Sophia Delgado
The use of gel nail polish has been known to interfere with pulse oximeter readings. Pulse oximeters work by shining light through the finger to detect oxygenated and deoxygenated haemoglobin in the nail bed. While some sources claim that a single coat of light colours may not cause a problem, others suggest that any strong barrier that can stop infrared light from passing through nails can affect readings. There are also suggestions that the type of oximeter used may also be a factor, with some devices being better at separating the arterial signal from venous and other artefactual signals, such as gel nail polish.
| Characteristics | Values |
|---|---|
| Interference with oximeter readings | Nail art, gel nails, nail paints, dark nail polish, nail extensions, and fancy accessories interfere with readings. |
| Impact on accuracy | Nail polish can impact the accuracy of oximeter readings by affecting the detection and measurement of oxygenated hemoglobin. |
| Recommended action | It is recommended to remove nail polish before taking oximeter readings to ensure accurate results. |
| Alternative methods | In some cases, the oximeter probe light can be taped above the nail bed or rotated to shine on the side of the finger, or placed on other areas with pulsatile blood flow like the ear, nose, lip-cheek, or toes. |
| Color impact | Black, brown, green, red, blue, and holographic nail polishes have been reported to decrease oximeter readings. Light colors like pink may not cause significant issues. |
| Gel nail impact | Gel nails can interfere with oximeter readings and may result in overestimations of actual readings, potentially delaying the detection of hypoxaemia. |
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What You'll Learn
Oximeter readings can be inaccurate due to gel nails
Gel nails create a strong barrier over the nail, which can interfere with oximeter readings. This is because the oximeter's infrared light cannot pass through the gel to the capillaries, resulting in inaccurate readings. In some cases, the oximeter may not be able to detect any oxygen levels at all if the gel nails are too thick or opaque.
Additionally, the colour of gel nails can also affect the accuracy of oximeter readings. For example, light blue and orange gel nails have been found to result in a statistically significant increase in SpO2 readings on certain oximeter devices. Black and brown nail polish have also been found to cause a significant decrease in SpO2 readings.
To avoid inaccurate oximeter readings, it is recommended to remove gel nails or nail polish before taking readings. This will ensure that the oximeter can accurately detect the oxygen levels in the blood. However, removing gel nails can be a specialised procedure that requires time and resources. As an alternative, the oximeter probe light can be taped above the nail bed or rotated so that the light shines on the side of the finger, avoiding the nail altogether.
It is important to note that there are no large-scale studies that definitively prove that gel nails or nail polish interfere with the accuracy of oximeter readings. However, healthcare professionals advise against wearing nail polish or gel nails when taking oximeter readings to ensure the most accurate results.
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Oximeters work by shining light through the finger
Oximeters are small, clip-like devices that attach to the finger, toe, or ear. They are non-invasive and painless, and they work by shining light through the finger to measure oxygen saturation levels in the blood. This is done by measuring changes in light absorption in oxygenated or deoxygenated blood.
Oximeters can be used to monitor individuals with conditions that affect blood oxygen levels, such as asthma, pneumonia, lung cancer, and other respiratory illnesses. They can also be used to assess an individual's tolerance for physical activity or to analyse their breathing patterns when sleeping, such as in sleep apnea. During the COVID-19 pandemic, oximeters became household devices as they can alert individuals to falling blood oxygen levels, which may be an indication of infection.
The accuracy of oximeters can be affected by certain factors. For example, darkly pigmented skin can increase the "noisiness" of the denominator when taking readings, leading to strange effects in the results. Engineers are working to address this issue by developing devices that can detect poor signal quality or darker skin tones and compensate by sending more light through.
Another factor that can impact the accuracy of oximeter readings is nail polish or nail varnish. This is because the light from the oximeter may not be able to penetrate painted nails correctly. As a result, doctors recommend removing nail polish, gel nails, and nail extensions before taking oximeter readings to ensure accurate results. However, some people have reported that light colours or a single coat of nail polish may not interfere with the readings.
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Nail polish can interfere with oximeter readings
While oximeters are a great way to monitor oxygen levels, certain factors can interfere with their accuracy. One such factor is the presence of nail polish, including gel nails.
Nail polish, especially darker or glittery shades, can obstruct the oximeter's ability to detect oxygenated haemoglobin in the nail bed. This is because oximeters work by passing infrared light through the nails into the capillaries, and nail polish can act as a barrier, preventing the light from passing through. As a result, the readings may be inaccurate, which can delay the detection of hypoxaemia.
Several doctors and studies have confirmed the impact of nail polish on oximeter readings. Dr Joyeeta Basu, co-founder and Consultant Physician at Doctors Hub, shared on Twitter that "nail polish interferes with Pulse Oximetry readings". She advised removing nail polish to obtain accurate readings. Similarly, Dr Vikas Maurya, Director and Head of Department of Pulmonology at Fortis Hospital, also emphasised the importance of removing nail polish for accurate oximeter measurements.
Additionally, a study published in 2007 by Research Gate explored the effects of gel-based manicures on pulse oximetry. The study found that certain colours, such as light blue and orange, resulted in a statistically significant increase in SpO2 readings on a Masimo device. On the other hand, the Philips oximeter showed imprecision, with the limits of agreement ranging from 2% for pink to 17% for black nail polish. These findings highlight the potential interference of nail polish, specifically gel nails, with oximeter readings.
To ensure accurate oximeter readings, it is generally recommended to remove nail polish. However, some individuals have shared creative solutions, such as leaving one nail polish-free or rotating the oximeter probe to the side of the finger, to still allow for accurate readings without completely removing the nail polish.
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Oximeter readings can be taken from other parts of the body
Oximeters are small electronic devices that can be clipped onto different parts of the body to measure the oxygen in a person's blood. They are usually placed on the fingertip, but can also be placed on the earlobe or toe.
The devices emit light that passes through the fingernail, skin, tissue, and blood. On the other side of the finger, a sensor detects and measures the amount of light that passes through without being absorbed. Using that measurement, the device calculates the oxygen saturation of the blood.
In such cases, you can try placing the oximeter on your toe or earlobe. However, keep in mind that the cables may not be long enough to reach your toe, and earlobe readings may not be ideal. Additionally, some people have reported that the sensor couldn't see through black polish, so they turned the device sideways so that it was still on the fingertip but not on the nail.
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Removing gel nail polish requires a specialised procedure
Doctors recommend removing gel nail polish before taking oximeter readings. This is because the oximeter may not be able to detect the oxygenated and deoxygenated haemoglobin in the nail bed due to the gel polish acting as a barrier.
Another method is to use an electric nail drill or nail dremel to remove the bulk of the gel polish, and then finish by hand filing or soaking and scraping. You can also try soaking your nails in hot water for 5-6 minutes to weaken the base coat and then push it off with a cuticle pusher. However, it is important to note that picking, filing, or scraping off gel nail polish can damage your nails, so it is best to avoid these methods if possible.
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Frequently asked questions
No, it is best to remove gel nails before using an oximeter as they can interfere with readings.
Oximeters detect oxygenated and deoxygenated haemoglobin in the nail bed by passing infrared light through the nails. Gel nails can block the infrared light from passing through.
Light colours such as pink may not cause a problem. However, it is best to remove all nail polish before taking an oximeter reading.
Yes, the oximeter probe light can be taped above the nail bed, or the probe can be rotated so that the light shines on the side of the finger. The probe can also be placed anywhere there is pulsatile blood flow, such as the ear, nose, lip-cheek, or toes.
No, some oximeters may be more or less affected by gel nails. For example, the Masimo oximeter showed a statistically significant increase in readings with light blue and orange gel nail polish, while the Philips oximeter showed imprecision with limits of agreement ranging from 2% for pink to 17% for black.
