Liam Carter
Fingernail polish has been described to alter oxygen saturation readings on pulse oximeters, with some studies indicating a clinically significant decline in oxygen saturation due to nail polish. This has led to the common recommendation to remove nail polish prior to taking an oximeter reading. However, the removal of gel nail polish requires a specialized procedure, which can be time-consuming and costly. As there are no available studies on the effect of gel-based manicures on pulse oximetry readings, it is unclear whether gel nail polish affects oxygen saturation readings to the same extent as regular nail polish.
| Characteristics | Values |
|---|---|
| Effect on oxygen saturation | Some studies show a decrease in oxygen saturation, while others show no change. |
| Interference with pulse oximeter readings | Nail polish can interfere with the passing of the beam through the pulse oximeter to the nail bed, affecting the accuracy of the readings. |
| Colour | Dark shades of nail polish are more likely to interfere with readings than light or clear colours. |
| Type of nail polish | Gel nail polish may require a specialised removal procedure, which can be time-consuming and resource-intensive. |
| Clinical significance | The changes in oxygen saturation due to nail polish are typically not clinically significant. |
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What You'll Learn
Nail polish can cause inaccurate oximeter readings
The nail polish can interfere with the light beam, affecting the accuracy of the readings. Some studies have shown that nail polish, especially darker shades, can result in an overestimation of actual oxygen saturation levels. This is because the chromatic characteristics of nail polish can alter light absorption and scattering, leading to optical shunting of light around the finger. This interference may be more or less prominent depending on the type of oximeter used.
The impact of nail polish on oximeter readings has been observed by medical professionals. Dr Vikas Maurya, Director and Head of Department, Pulmonology at Fortis Hospital, noted that "an oximeter detects the oxygenated and deoxygenated haemoglobin in the nail bed. They are of two different wavelengths. It passes a beam of light and detects oxygen levels." He further added that the waveform on the oximeter can indicate if the readings are accurate.
Additionally, Dr Joyeeta Basu, co-founder and Consultant Physician at Doctors Hub, tweeted, "Nail polish interferes with Pulse Oximetry readings. So, ladies, if you get COVID, please remove your nail polish to get accurate readings." She shared this information after witnessing three consecutive patients who showed fluctuations in their oximeter readings due to their nail polish.
While the impact of nail polish on oximeter readings is generally small and not clinically significant, it is important to be aware of this potential source of inaccuracy. In certain situations, such as during the COVID-19 pandemic, accurate oximeter readings can be crucial for monitoring respiratory health. Therefore, it is recommended to remove nail polish or use alternative monitoring techniques to ensure accurate oxygen saturation measurements.
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The colour of nail polish can affect oximeter readings
The colour of nail polish can indeed affect oximeter readings. Oximeters are devices that monitor oxygen saturation (SpO2) in the blood and heart rate. They do this by passing a beam of infrared light through the nails into the capillaries, which detects oxygen levels.
The use of fingernail polish has been described to alter SpO2 readings, and its removal is often recommended before taking an oximeter reading. This is because the chromatic characteristics of nail polish can determine its light absorption and scattering, resulting in optical shunting of light around the finger. This can lead to an overestimation of actual oxygen saturation levels.
Some studies have found that certain colours of nail polish can cause a decrease in SpO2 readings, with red and brown polishes leading to lower values. Other colours, such as light blue and orange gel nail polish, have been found to cause an increase in SpO2 readings. The type of oximeter used may also impact the accuracy of readings, with some devices being more affected by the presence of nail polish than others.
It is important to note that the effect of nail polish on oximeter readings may not be clinically significant, and there are conflicting results across studies. However, in certain situations, such as during acute altitude exposure or in cases of acute mountain sickness, accurate oximeter readings are crucial. Therefore, it is generally recommended to remove nail polish before taking oximeter readings to ensure accuracy.
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Gel nail polish requires a specialised removal procedure
Gel nail polish has gained popularity due to its attractiveness and longevity. However, removing gel nail polish requires a specialised procedure, and it is recommended to remove it before measuring oxygen saturation using a pulse oximeter.
One method for removing gel nail polish involves using acetone, a commonly available household item. To start, file the top layer of the gel nail polish gently. This step is crucial as it enables the acetone to penetrate and dissolve the polish more effectively. Next, soak cotton pads or balls in acetone and place them on your nails. Then, wrap each nail with plastic food wrap or foil to create a tight seal, ensuring that the cotton remains in contact with the nail. Leave the wrap on for approximately 10 to 20 minutes. Finally, remove the wrap and use a cuticle pusher or washcloth to gently scrape off any remaining gel nail polish. It is important to be cautious during this process to avoid damaging your nails or the surrounding skin.
Another approach to removing gel nail polish is to simply let your nails grow out. While this method is slower and may take several months, it helps prevent damage to your nails. During this process, it is important to resist the urge to pick or scrape off the gel nail polish, as this can harm your nails.
In some cases, the gel nail polish may be particularly difficult to remove. If the above methods are unsuccessful, it is advisable to seek the assistance of a professional nail technician or visit a nail salon. They can safely remove the gel nail polish using specialised tools and techniques.
It is worth noting that gel nail polish can affect oxygen saturation readings on a pulse oximeter. Therefore, it is generally recommended to remove gel nail polish or consider alternative monitoring techniques to ensure accurate measurements.
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The accuracy of oximeters varies
Oximeters are generally accurate to within 2% to 4% of the actual blood oxygen saturation level, but a number of factors can impair their accuracy. These include nail polish and artificial nails, which may block the light emitted by the device. The chromatic characteristics of nail polish can determine its light absorption and scattering interactions, resulting in optical shunting of light around the finger. The effect may be more prominent in certain models, such as the Masimo oximeter, due to its brighter LED light. The Philips oximeter, on the other hand, has been associated with poorer precision in readings and failed to detect readings 1.8% of the time compared to the Masimo oximeter.
The colour of the nail polish also seems to make a difference. While some studies have found that red and brown nail polish result in a significant decrease in SpO2, others have shown that even opaque, dark colours like black, blue, and purple do not cause a clinically significant change in readings. A study on the effects of gel-based manicures found that light blue and orange gel nail polish resulted in a statistically significant increase from baseline SpO2 readings, while the Philips oximeter's limits of agreement ranged from 2% for pink to 17% for black.
Other factors that can affect the accuracy of oximeters include skin temperature and thickness, skin pigmentation, tobacco use, and excessive motion. Recent evidence suggests that oximeters more frequently fail to detect hypoxemia, or low blood oxygen levels, in Black patients compared to white patients. This has led to questions about the accuracy of the technology for patients with dark skin. Oximeters are most accurate when blood oxygen saturation is between 90% and 100%, with accuracy decreasing as levels fall below 90%.
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The impact of gel nail polish on oximeter readings is not yet known
Fingernail polish has been described to alter SpO2 readings, and its removal is often recommended before measuring oxygen saturation. While gel-based manicures have become increasingly popular, there is limited research on how they affect pulse oximeter readings.
Another study by Brand et al. (2002) and Chan et al. found that SpO2 measurements were accurate even with opaque nail polish colours, including black, blue, and purple. However, Yamamoto et al. (2008) reported conflicting results, indicating a clinically significant decline in oxygen saturation of 5-10% due to nail polish.
The chromatic characteristics of nail polish affect light absorption and scattering, resulting in optical shunting of light around the finger periphery. This effect may be more prominent in certain oximeter models with brighter LED lights, such as the Masimo oximeter. Additionally, the Philips oximeter has been associated with poorer precision in readings.
While the impact of gel nail polish on oximeter readings is not fully understood, it is recommended to remove nail polish or use an alternative monitoring technique to ensure accurate results, especially in medical contexts.
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Frequently asked questions
Yes, gel nail polish can affect oxygen saturation readings on a pulse oximeter. It can cause an overestimation of the actual oxygen saturation level.
The chromatic characteristics of nail polish determine its light absorption and scattering interactions, resulting in optical shunting of light around the finger periphery.
Dark shades of nail polish, including black and brown, have been shown to result in a significant decrease in oxygen saturation readings.
An alternative monitoring technique should be sought if gel nail polish cannot be removed.
Yes, the device being used can also affect the accuracy of the readings. For example, the Philips oximeter has been associated with poorer precision in readings compared to the Masimo oximeter.
