Liam Carter
The popularity of gel nail polish has raised concerns about its potential to harbor bacteria, especially among healthcare workers. Several studies have been conducted to evaluate the bacterial burden associated with gel nails, standard nail polish, and natural nails. While some research suggests that gel nail polish may retain more bacteria than other types of nail treatments, even after hand sanitization, other studies have found no significant difference in bacterial counts between gel nails and other options. The discrepancy in findings highlights the need for further investigation to inform evidence-based infection control practices and guidelines for individuals and healthcare workers alike.
| Characteristics | Values |
|---|---|
| Bacterial Burden | All nail types become contaminated over time regardless of the product applied. |
| Bacterial Burden Reduction | Standard polish and natural nails are more amenable to hand hygiene than gel polish. |
| Gel Nails | May be more difficult to clean using alcohol hand gel. |
| Gel Nails | May retain bacteria on healthcare workers' fingers, even after hand sanitiser is used. |
| Acrylic Nails | Harbor more bacteria than natural nails and are not recommended for health care workers. |
| Standard Polish | Has higher bacterial counts than unpolished nails after 4 days and 21 days. |
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What You'll Learn
- Bacterial burden of gel nails, standard nail polish, and natural nails
- The impact of nail polish on the bacterial burden of nail surfaces
- The difficulty of cleaning gel nails with alcohol hand gel
- The effectiveness of hand disinfection depending on the type of nail coating
- The role of hand hygiene practices in preventing healthcare-associated infections
Bacterial burden of gel nails, standard nail polish, and natural nails
The hands of healthcare workers (HCWs) can become progressively colonized with normal flora and potential pathogens. As such, the importance of hand hygiene practices for HCWs cannot be overstated.
A study published in the American Journal of Infection Control evaluated the bacterial burden of gel nails, standard nail polish, and natural nails on the hands of HCWs. The study found that all three nail types become more contaminated with bacteria over time, regardless of the nail product applied. However, gel nails retained the most bacteria after cleaning with alcohol hand gel. The authors suggest that the crevices created by gel polish as nails grow may make sanitizing nails more difficult.
Another study, conducted at three health centers, found that bacterial burden increased over time for all nail types. Reductions in the bacterial burden of natural nails and standard polish were seen after hand hygiene, but not for gel polish.
It is worth noting that freshly polished nails (≤2 days since application) did not have higher bacterial counts than unpolished nails. Additionally, chipped nail polish may support the growth of larger numbers of organisms on fingernails.
While the evidence suggests that gel nails may harbor more bacteria than standard nail polish or natural nails, especially after hand hygiene practices, more research is needed to fully understand the bacterial burden associated with each type of nail.
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The impact of nail polish on the bacterial burden of nail surfaces
The hands of healthcare workers (HCWs) can become progressively colonized with normal flora and potential pathogens. As a result, it is important to evaluate the impact of nail polish on the bacterial burden of nail surfaces.
A study conducted at three health centers evaluated the bacterial burden of gel nails, standard nail polish, and natural nails on the dominant hand of 88 HCWs. The nails were painted with gel polish and standard polish, and cultures were obtained on days 1, 7, and 14 of wear, as well as before and after hand hygiene with alcohol hand gel. A total of 741 cultures were obtained, and the results showed that the bacterial burden increased over time for all nail types. However, reductions in bacterial burden were observed for natural nails and standard polish after hand hygiene, but not for gel polish.
Another study evaluated the bacterial burden of nail surfaces with standard polish (SP) and gel polish (GP) among 46 HCWs. Nail length was maintained at ≤2 mm during the study, and nail surface cultures were performed before and after hand hygiene (HH) with an alcohol-based hand rub on days 1, 4, 7, 14, and 21 after application. The results showed that SP nails were associated with a higher bacterial burden than GP nails on day 4, and with a higher burden than GP nails and unpolished (UP) nails on day 21. However, it is important to note that the mean number of colony-forming units (CFUs) for all nail types after HH did not differ significantly.
While some studies suggest that gel nail polish may retain more bacteria after cleaning compared to standard polish or unpolished nails, other studies have found no significant difference in bacterial burden between nail types. It is worth noting that freshly applied nail polish does not increase the number of bacteria recovered from the periungual skin, but chipped nail polish may support the growth of larger numbers of organisms on fingernails. Therefore, it is recommended that scrubbed team members should not wear any type of nail polish to minimize the risk of bacterial contamination.
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The difficulty of cleaning gel nails with alcohol hand gel
While gel nail polish has not been shown to host an increased number of microorganisms compared to natural nails or standard nail polish, it may be more difficult to clean using alcohol hand gel. This is because the alcohol can cloud certain polishes and topcoats, and may ruin the manicure. However, this is not a problem unique to gel nail polish, as natural nails and standard nail polish also experience reduced bacterial burden after hand hygiene with alcohol hand gel.
Alcohol hand gel can be drying to the skin, and may cause contact dermatitis, so it is recommended that gloves are worn when using it for cleaning. Frequent contact with alcohol hand gel may also dry out the skin around the nails and cuticles, so it is important to wash hands well after use and apply a rich hand cream.
One way to avoid the potential issue of alcohol hand gel drying out the skin is to use thin vinyl or nitrile gloves, such as those used by food service workers. These gloves are thin enough that the wearer can still feel and grip things normally, but provide protection from the drying effects of the alcohol.
It is worth noting that the use of alcohol hand gel is not the only factor that contributes to the cleanliness of gel nails. The length of time since the manicure was applied, the presence of chipping or cracking, and the overall hand hygiene practices of the individual are also important considerations. Additionally, the use of acetone, rather than alcohol, is more likely to remove gel nail polish.
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The effectiveness of hand disinfection depending on the type of nail coating
Hand hygiene is a basic principle of preventing nosocomial infections, and it is important to understand how the type of nail coating affects the effectiveness of hand disinfection.
A study conducted among nurses in a specialist hospital found that the highest percentage of pathogenic microorganisms grew on nails covered with regular varnish (21.7%, p < 0.05). Long-lasting (10 days on average) regular nail varnish was likely to result in ineffective hand disinfection (p < 0.001). This is because the bacterial burden increases over time for all nail types, and while reductions in bacterial burden were seen on natural nails and standard polish after hand hygiene, this was not the case for gel polish.
The same study also found that the risk of growing pathogenic microorganisms after hand disinfection was similar for nails coated with a conditioner or a hybrid varnish to that of natural nails. However, modelling and/or extending the nail plate with a LED/UV light curing gel, and then painting it with a hybrid varnish, also increases the risk of ineffective hand disinfection.
Additionally, it is important to note that acrylic nails and long nails, in general, harbor more bacteria than natural nails, and their wear is not recommended for healthcare workers. This is because the presence of potentially pathogenic microorganisms was correlated with nail length and the presence of ultraviolet (UV)-cured nail polish.
Therefore, it is recommended that healthcare workers maintain short and unpainted nails to ensure effective hand disinfection.
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The role of hand hygiene practices in preventing healthcare-associated infections
Hand hygiene is an essential component of preventing and controlling healthcare-associated infections (HCAIs). The hands of healthcare workers (HCWs) are the most common vehicle for the transmission of healthcare-associated pathogens from patient to patient and within the healthcare environment.
Studies have shown that subungual areas of the hand, which are the areas underneath the nails, harbour high concentrations of bacteria, most frequently coagulase-negative staphylococci, gram-negative rods (including Pseudomonas spp.), Corynebacteria, and yeasts. Freshly applied nail polish does not increase the number of bacteria, but chipped nail polish may support the growth of larger numbers of organisms on the nails. All nail types, including natural nails, standard nail polish, and gel nail polish, become more contaminated with bacteria over time, regardless of the nail product applied.
Acrylic nails, in particular, have been found to harbour more bacteria than natural nails, and their wear is not recommended for HCWs. While gel nail polish does not show an increased number of microorganisms on nails, it may be more difficult to clean using alcohol hand gel.
The World Health Organization (WHO) has emphasized the importance of hand hygiene in healthcare settings, providing guidelines and recommendations to promote improved hand-hygiene practices. However, compliance with optimal hand hygiene practices among HCWs remains low in most settings. Educational programs and interventions are necessary to improve hand hygiene practices and reduce the risk of HCAIs.
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Frequently asked questions
All nail types become contaminated with bacteria over time, regardless of the product applied. However, gel nails may retain the most bacteria after cleaning with alcohol hand gel. This is because the crevices that are created by gel polish as nails grow might make sanitizing nails more difficult.
In a study, standard nail polish was associated with a higher bacterial burden than gel polish on day 4, and with a higher bacterial burden than gel polish and unpolished nails on day 21. However, another study found that gel nails retained the most bacteria after cleaning.
Acrylic nails have been found to harbor more bacteria than natural nails. However, it is unclear whether gel nails have more bacteria than natural nails, as some studies have found that all nail types become contaminated with bacteria at similar rates, while others have found that gel nails retain the most bacteria after cleaning.
The crevices that are created by gel polish as nails grow might make sanitizing nails more difficult, leading to an increased bacterial burden. Additionally, gel nails may be more challenging to clean using alcohol hand gel.
