Presence of 2-hydroxyethyl methacrylate (HEMA) and other (meth)acrylates in nail cosmetics, and compliance with EU legislation: An online market survey

[Nail cosmetics-risks and opportunities]

The use of nail cosmetics has experienced a strong upswing in recent years, particularly due to product innovations and the increasing popularity in social media. The market value of nail cosmetics amounted to USD 24.55 billion in 2024 with a forecast annual growth rate of almost 5%. It is therefore also important for dermatologists to be aware of the most common complications, risks, and areas of application associated with nail cosmetics and to provide appropriate guidance and care to affected patients.

Contact Allergy to Methacrylate Containing Nail Products: Lack of Impact of EU Legislation. An Audit on Behalf of the European Environmental Contact Dermatitis Research Group (EECDRG)

BACKGROUND

There is a current fashion for the use of methacrylate-containing nail cosmetics that can induce allergic contact dermatitis. European Union (EU) legislation was introduced in 2021 that had the aim of preventing its development.

OBJECTIVES

To assess prevalence and exposures causing contact allergy to 2-hydroxyethyl methacrylate (HEMA) prior to and following implementation of the legislation.

METHODS

A retrospective audit was conducted by 7 European centres patch testing to HEMA prior to the legislation and for 2 years afterwards.

RESULTS

A total of 26 297 patients were tested to HEMA in the baseline series between 2016 and 2023. The prevalence of contact allergy to HEMA from all sources amongst females was 2.82% compared to 0.34% amongst males. The prevalence of nail related contact allergy rose from 0.91% in 2016 (2 centres) to: 0.99% in 2017 (3 centres); 1.24% in 2018 (5 centres); 1.23% in 2019 (6 centres); 1.36% in 2020 (7 centres); 1.30% in 2021 (7 centres); 1.52% in 2022 (7 centres) and 1.98% in 2023 (7 centres). Contact allergy to HEMA from exposure to nail cosmetics accounted for 3.4% of all occupational skin disease.

CONCLUSIONS

EU legislation appears not to have had the intended impact on controlling allergic contact dermatitis from methacrylates in nail cosmetics. There is an urgent need to revisit Scientific Committee on Consumer Safety (SCCS) opinion to reconsider exposure to methacrylates and cross-reactions between them. A strategy needs to be developed and implemented to better control the current outbreak.

Nail Polishes: A Review on Composition, Presence of Toxic Components, and Inadequate Labeling

Nail polishes were developed in 1920, and since 1940, it has been known that these cosmetics contain toxic and sensitizing components. Over the years, nail polishes have undergone several changes in their formulation to avoid this problem, but new components have also been considered toxic and allergenic. The growing demand for gel nails has also been highlighted in cases of allergy to (meth)acrylates, and the biggest concern that was previously related to the presence of toluene sulfonamide-formaldehyde resin (TSFR) in traditional nail polish formulations is now also part of (meth)acrylate-based cosmetics. The beautification caused by nail polish is the main factor behind its constant use throughout the world, but studies have demonstrated its use for other purposes, such as treating fungal diseases, sun protection factor in cancer patients, and as a possible ally in forensic area. This review brings the beginning of the discovery of nail polish and its trajectory to the present day, including its effects on health and its inadequate labeling. Therefore, it is extremely important that legislation monitors the composition of nail cosmetics and that new formulations are studied to make them safe for health and the environment.

Allergic contact dermatitis caused by glucose sensors and insulin pumps: A full review: Part 2. Case reports and case series, clinical features, patch test procedures, differentiation from irritant dermatitis, management of allergic patients and (proposed) legislation

During the past 8 years, a large number of reports have appeared on allergic contact dermatitis to glucose sensors and insulin pumps in paediatric and adult patients with type 1 diabetes mellitus. Isobornyl acrylate in one particular sensor sensitised many hundreds of (published) individuals, and many other allergens were discovered in a large number of sensors and pumps. Diagnostic procedures with patch tests proved very complicated, as manufacturers showed a serious lack of cooperation with dermatologists in providing information on the ingredients of their products and samples for patch testing. This two part article provides a full and detailed review of all aspects of the subject of allergic contact dermatitis to glucose sensors and insulin pumps. Part 1 provided a general introduction to sensors and pumps, a survey of the cutaneous adverse reactions that they have caused, a full account of the allergens in the diabetes devices and an overview of the glucose sensors and insulin pumps that have caused allergic contact dermatitis. This part 2 presents all published case reports and case series, clinical features of allergic contact dermatitis, patch test procedures, differentiation from irritant dermatitis, management of allergic patients and (proposed) legislation.

Sensitisation to the acrylate co-polymers glyceryl acrylate/acrylic acid co-polymer, sodium polyacrylate and acrylates/C10-30 alkyl acrylate cross-polymer (Carbopol®) is rare

BACKGROUND

Acrylate polymers and cross-polymers (ACPs) are frequently used cosmetic ingredients. The British Society for Cutaneous Allergy (BSCA) and the UK Cosmetic, Toiletry and Perfumery Association (CTPA) collaborated to investigate the allergenic potential of three commonly-used ACPs.

OBJECTIVES

The objective of this study is to determine the prevalence of allergic contact dermatitis (ACD) to three ACPs: glyceryl acrylate/acrylic acid co-polymer, sodium polyacrylate, and acrylates/C10-30 alkyl acrylate cross-polymer (Carbopol®).

MATERIALS AND METHODS

The BSCA prospectively audited data collected from 20 centres in the UK and Ireland between 1st September 2021 and 1st September 2022. Patients with suspected ACD to (meth)acrylates, with facial dermatitis, or consecutive patients, were patch tested to glyceryl acrylate/acrylic acid co-polymer 10% aqueous (aq.) sodium polyacrylate 2% aq., and to acrylates/C10-30 alkyl acrylate cross-polymer 2% aq. (Carbopol®). The frequencies of positive, irritant, and doubtful reactions were recorded.

RESULTS

In total, 1302 patients were patch tested. To glyceryl acrylate/acrylic acid co-polymer, there was one doubtful reaction in a patient allergic to multiple (meth)acrylates, and one irritant. To sodium polyacrylate, there were four irritant reactions, one doubtful, and one positive reaction; in all cases, relevance was unknown and there was no demonstrable (meth)acrylate allergy. There were no reactions to Carbopol®.

CONCLUSIONS

Sensitisation to these concentrations of the three tested ACPs is rare. Elicitation of dermatitis in (meth)acrylate-sensitised patients by exposure to these three ACPs appears unlikely.

Contact allergy to acrylate-containing nail cosmetics: A retrospective 8-year study

BACKGROUND

Over the last 10 years, allergic contact dermatitis (ACD) from acrylate-containing nail cosmetics (acrylic nails, gel nails, gel nail polish) has been reported repeatedly.

OBJECTIVES

To investigate the frequency and clinical features of ACD in nail cosmetics in a university hospital in Amsterdam, The Netherlands.

PATIENTS AND METHODS

A retrospective study in patients diagnosed with ACD from acrylate-containing nail cosmetics at the Amsterdam University Medical Centers between January 2015 and August 2023.

RESULTS

Sixty-seven patients, all women, were diagnosed with ACD from nail cosmetics, representing 1.6% of all individuals and 2.3% of all women patch tested in this period. Sixty-five of sixty-seven (97%) subjects had a positive patch test to 2-hydroxyethyl methacrylate (HEMA). Forty-nine patients (73%) were consumers and 18 (27%) were professional nail stylists. The sites most frequently affected with dermatitis were the fingers (79%), hands (40%) and the head and/or neck. Avoidance of contact with acrylate-containing products resulted in complete clearing of dermatitis in 80% of patients.

CONCLUSIONS

ACD from acrylate-containing nail cosmetics is frequent in women patch tested in Amsterdam. Nearly all were identified by a positive patch test to 2-hydroxyethyl methacrylate in the (meth)acrylate series or the European baseline series.