With the ease that comes from years of practice, Julie Le, of Nails R Us in Alexandria, Va., sets out to remake customer Natalie Harris' nails. She buffs, files, snips, clips, smooths, and then, with a nod from Harris, paints on ruby red polish.
It's a process repeated every day throughout the country as thousands of women like Harris--and men, too--strive for beautiful nails. They seek the services of nail and beauty salons or manicure their nails themselves with a host of nail products available on the market.
The reason, said Kim Siridavong, owner of Nails R Us, is simple: "Everybody wants to look good."
But achieving that look is not without potential hazard. Infections and allergic reactions can occur with some nail services and products. Some chemicals in nail products, if ingested, are poisonous. Many are flammable.
Relying on nail and beauty salons is not risk free, either. They use the same products, and they may present a greater risk for disease transmission.
Federal and state regulations help reduce the risks, but consumers also need to take care that their pursuit of beautiful nails ensures healthy nails.
Growth of an Industry
link to larger picture of graph showing market projections for nail services With the increased use of nail services and products in recent years has come growing concern about safety. According to Nails 1995 Fact Book, U.S. consumers will spend an estimated $5.2 billion on nail services in 1995, half a billion more than in 1994. They can choose from 34,852 freestanding nail salons across the country--nearly 2,000 more than a year ago--or hundreds of thousands of beauty salons that offer nail services.
The most requested service, according to the Fact Book, is artificial nails. Manicures are No. 2. Other popular services include nail jewelry and nail art.
Because of the variety of nail services, the preferred term for a person who provides nail services is "nail technician" rather than manicurist, said Suzette Hill, managing editor for Nails, a magazine for professionals and students.
"Twenty years ago, they mainly did manicures," she said. "Now, they're doing so much more."
They use a range of products, including polishes, paints, artificial nails, glues, and laminates, many of which are available for home use, too.
Nail Products as Cosmetics
Nail products for both home and salon use are regulated by the Food and Drug Administration. Under the Federal Food, Drug, and Cosmetic Act, these products are considered cosmetics because they are "articles other than soap which are applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance."
By law, nail products sold as cosmetics in the United States must be free of poisonous or deleterious substances that might injure users under the usual or customary conditions of use intended by the manufacturer. These uses are printed on the package or on a package insert. Many nail products contain poisonous substances, such as acetonitrile in glue removers, but are allowed on the market because they are not harmful when used as directed. They're poisonous only when ingested, which is not their intended use.
Products sold for home use also must be labeled properly, with the names of the ingredients listed in descending order of predominance.
FDA does not review or approve nail products and other cosmetics before they go on the market. However, the agency inspects cosmetic manufacturers and samples and analyzes cosmetics as needed. If a safety problem arises, the agency can take legal action against the product.
FDA also tracks safety problems through its Cosmetic Voluntary Registration Program, in which cosmetic manufacturers voluntarily report to FDA the types of adverse reactions their customers have reported to them. FDA uses this information to determine a baseline reaction rate for specific product categories, such as cuticle softeners, nail extenders (artificial nail ends), and nail polishes. The agency gives this information to participating companies so they can compare their adverse reaction rates to FDA's determined baseline.
FDA also learns about potentially harmful products from manufacturers' competitors, consumers, doctors, and nail technicians, who report adverse reactions directly to the agency.
Salon Safety
The salons and their technicians are regulated by the states, usually their cosmetology boards. Lois Wiskur, past-president of the National Interstate Council of State Cosmetology Boards, said that as far as she knows, every state has some type of licensing requirements for nail salons, nail technicians, or both.
Under these requirements, salons providing nail services usually must meet certain requirements, such as:
* Employing nail technicians who have had a minimum number of hours of classroom and practical training.
* Properly sterilizing manicure implements. The preferred methods are autoclaving (heat sterilization) or chemical sterilization.
* Undergoing a state inspection periodically.
* Maintaining sufficient equipment, such as at least one manicure table and one sink that runs hot and cold water.
* Making sure that employees wash their hands before beginning work on a customer.
To prevent blood-borne infections, such as HIV and hepatitis, the national Centers for Disease Control and Prevention recommended similar sanitary practices for salon employees in guidelines issued in 1985. The guidelines targeted, among others, personal-service workers, such as manicurists and pedicurists. To date, there have been no reports of transmission of blood-borne diseases to or from a personal service worker, according to CDC.
Nail Infections
More common nail problems, dermatologists report, are infections from bacteria, such as Staphylococcus; fungi, such as Candida (also known as yeast); and skin viruses, such as warts.
Bacterial and fungal infections frequently result from artificial nails, whether applied at home or in a salon. A bump or knock to a long artificial nail may cause it to lift from the natural nail at the base, leaving an opening for dirt to get in. If the nail is reglued without proper cleaning (with rubbing alcohol, for example), bacteria or fungi may grow between the nails and spread into the natural nail.
Also, as the natural nail grows, an opening develops between the natural nail and artificial nail. If this space is not filled in regularly, it can increase the chances for infection.
A fungal infection can take hold when an acrylic nail is left in place too long--such as three months or more--and moisture accumulates under the nail.
Bacterial, fungal and viral infections also can occur from using insanitary nail implements, especially in a salon, where the same implements are used on many people.
Unclean implements are especially dangerous if the skin around the nail is broken. This can occur with overzealous manicuring--if, for example, too much of the cuticle is cut or pushed back too far. If the cuticle is cut or separated from the fingernail, infectious agents can get into the exposed area. This is why dermatologists recommend leaving cuticles intact.
Symptoms of an infection include pain, redness, itching, and pus in or around the nail area. Yellow-green, green, and green-black nail discolorations are signs of a Pseudomonas bacterial infection. A blue-green discoloration signals a fungal infection.
If an infection appears while wearing artificial nails, they should be removed and the area cleaned thoroughly with soap and water. If symptoms persist, the person should consult a doctor, who may prescribe a topical or oral anti-infective medicine.
There are no approved nonprescription products to treat fungal nail infections, and over-the-counter products to treat other types of fungal infections should not be used for nail infections. In a review of OTC antifungal products, FDA found that fungal infections of the nails respond poorly to topical therapy, partly because of the nail's thickness. So, in 1993, the agency ruled that any OTC product labeled, represented or promoted as a topical antifungal to treat fungal infections of the nail is a new drug and must be approved by FDA before marketing. This rule, which went into effect in 1994, does not include prescription antifungal products.
Despite the rule, some companies continue to sell unapproved OTC nail products, such as nail glues, with antifungal claims. FDA has warned these companies it might take legal action if they don't stop selling the products. |
| Author: Leslie Johnes |
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