A Gel Nail Allergy Helped Me Recognize A Pattern Of Medical Misogyny

I noticed there was something wrong with my hands on the first day of my honeymoon. Deep in the Okavango Delta, the scorching Botswanan sun slowly rising over the floodplains on our first game drive, all I could think about was the skin around my fingernails. Overnight, it had become bright red, flaky, and overwhelmingly itchy. I slathered my fingertips in the mini tube of hand cream I’d thrown in my carry-on, which did little to alleviate the problem. 

By day five, my skin was so dry and irritated that deep cracks had started to form under my fingernails. The itching was relentless. The only mild respite came from doubling up on antihistamines (reader, don’t try this at home) and using my hands as infrequently as possible. Surprisingly difficult, even while sitting for long periods in a safari jeep. 

I couldn’t work it out. I’d had my gel extensions infilled the day before my flight, as I’d been doing religiously at the same salon for the past four years. Surely it couldn’t be that? I thought. As soon as I landed back home, I booked a doctor’s appointment, desperate for answers. The (male) practitioner took one look at my hands and asked me if I bite my nails. “Yes, a terrible habit, I know”, I chuckled in embarrassment. I left with a prescription for hydrocortisone cream and his professional medical opinion: “Maybe you should stop biting your nails.”  

My protests that, actually, I’d been biting my nails since before wi-fi became a thing, and this hadn’t happened before, were ignored. Hydrocortisone helped ease the symptoms, but the skin was still inflamed and itchy. After a few more unsuccessful trips to my doctor — where either my nail-biting was blamed, or I was told to “avoid nail treatments” — photos were sent to a dermatologist, who confirmed allergic contact dermatitis, a skin irritation that develops after exposure to a certain substance. I’m waiting for patch test results to confirm the exact allergen, but it’s more than likely to be 2-hydroxyethyl methacrylate (HEMA), an acrylate used in gel nail enhancements.

What causes a HEMA nail allergy? 

Reactions typically occur when uncured gel polish comes into contact with the skin, which then develops a sensitization to the acrylate molecules. This can happen when gel is applied by unskilled hands, allowing product to flood the skin, or when the UV or LED lamp isn’t strong enough to cure the polish properly, leaving uncured acrylates behind. 

Rani Ghosh, a registered toxicologist, says that the toxicology and dermatology communities have seen increasing reports of this over the past decade thanks to gel manicures and at-home nail kits. “An acrylate sensitization means the immune system has learned to recognize a substance as a threat and may react every time it encounters it in the future,” she says. Think medical or cosmetic procedures that contain acrylates, such as dental fillings, joint replacements, and the use of false lashes and hair extensions.

Where nails are concerned, Ghosh adds, “Symptoms can include itching, redness, swelling, blistering, peeling skin around the nails and fingertips, and sometimes nail changes.” It’s not just confined to nails, though. Reactions can also appear on the face or eyelids if allergens are transferred by touch, says Ghosh. If social media is anything to go by, I’m far from alone. TikTok is filled with people documenting their experiences of gel nail allergies, with lots developing contact dermatitis on their faces.

@louisegieke I was lowk rushing so idk if I forgot anything comment if yall have any questions ???? #contactdermatitis #gelallergy #gelawareness #gelsafety ♬ original sound – lou!!

It’s important to note that there’s nothing inherently wrong with acrylates as ingredients, and many of us will use gel products without issue. Joshua Zeichner, MD, professor of dermatology and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital, says that those with a history of eczema or other allergic reactions may be more likely to experience this than others: “We cannot predict who will develop the sensitivity to gel nail ingredients,” he says, “but in some people, it can develop even when there are no other related conditions.” 

The exact prevalence of gel nail allergies in the US is unknown, but concern is growing globally. In 2018, the British Association of Dermatologists warned that methacrylate allergies could affect at least 2.4% of people, urging caution with DIY gel kits and better salon training. The European Commission restricted HEMA-containing nail products to professional use in 2021. In 2023, the UK’s Office for Product Safety and Standards (OPSS) launched an ongoing investigation into reports of lifelong acrylate allergies linked to uncured gel products, reiterating that all UK cosmetics must comply with strict safety laws and include ingredient lists to help consumers identify potential allergens. 

What’s behind the rise in HEMA allergies? 

Fariha, 39, an LA-based nail artist and content creator behind @nailjob, says the highest increase in clients reporting gel allergies happened post-lockdown. “This was a result of people doing DIY gels at home, especially gel extensions,” she says. “Most gel extension products require a thorough curing cycle in a professional-grade LED lamp. When people use a low-power lamp or don’t place their hands in properly for full exposure, the gel remains uncured.” Fariha says that even small amounts of uncured gel could cause a flare-up.

Ren, 29, developed a reaction after using a specific brand of DIY UV glue on her left hand; on the right, she’d sculpted the nails using polygel. “The next morning, the skin on my left hand was red and itchy, then it started swelling. By day three, it started oozing this clear liquid. That’s when I was like, This is unmistakably an allergy.” Soon, the reaction spread to Ren’s right hand. She recalls, “I’ve been doing my nails at home for 15 years, and I don’t do anything without doing extensive research. I knew what the allergy was; I knew the risk, and I stupidly did it anyway. We all think, ‘It’s not going to happen to me.’” 

@noracummins_ Finally cracked the case!! Gel nail allergy is no joke!!! #perioraledermatitis #dermatitis #buildergel #gelnails #gelallergy ♬ original sound – nora

Ren’s experience was, like mine, minimized by medical professionals. “I’m fortunate that I have a job which provides good health insurance, but for the majority of people in the US, allergy patch testing for acrylates isn’t covered,” she says. Ren adds, “The way that insurance companies see it — and the way even doctors see it — is, ‘Well, this is completely optional. You don’t have to get your nails done, so just stop.’” 

It’s the same dismissive attitude I encountered with my doctor. But while the focus on nails and nail art might seem frivolous to some, for others they’re closely tied to our confidence and sense of identity. Getting our nails done isn’t just a vanity practice; it’s a self-care ritual. This makes giving it up entirely far more difficult than it sounds. 

Both Ren’s primary care physician and dermatologist were unfamiliar with acrylate allergies. Ren believes this lack of awareness further prevents women from receiving adequate support. Eventually, she obtained patch testing through an allergist, though she says the process was poorly managed. “They knew what acrylates were, but they didn’t know how to test for them,” she tells me, adding, “I had to bring in my own document with all of the acrylates that I wanted to be tested for. It took months and I was just not taken seriously.” 

If your symptoms are being dismissed by your doctor, Dr. Zeichner recommends seeking specialist advice. “Dermatologists are the skin experts,” he says. “If you have a rash that lasts more than one to two weeks and isn’t improving, either with an over-the-counter treatment or recommendation from your primary care doctor, seek the opinion of a board-certified dermatologist.”

But the general dismissive attitude towards gel nail allergies reflects a broader pattern of medical misogyny, where women’s health issues around beauty treatments and aesthetics are often disregarded. While the data is predominantly anecdotal at this stage, there is substantial research into the dismissal of women’s symptoms in mainstream healthcare, particularly for Black and brown women. 

For 47-year-old beauty therapist Tamiah, developing a HEMA allergy was occupational. “I first noticed the symptoms in summer 2023,” she says. “I developed a rash on my right hand that I initially thought was bug bites. The doctor diagnosed me with eczema, and it was treated with an oral and topical steroid.” 

Shortly after, Tamiah went on her honeymoon. When she returned to work, so did her symptoms. “It took me a while before I realized the source was the new gel nail products I’d ordered online,” she says. “I never got the gel on my skin, but the reaction was from the dust while removing product from my client’s nails. I was overexposing myself to HEMA without realizing it.”

Fortunately, Tamiah’s experience was largely positive. “I’ve experienced medical gaslighting before, but now I’m fortunate to have a great primary care team and a dermatologist who is also a Black woman. This means she understands how specific conditions look on every skin tone and texture.” 

For Fariha, education is the answer. “There is a general lack of awareness and dismissal surrounding nail health, or nail health issues being seen only as an ‘aesthetic concern’. There needs to be much more accessible and mandatory education regarding improper curing, the use of inadequate gel lamps, and other factors that can contribute to allergies.” 

What are the best HEMA-free gel nail products?

Happily, Fariha has noticed an increase in professional-grade brands making efforts to remove HEMA and other potential allergens, including The GelBottle Inc, Halo, and Kiara Sky. But for many gel-allergic people, finding the nail routine that works for them takes trial and error. Nineteen-year-old Louise developed a gel allergy in her sophomore year of high school after visiting what she describes as a “chop shop”. She says, “My hands were covered in itchy blisters, and my arms and legs had hives all over them.” After plenty of research, Louise concluded that it was HEMA that triggered her reaction, and now she mainly wears press-ons. Most of the gel-allergic women I spoke to prefer press-ons as the safest, easiest, and most affordable way to bypass acrylates and UV lamps. 

@louisegieke i hope this answers yalls questions ???? #contactdermatitis #gelallergy #allergicreaction #diynails #fypシ ♬ original sound – lou!!

I’ve tried press-ons since developing my HEMA allergy, but I find they only last about five days, while regular polish chips quickly in comparison to gel. I also miss getting nail extensions, and the confidence boost from a long, fresh, full set. If patch test results do confirm a HEMA allergy, Lucy Kavrazoni of LK Nails & Beauty tells me I have another option, namely silk or fiberglass nail extensions, which are wraps bonded with resin or glue to create a strong yet gentle nail enhancement — but the service is hard to come by. 

“Unlike gel polish, silk and fiberglass systems don’t rely on HEMA or similar methacrylate monomers for curing,” she says, adding, “Instead, the enhancements use a cyanoacrylate-based resin, which is rapidly set using an activator rather than being cured under a UV or LED lamp.” Kavrazoni continues that some people can, however, still be sensitive to cyanoacrylate: “With that in mind, it’s important to confirm the exact allergen with a patch test,” she says. Additionally, Dr. Zeichner recommends websites like skinsafe.com, which provide a database of ingredients to help people with sensitivities find products that might be better suited. 

As a journalist who investigates beauty for work, I spent weeks researching HEMA-free nail options following my own life-changing reaction, and I was struck by how limited they still are. Until acrylate allergies — and the wider women’s health concerns linked to aesthetic treatments — are taken seriously by both medical professionals and the industry, progress will remain slow.

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