Acrylic Client With Itchy, Red Nail Folds
A client who has had acrylic enhancements for eight months returns for an infill. She reports itching and redness around the nail folds that started about three days ago, and she has small bumps on the sides of two fingers. She says she started using a new scented hand cream last week and that a previous salon used a different monomer. She wants you to "just fill them and cover it up" because she has an event tonight. The salon uses EMA monomer and a UV lamp.
1. How do you assess whether this is irritation, allergy, or infection, and what do you do today?
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You cannot diagnose, but you can triage. Itching, redness, and small bumps appearing after a new product are consistent with contact dermatitis, either irritant or allergic, and allergy to acrylates is possible with repeated exposure. Infection is more likely with pus, spreading redness, heat, or pain. Do not fill or cover the area today, because trapping product over inflamed skin can worsen it. Remove the product gently if it is lifting or if she agrees, or leave it and refer. Advise her to stop the new hand cream, keep the area clean and dry, and see a pharmacist or GP, mentioning her acrylic use. Document the symptoms, timeline, and advice, and flag it in her record for future visits.
2. What are the salon's responsibilities if an acrylate allergy is suspected, for the client and for you?
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Suspected acrylate allergy is a serious occupational and client safety issue. Advise the client to seek medical assessment and, if confirmed, to avoid acrylate products and tell future nail professionals. Do not apply acrylic, gel, or bonding products to her until cleared. For you, review your own exposure: uncured monomer on skin is the main sensitisation route, so check glove type, avoid skin contact, keep products off skin, ensure full cure, and ventilate. Do not use the same contaminated brush or pot. Record the incident, review product SDS, and consider a patch test referral. If you develop symptoms, seek advice. This protects her and your ability to keep working.
3. She insists on having the nails filled tonight. How do you refuse safely and offer a workable alternative?
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Be firm but kind. Explain that filling over red, itchy, bumpy skin risks making the reaction worse and could trap irritant under the product, and that you are not insured to work over inflamed skin. Offer alternatives: a gentle soak-off if she wants the product removed, a protective coat only on healthy nails away from the bumps if policy allows, or a natural nail tidy with no acrylate. Suggest she see a pharmacist today about the itching. If she still insists, decline the fill and offer to rebook once the skin settles or she is cleared. Document her request, your refusal, and the alternative offered. This protects her health and your professional standing.