nm, with peaks at approximately 385–405 nm, allowing shorter curing times of 30–60 seconds due to higher power output. In the study by Markova and Weinstock, three devices were analyzed: a 4×9 W UV lamp (peak ~368 nm; irradiance 15,523 mW/m²), a 1×9 W UV lamp (peak ~370 nm; 15,202 mW/m²), and a 6×1 W LED lamp (peak ~405 nm; 2,845 mW/m²), demonstrating that LED devices deliver lower UVA irradiance but at longer wavelengths closer to visible light[19]. Several studies evaluating commercially available salon and home-use lamps have reported several-fold differences in emitted UVA, with measured values ranging from 39 to 185 W/m² in eight home devices and marked variability across 17 salon lamps[20, 21]. Approximately 30% of tested devices were found to emit higher UVA irradiance than midday summer sunlight; nevertheless, the erythemogenic dose received during a single manicure session remained lower than that resulting from equivalent sun exposure[22]. Importantly, irradiance within individual lamps is not uniformly distributed, with higher intensities observed at the periphery than at the center, potentially resulting in greater exposure to specific fingers[20, 23]. Photobiological safety assessments of six nail lamps classified all devices as risk group 1–2 (low to moderate risk), with permissible daily skin exposure estimated at approximately 30–276 minutes of continuous irradiation, compared with typical manicure exposures lasting only a few minutes every 2–3 weeks[24]. Dose modeling by Markova and Weinstock suggested that 13,000–40,000 ten-minute sessions would be required to reach an exposure equivalent to a single full course of narrowband UVB phototherapy[19]. In contrast, Curtis et al. reported that in under 10 minutes, hand exposure could approach the daily occupational UVA limit for outdoor workers, as nail lamps emitted up to 4.2-fold higher energy than sunlight at a UV index of 6 within the 355–385 nm range[25]. Overall, despite pronounced inter-device variability, most studies and reviews conclude that under typical usage conditions the delivered UVA doses remain below established safety thresholds and confer a very low additional risk of skin cancer. Nonetheless, certain devices may locally exceed occupational exposure limits during short, high-intensity exposure, and the received dose is strongly influenced by lamp model, number and power of bulbs or LEDs, hand position, distance from the light source, and device geometry. Consequently, the use of preventive measures such as sunscreen application, UV-protective gloves, and moderation in treatment frequency is recommended, even though the overall risk remains low.
Mathematical modeling suggests that thousands of manicure sessions would be required for cumulative exposure to approach that of a single course of UVB phototherapy, and the associated risk of skin cancer is therefore considered very low[26]. In vitro studies have demonstrated DNA damage and reduced keratinocyte viability following prolonged UVA exposure, while the application of broad-spectrum sunscreen (SPF 50) significantly attenuates these cellular effects[27].
Despite the low overall risk, several preventive measures are recommended to minimize unnecessary UVA exposure. The application of a broad-spectrum sunscreen with SPF ≥30–50 to the hands 20–30 minutes prior to exposure has been shown to reduce UVA dose and cellular damage[28]. The use of fingerless UV-protective gloves provides near-complete shielding of the dorsal hands and represents one of the most effective protective strategies[29]. Preference for LED nail lamps over traditional UV fluorescent devices may further reduce effective carcinogenic exposure, as LED lamps typically emit longer wavelengths and lower biologically effective doses. Additionally, limiting exposure duration and reducing the frequency of manicure sessions is advised, as cumulative risk increases with total exposure time and number of procedures[20, 27].
Concerns about the potential cancer risk of ultraviolet (UV) nail polish curing lamps have led to recent comprehensive reviews of the evidence. Duong et at. 2025[30] conducted an extensive review of 14 studies addressing UV nail lamp exposure and cutaneous malignancies, finding that while a small number of case reports describe squamous cell carcinoma in individuals with histories of UV nail lamp use, the majority of epidemiological and mathematical modeling studies indicate minimal to no increased skin cancer risk attributable to these devices. Their analysis also noted that only two in vitro studies directly evaluating cytotoxicity and mutagenicity demonstrated mixed results, and a national cancer registry study found no association with melanoma[30]. Based on the current evidence, the authors concluded that there is no compelling support for significant carcinogenic potential, though photoprotection is recommended for individuals anticipating long-term use [30].
Similarly, Bollard et al. (2018)[31] emphasized that although UV nail lamps emit ultraviolet radiation capable of theoretical photocarcinogenic effects, current evidence remains limited and inconclusive, with no definitive causal relationship established between lamp use and skin cancer development[31]. The authors also highlighted a general lack of public awareness of potential UV risks and suggested precautionary measures such as applying broad-spectrum sunscreen or wearing protective gloves during exposure[31]. Taken together, these reviews suggest that while mechanistic concerns and isolated case reports have been documented, robust epidemiological data linking UV nail lamp exposure to clinically significant skin cancer risk are lacking, justifying ongoing research and patient education[30, 31]. The results of the other studies included in the review are summarized in the table below.
The main characteristics and key findings of studies assessing potential skin cancer risk associated with ultraviolet nail lamp exposure are summarized in the table below.
Table 1. Summary of studies evaluating ultraviolet nail lamp exposure and reported skin cancer risk
| Author, Year | Study design | Country | Sample size | Study outcome |
| Bollard, Beecher et al. 2018 [31] | Cross-sectional study and reserach letter | Ireland | 424 people | The study shows low public and nail technican awareness of the potential cancer risk from UV nail lamps, as only 3% of users applied sunscreen despite medical recommendations. |
| Duong, Ceresnie et at. 2025[30] | Systematic review | USA | 14 studies | Existing evidence suggests that most UV nail lamps pose a minimal risk of skin cancer to the typical user. Additional longitudinal are warranted. |
| Beylin, Kornhaber et al. 2025[32] | Systematic review | Israel | 11 studies | Current evidence does not conclusively show that UV/LED nail lamps cause cancer; some data suggest potential mutagenic effects, but findings are limited and inconsistent, and exposure under typical salon conditions appears to pose minimal risk. |
| Diffey 2012[33] | Experimental study | United Kingdom | N/A | The study indicates that the risk of developing SCC from UVA nail lamps is extremely low, with 72 709 women needing long-term exposure for one additional case to occur |
| Shipp, Warner et al. 2014[34] | Experimental study | USA | participants from 16 nail saloons | UV-A and UV-B exposure from nail lamps varies widely between devices and hand positions, with higher wattage and longer exposure increasing potential DNA damage |
| Schwartz, Ezaldein et al. 2020[35] | Systematic review | USA | participants aged under 40 years old as reported in various research studies | Review found no studies reporting melanoma or NMSC on the hands or nail matrix in patients under 40 with a history of chronic gel manicures |
Gel manicure significantly modify the nail surface, creating additional niches and microdamages that may promote the development of microorganisms and, what is especially important in healthcare workers, reduce the effectiveness of hand hygiene procedures[36, 37]. Most available evidence originates from studies conducted among healthcare workers; however, the underlying mechanisms—such as increased surface area, presence of microgaps between the artificial material and the natural nail plate, and reduced accessibility during cleaning—are applicable to the general population[38]. Multiple clinical studies have demonstrated higher rates of colonization with pathogenic bacteria and yeasts on artificial (particularly acrylic) nails compared with natural nails[39, 40]. In a 2018 U.S. study of healthcare workers, alcohol-based hand disinfection reduced bacterial counts on natural and conventionally polished nails but not on gel-polished nails. Although baseline colonization was similar, gel-polished nails were significantly less amenable to effective decontamination than nails with conventional polish[36]. Importantly, after standard handwashing or alcohol-based hand rub application, individuals with artificial nails are more likely to retain pathogenic microorganisms than those with natural nails, indicating reduced efficacy of routine hand hygiene measures. In contrast to studies demonstrating reduced decontamination efficacy with gel-polished nails, a 2021 randomized trial evaluating surgical hand scrubbing with chlorhexidine found no significant difference in the reduction of viable bacteria between gel-coated and uncoated nails at 1 and 14 days[41]. Moreover, Gram-negative bacilli, including Pseudomonas spp. and Klebsiella spp., as well as yeasts, are more frequently isolated from artificial nails, with microbial burden increasing proportionally to the duration of nail wear[42, 43]. Some studies report that nails extending more than 2 mm beyond the fingertip are associated with higher bacterial counts, regardless of the type of nail coating[44].
This narrative review integrates evidence on health risks associated with gel manicure use, allowing comparison of chemical, photobiological, occupational, carcinogenic, and microbiological aspects within a single analytical framework [1,3,16,17]. The reviewed literature demonstrates that adverse outcomes related to gel manicure are heterogeneous and differ substantially in frequency, clinical manifestation, and robustness of supporting data.
Across the analyzed sources, allergic contact dermatitis is the most consistently documented and clinically relevant adverse effect [4,6,7,9,11]. Multiple studies identify acrylates and methacrylates, particularly 2 hydroxyethyl methacrylate, as key sensitizing agents in nail cosmetics [7,10]. Clinical manifestations range from periungual eczema and onycholysis to distal and facial dermatitis, with several reports describing severe presentations in children and adolescents using self applied gel nail products [6,9,12]. Occupational studies further indicate higher sensitization rates among nail technicians, reflecting repeated exposure and inadequate protection in salon settings [14,15]. Cross reactivity with acrylates present in medical and dental materials has been highlighted as an additional clinically relevant consequence of sensitization [4,11]. Despite consistent reporting of allergic outcomes, the evidence base remains limited by heterogeneity in diagnostic criteria, study design, and exposure assessment, precluding reliable prevalence estimates [16,17].
In contrast, the body of evidence addressing ultraviolet radiation exposure from nail curing lamps indicates a low dermatologic and carcinogenic risk under typical conditions of use [2,18,19,26,30]. Experimental studies demonstrate substantial variability in emitted wavelength and irradiance between devices, lamp types, and hand positioning [19,21,22,24]. While some devices emit higher instantaneous UVA irradiance than natural sunlight, dose modeling studies consistently show that cumulative exposure during routine manicure sessions remains below levels associated with clinically significant skin damage or malignancy [19,26,30]. Systematic and scoping reviews report no convincing epidemiological association between UV nail lamp exposure and melanoma or non melanoma skin cancer, particularly in younger populations [2,27,30,32,35]. Nonetheless, methodological limitations persist, including reliance on surrogate endpoints, short observation periods, and indirect exposure estimation [18,25,31].
Occupational exposure represents a distinct risk domain. Nail salon workers experience repeated contact with acrylate containing products, ultraviolet radiation, and volatile organic compounds [14,15,17]. Available studies consistently describe higher exposure intensity and frequency in this group compared with consumers, but longitudinal data linking exposure to long term health outcomes are scarce [14,15]. This limits causal inference and underscores the need for standardized exposure monitoring in occupational settings.
Microbiological findings suggest that gel and artificial nail coatings may impair effective hand hygiene and promote microbial persistence, particularly in healthcare environments [36,37,38]. Several studies demonstrate higher colonization rates with pathogenic bacteria and yeasts on gel or acrylic nails compared with natural nails, as well as reduced efficacy of alcohol based hand disinfection [36,39,40]. However, results are not uniform across all disinfection protocols, and some controlled studies report no significant difference following surgical hand scrubbing [41]. Nail length, duration of wear, and hygiene method appear to modify these effects [44]. The clinical relevance of these findings outside healthcare settings remains insufficiently defined [38,42].
Overall, the reviewed evidence indicates that the predominant and best documented health risk associated with gel manicure use is allergic sensitization to acrylate containing products [4,6,7,11]. Ultraviolet radiation exposure from nail curing lamps appears to contribute minimally to dermatologic or carcinogenic risk when devices are used as intended, despite pronounced inter device variability [2,19,26,30]. Occupational exposure and microbiological considerations constitute additional concerns, particularly in professional and healthcare contexts [14,36,38].
The limitations of the current evidence base are consistently noted across studies and include methodological heterogeneity, lack of standardized exposure assessment, limited longitudinal data, and frequent reliance on indirect or experimental endpoints [17,18,27]. These constraints limit precise risk quantification and justify further well designed studies using harmonized methodologies.
In summary, this review supports a differentiated risk profile for gel manicure practices, in which chemical sensitization represents the primary clinically relevant concern, while ultraviolet radiation related risks appear secondary under typical use conditions [4,19,30]. Further research is required to clarify long term outcomes, refine exposure characterization, and support evidence based safety recommendations for both consumers and nail professionals.
This narrative review evaluates health risks associated with gel manicure practices by integrating evidence on ultraviolet radiation exposure from nail curing lamps, chemical sensitization to nail product components, occupational exposure, and microbiological considerations. The reviewed data indicate that ultraviolet radiation emitted by nail curing devices, despite variability between lamp types and exposure conditions, results in cumulative doses that remain below thresholds associated with clinically significant dermatologic damage or increased skin cancer risk under typical patterns of use. Current experimental, modeling, and epidemiological studies do not demonstrate a consistent association between routine use of UV nail lamps and cutaneous malignancy.
In contrast, allergic contact dermatitis related to acrylate and methacrylate containing nail products is the most frequently reported and clinically relevant adverse outcome. Sensitization occurs predominantly due to direct skin contact with uncured or inadequately cured products and is observed more often among nail technicians and younger users, including adolescents using home manicure kits. Occupational exposure represents an important risk domain, as nail technicians experience repeated and prolonged contact with sensitizing chemicals and other workplace exposures, although long term outcome data remain limited.
Evidence regarding microbiological risks suggests that gel and artificial nail coatings may reduce the effectiveness of routine hand hygiene and increase microbial retention, particularly in healthcare settings and in the presence of increased nail length. However, findings across studies are heterogeneous and context dependent, limiting definitive conclusions on their broader clinical relevance.
Overall, the available evidence supports a differentiated risk profile for gel manicure use, in which chemical sensitization constitutes the primary health concern, while ultraviolet radiation related risks appear secondary under standard usage conditions. Further research is needed to standardize exposure assessment, improve comparability between studies, and clarify long term occupational and microbiological implications to support evidence based safety recommendations.
Conceptualization: Michał Stermach, Nina Kubikowska
Methodology: Nina Kubikowska, Michał Stermach
Formal analysis: Iga Poprawa, Zuzanna Gąsior
Investigation: Przemysław Krukowski, Patryk Krawczak
Writing-rough preparation: Marta Kwiatkowska, Małgorzata Landowska
Writing-review and editing: Michał Stermach, Iga Poprawa
Supervision: Nina Kubikowska, Artur Marcysiak
All authors have read and agreed with the published version of the manuscript.
The authors declare that no artificial intelligence tools were used in the generation, writing, editing, or revision of this manuscript. All content was created solely by the authors.
The article did not receive any funding.
Authors declare no conflicts of interest.
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