Contact Allergy to Methacrylate Containing Nail Products: Lack of Impact of EU Legislation. An Audit on Behalf of the European Environmental Contact Dermatitis Research Group (EECDRG)

BACKGROUND: There is a current fashion for the use of methacrylate-containing nail cosmetics that can induce allergic contact dermatitis. European Union (EU) legislation was introduced in 2021 that had the aim of preventing its development.

OBJECTIVES: To assess prevalence and exposures causing contact allergy to 2-hydroxyethyl methacrylate (HEMA) prior to and following implementation of the legislation.

METHODS: A retrospective audit was conducted by 7 European centres patch testing to HEMA prior to the legislation and for 2 years afterwards.

RESULTS: A total of 26 297 patients were tested to HEMA in the baseline series between 2016 and 2023. The prevalence of contact allergy to HEMA from all sources amongst females was 2.82% compared to 0.34% amongst males. The prevalence of nail related contact allergy rose from 0.91% in 2016 (2 centres) to: 0.99% in 2017 (3 centres); 1.24% in 2018 (5 centres); 1.23% in 2019 (6 centres); 1.36% in 2020 (7 centres); 1.30% in 2021 (7 centres); 1.52% in 2022 (7 centres) and 1.98% in 2023 (7 centres). Contact allergy to HEMA from exposure to nail cosmetics accounted for 3.4% of all occupational skin disease.

CONCLUSIONS: EU legislation appears not to have had the intended impact on controlling allergic contact dermatitis from methacrylates in nail cosmetics. There is an urgent need to revisit Scientific Committee on Consumer Safety (SCCS) opinion to reconsider exposure to methacrylates and cross-reactions between them. A strategy needs to be developed and implemented to better control the current outbreak.