Report

Evaluation of structural damage and pH of nail plates of

hands after applying different methods of decorating
Mirella Batory1, PhD, Piotr Namiecin

ski2, MSc, and Helena Rotsztejn1, MD, PhD

1
Department of Cosmetology and Aesthetic
Dermatology, Faculty of Pharmacy, Medical
University of Lodz, Lodz, Poland, and
2
Department of Operational Research,
Faculty of Economics and Sociology,
University of Lodz, Lodz, Poland
Correspondence
Mirella Batory, PhD
Department of Cosmetology and Aesthetic
Dermatology, Faculty of Pharmacy
Medical University of Lodz
6 Lindleya St.
90-131 Lodz
Poland
E-mail: mirella.batory@umed.lodz.pl
Conflict of interest:
The authors report no conflict of interest.
The authors alone are responsible for the
content and writing of the article.
doi: 10.1111/ijd.14198
Abstract
Background The purpose of this study was to evaluate the effect of nail polish, gel polish
hybrid, gel nail, and acrylic nail powder and the removal of these formulas on the nail
plates properties, particularly the influence of different coatings on morphology and pH.
Methods The morphology and structure of nail plates were analyzed with use of scanning
electron microscopy. The pH values of the nail plates of hands were measured using the
system Courage & Khazaka.
Results The analysis of morphology and structure of the surface of nail plates showed
distinct changes caused by decorative coatings. The most common ones include fragility
and splitting of the nails. The pH value measured in the whole group ranged from 5.21 to
7.00.
Conclusions The methods used to prepare nails for decoration and all methods of
removing the applied preparations damage the healthy nail plates. The most common
changes are brittleness and nail splitting. The nail polish remover causes less damage
than acetone, and the use of a nail drill machine and nail file causes the greatest
destruction of nail plates. The biggest effect on the pH change has the gel polish hybrid,
gel nail, and acrylic nail powder, causing the pH value of nail plates to rise above 6.0,
whereas after the application of the nail polish, the pH of the plates was on average 5.8
which is closest to the normal value, assumed as physiological.

can absorb substances from the environment as well as medi-

Introduction
The structure, color, and pH of the nails sometimes enable us
to diagnose certain diseases. A healthy nail is pale pink,
smooth, and shiny. Transverse or longitudinal displacement, fri-
ability, fragility of the plate, and basic pH indicate deviation from
the normal condition due to external or internal factors. External
factors that damage the nail plates include use of nail polish,
gel polish hybrid, gel nail, and acrylic nail powder.1–5
The nail plates are made up of 80–90 layers of dead, kera-
tinized flat cells. They are surrounded by the intracellular
cement composed of proteins and/or mucopolysaccharides.
What ensures hardness and elasticity of the nail plates is pres-
ence of its essential ingredient, keratin. It also contains water
(between 5 and 30%) and lipids (less than 5% in adults) such
as cholesterol sulfate, ceramides, free sterols, free fatty acids,
triglycerides, sterol, and wax esters as well as squalene.2,5–13
In the literature, it is possible to find results of analyses of
calcium, magnesium, sodium, potassium, iron, copper, zinc, alu-
minum, and chlorine concentration in the nail plates.6,14,15
There are also reports on identified isotopes (e.g. 13° C, 15°N),
6-monounsaturated fatty acids, hormones, fluorides, and arsenic
from the contaminated environment. The growing nail plates
cations and drugs through the systemic circulation.5,6,16–21
Water is constantly removed from the body to the external
environment also through the nail plates, and transonychial
water loss (TOWL) ranges from 7 to 75 g/m2 per hour.22–32
In spite of numerous reports describing different properties of
the nail plates, only Murdan et al.6 examined its pH. The
authors determined the effect of washing, anatomical sites
(hands/feet), sides (left/right), all fingers, and gender on the
nails’ pH. The mean pH of the uncoated nail plates was equal
to 5.0  0.5, with a minimum of 3.4 and a maximum of 6.3.
They found that the anatomical location and sex have a signifi-
cant effect on pH. The nail plates pH in males and pH of nails
of the feet were higher. There were no differences between the
ten nails of the hands and between the two big toenails of the
feet. The location did not affect pH. Gender had an effect on
the pH of unwashed nails – in women the pH was lower than in
men, however, it did not affect the pH of washed nails, indicat-
ing an impact of exogenous factor. Nail cleaning with a liquid
detergent and tap water temporarily increases pH, which then
returns to the prewash value within 20 minutes. The use of tape
stripping in the examination caused a lower pH within the nail
plates as compared to the surface. In general the study has 1

ª 2018 The International Society of Dermatology International Journal of Dermatology 2018

2 Report Structural damage and pH of nail plates of hands
shown that it is possible to measure the pH of the nail plates
using a Courage & Khazaka pH-Meter, although a longer stabi-
lization time is required to obtain accurate measurements. A
small surface and high curvature of some nail plates made pre-
cise measurements impossible.6
Materials and methods
All the tests were performed with the approval of the Bioethics
Committee of the Medical University of Lodz (RNN/104/17/KE)
and with the consent of respondents.
Materials
In the questionnaire, the participants were 162 healthy
Caucasian women, whereas the second stage (pH studies),
included 68 healthy Caucasian women aged between 19 and
56 years. All examined individuals were acclimatized in a room
prior to the measurements so that their nails could fully adapt to
environmental conditions.
Methods
Scanning electron microscopy
Morphology and structure of the nail plates before and after
various procedures were assessed using a JSM-6610LV
(JEOL) scanning electron microscope (SEM) working in a low
vacuum mode. The study was conducted at magnification
range 50–1,0009. The images in Figure 1 are magnified 500
times.
Evaluation questionnaire
The questionnaire included 16 closed questions on use of nail
polish, gel polish hybrid, gel nail, acrylic nail powder, and
condition of the nails.
Courage & Khazaka probes
Prior to the tests, the pH values of nail polish, gel polish hybrid,
gel nail, and acrylic nail powder were determined using
Courage & Khazaka TM PH 905 pH-meter. The measurements
were repeated three times.
All measurements of the nail plates were performed using
the system Multi Probe Adapter Courage & Khazaka 580 with
TM
pH-Meter PH 905. The high-quality combination electrode
consists of a high sensitivity glass electrode H+ and an
additional reference electrode installed in a single housing.
The instrument was calibrated using buffers at pH of 4.0 and
7.0. The tests were carried out under standard conditions at
room temperature of 21  1° C and humidity of 42  1%
according to EEMCO (European Group on Efficacy
Measurement of Cosmetics and Other Topical Products).33
The probe was applied at an angle of 90 degrees with a
gentle pressure. At first, three measurements were taken on
all ten nail plates of hands, and no significant differences
International Journal of Dermatology 2018
 ski, and Rotsztejn
Batory, Namiecin
were found between the individual nails. Therefore, the
measurements were performed on the largest finger (thumb)
of a nondominant hand, which gave an optimum contact with
the nail plates.2 The examined individuals used liquid soap
containing sodium lauryl sulfate and cocamidopropyl betaine,
which have no significant effect on the pH. They were also
informed that 1 hour before the measurement, they should
not wash their hands or apply any cosmetics on the
measured areas.6 It was also necessary to remove the nail
polish, gel polish hybrid, gel nail, and acrylic nail powder at
least 24 hours before the measurement. The measurements
were performed three times in the same place, and the
results obtained were averaged. The nails of individuals who
did not follow the same procedure were also studied for
comparison.
Statistical analysis
The obtained data were analyzed statistically. The analysis was
performed using the “R” version 3.3.2.34–37 and Microsoft Excel
software. The arithmetic mean, standard deviation, and
confidence intervals were taken into account.
The independence test v2 was used to verify whether the
choice of one nail decoration method was statistically
significant depending on the choice of another one. Due to a
limited number of subgroups, Fischer’s exact test was done to
check the dependence between gel nail and gel polish hybrid.
Shapiro–Wilk’s test with a significance level of 5% was used
for normality testing. To test for age homogeneity in
subgroups using or not using the particular methods, the U
Mann–Whitney–Wilcoxon test was used with a 5% level of
significance. Occurrence of changes depending on use of
individual methods was tested with test  2 (for acrylic nail
powder due to few subgroups, Fisher exact test was used)
with a significance level of 5%. The Cochran–Mantel–Haenszel
test was used to test the hypothesis of impact of nail polish
use on occurrence of nail changes taking into account a
simultaneous use of gel polish hybrid.
The relationship between age and pH of the nails was
measured by Pearson’s correlation coefficient. Shapiro–Wilk’s
test with a significance level of 5% was used for normality
testing of measured pH values. To examine the impact of
particular nail decorating methods on their pH, the U Mann–
Whitney–Wilcoxon test was performed.
Results and Discussion
The pH of preparations themselves is similar to the pH of
preparations applied on the nails. Table 1 shows the average
results of the pH measurement of the preparations that have
been applied to the nail plates (nail polish, gel polish hybrid, gel
nail, acrylic nail powder).
The pH of preparations themselves is similar to the pH of
preparations applied on the nails.
ª 2018 The International Society of Dermatology
  ski, and Rotsztejn
Batory, Namiecin Structural damage and pH of nail plates of hands Report 3

(a) Nailplate (b) Gel polish hybrid

(c) Acetone (d) Nail polish remover

(e) Nail drill machine (f) Nail file

Figure 1 Scanning electron microscopy

image showing morphology of the nail
surface: (a) in the initial state, (b) after
application of gel polish hybrid, (c) after
application of acetone, (d) after application
of nail polish remover, (e) after using a nail
drill machine, (f) after using a nail file

hybrid (marked by arrow). This nail plate is characterized by a

Table 1 Mean pH values of nail polish, gel polish hybrid, gel
more developed morphology with numerous damages visible.
nail, and acrylic nail powder
Surface structure shows the directional nature that may be the
result of the nails preparation process (mechanical impact on
Acrylic
Nail polish Gel polish hybrid Gel nail nail powder the surface of the nail plate), primer interaction (methacrylic
acid or acetic acid ethyl ester), or removal of the nail polish
pH 5.80 6.77 6.78 6.13 (long-term acetone application). The effect of acetone on the
nail plate is shown in Figure 1c. The negative effect of acetone
is manifested as cracks and delamination of the nail plate. The
Scanning electron microscopy nature of nail plate damage due to a nonacetone remover
Figure 1 presents the SEM images of the uncoated nail plate (Fig. 1d) is quite different from the one described above.
and the nail plate following application of various nail decoration Namely, the individual keratinized cells are not clearly visible.
and/or nail extension. Figure 1a presents a healthy nail plate. In The surface of the nail plate is strongly developed, but the nat-
the SEM image, layered, keratinized, flat cells are visible. Each ure of the changes is rather mild and resembles a chemically
layer cohesively adheres to one another. No microcracks or modified surface. The surfaces of nail plates that were mechani-
other defects were observed. Morphology of the nail plates is cally prepared by a nail drill machine and a nail file are shown
uniform, and the plates themselves are smooth. Figure 1b in Figure 1e,f, respectively. Undoubtedly, these forms of
shows a damaged nail plate with visible residue of gel polish removal of acrylic nail powders, gel nails, and gel polish hybrids

ª 2018 The International Society of Dermatology International Journal of Dermatology 2018

4 Report Structural damage and pH of nail plates of hands
are the most destructive procedures for nails. The surface of
plate after drilling shows the most heterogeneous surface, with
numerous microscopical inequalities and a distinct lack of iso-
lated keratinized structures. The nature of damage is very seri-
ous, which is manifested by numerous parallel furrows and
microdamages resembling a porous structure. In the case of
the nail file (Fig. 1f), numerous parallel furrows, a number of
microdamages and, as in the case of the nail drill machine, a
distinct lack of keratinized structures are visible. In this case,
however, the damage scale is lower as compared to the dam-
age caused by the nail drill machine. The damage to the nail
plate coated with a gel polish hybrid results both from the detri-
mental effect of chemicals (acetone – Fig. 1c) and the mechani-
cal effect of the tool (nail file or nail drill machine) used to
prepare the surface of the nail plate (Fig. 1e,f).5,8,38
Questionnaire
Most of the respondents were young women. Median age was
23 years, the third quantum was equal to 25 years, when aver-
age age was on the level of 25.33 years (Fig. 2).
One hundred and four respondents declared themselves as
users of nail polish, 106 gel polish hybrid. Gel nail and acrylic
nail powder were much less commonly used, only by 26 and 6
women, respectively. The distribution and frequency of methods
applied by the respondents are shown in Figure 3.
Twelve women did not use any nail decoration method, 73
declared application of only one method, 64 declared two
methods, 11 declared three methods, and two respondents
used all four methods of nail decoration. The results of the
independence test v2 showed that there was no statistically
significant relationship between application of nail polish and
gel nail, whereas in case of nail polish and gel polish hybrid,
such relation was registered. It also showed that there is a
statistically significant relationship between application of gel
nail and gel polish hybrid (Table 2). Due to the very small
group of respondents who declared themselves as users of
International Journal of Dermatology 2018
 ski, and Rotsztejn
Batory, Namiecin
acrylic nail powder method, it was impossible to check the
relationship between application of this method and the other
ones.
The dependence of using or not using individual methods on
age (Fig. 4) proved to be statistically significant only for gel pol-
ish hybrid (P = 2.64 9 10 4). As for all subgroups, age did not
show the normal distribution.
The gel nail and acrylic nail powder were usually left for at
least 2 weeks. Only one respondent reported that she had left
gel nail coating for just a few days. A similar situation occurred
in the case of gel polish hybrid with as many as 80% of the
respondents declaring themselves as users of method for a
continuous period of at least 2 weeks. Much shorter time of
continuous use was declared for nail polish. None of the
respondents continuously applied nail polish for more than
2 weeks, and 74% of the respondents declaring application of
nail polish removed it from their nails after a few days (Fig. 5).
Eighty-seven respondents noticed changes on their nails.
The most common changes were nail brittleness (84 respon-
dents) and nail splitting (73 respondents). Only one case of
tinea unguium was observed and confirmed by a dermatologist.
Since this was an isolated case, no further studies on this
respondent were conducted. The exact distribution of each vari-
ation can be found in Figure 6.
Table 3 shows the exact distribution of respondents who
have observed nail changes depending on the method applied.
This relationship was statistically significant for the nail polish
(P = 0.0454) and the gel polish hybrid (P = 1,258 9 10 4). As
for gel nail (P = 1) and acrylic nail powder (P = 0.6869), there
was no relationship between use of these methods and occur-
rence of nail changes.
Due to the fact that as many as 61 of 104 respondents
who apply nail polish also use gel polish hybrid, there was a
probability that the positive result of v2 test for the depen-
dence between the nail polish application and occurrence of
changes may be false. The results of the Cochran–Mantel–
Figure 2 Age distribution in the sample
group
ª 2018 The International Society of Dermatology
  ski, and Rotsztejn
Batory, Namiecin Structural damage and pH of nail plates of hands Report 5

Figure 3 Number of respondents and

frequency of applying different nail
decoration methods

2
Table 2 Test results for independent (v /Fisher test) was 29 years (29.65  9.96); 25% were 22 years old or less,
and half of them were 24 years old or less. Among them there
Nail polish Gel nail vs. was one person with tinea unguium (as stated earlier). The
Nail polish vs. Gel polish Gel polish
measured pH value was 8.56, which significantly disturbed the
vs. Gel nail hybrid hybrid
measurement (P-value for the Grubbs test P = 3.78 9 10 4).
Test statistic 2
Χ = 2.0301 2
Χ = 5.0932 F = 4.857322 Because of a small number of respondents declaring using
P-value 0.1542 0.02402 0.006616 acrylic nail powder and gel nail method, that is, the two that
were tested, both techniques were categorized as one (referred
to as “the other”). In total, the two methods were used by 11
Haenszel test did not give any assumptions for rejection of respondents. Sixteen respondents did not use any method of
the hypothesis in terms of an independent relation between nail decoration.
occurrence of nail changes and use of nail polish Table 4 presents the results of pH measurement of the nail
(P = 0.2982). Thus, it may be concluded that nail polish does plates after removing the analyzed decorating formulas includ-
not cause changes. ing a basic statistical analysis and pH value of the untreated
nail plates for comparison.
pH test results analysis The relationship between age and pH of the nails measured
Among 162 respondents participating in the study, only 68 were by Pearson’s correlation coefficient was q = 0.3251 and was
ready to give up different forms of decoration or extension of statistically significant (P = 0.0073).
nails for at least 24 hours. Sixty-eight respondents underwent The pH value measured in the whole group ranged from 5.21
nail pH test. to 7.00, with the average value of 5.83  0.54. The pH values
The youngest woman examined by pH-meter was 20 years of nails depending on application of each nail decoration proce-
old, the oldest one was 56. The average age of the subjects dure are presented in Figure 7. The pH value shows the normal

Figure 4 Age distribution vs. application (or

no application) of the individual methods. X
is the mean value

ª 2018 The International Society of Dermatology International Journal of Dermatology 2018

6 Report Structural damage and pH of nail plates of hands  ski, and Rotsztejn
Batory, Namiecin

Figure 5 Number of respondents divided by the time of continuous use of nail polish and gel polish hybrid

Figure 6 Frequency of changes caused by

different nail coating procedures

Table 3 Number of respondents with nail changes after it was not possible to show such a dependence. The P-value
application of different methods of nail decoration for the nail polish is equal to 0.0577.
The acidic pH of the skin and nails within the range between
Applied method 4.0 and 5.6 protects them from harmful exogenous factors.39–44
Factors affecting the skin and nails also exert an impact on pH
Gel Acrylic
Nail polish nail values.39,42–47 Another important element is perspiration. Due to
polish hybrid Gel nail powder the acidic pH (4.0–6.8), perspiration inhibits proliferation of bac-
teria and fungi on the skin but does not concern the
Change occurred No Yes No Yes No Yes No Yes
nails.39,45,48–51 Murdan et al. estimated that the average pH of
No 28 47 38 37 63 12 73 2 uncoated nail plates was 5.0  0.5. These studies indicate that
Yes 30 57 18 69 73 14 83 4 the acidic pH is very important for maintaining regular micro-
Total 58 104 56 106 136 26 156 6 biome.6,39–42,52

Conclusion

distribution only in the group of subjects declaring not using the
gel polish hybrid. The results of U Mann–Whitney–Wilcoxon test
showed a statistically significant effect of use of gel polish
hybrid and other methods on the nail pH value. The P-value
9 5
was 5.265 9 10 and 8.638 9 10 for gel polish hybrid and
the others, respectively. In the case of application of nail polish,
Both methods used to prepare nails for decoration and all meth-
ods of removing the applied preparations damage the healthy
nail plates. The damage, in turn, depends on the method used.
The most common changes are brittleness and nail splitting.
According to the morphological evaluation, the nail polish
remover causes less damage than acetone, and the use of a

International Journal of Dermatology 2018 ª 2018 The International Society of Dermatology

  ski, and Rotsztejn
Batory, Namiecin Structural damage and pH of nail plates of hands Report 7

Table 4 Measured pH values of the nail plates with statistical analysis

Nails without
decorating Only nail polish Only gel polish hybrid Combined techniques

Number of people 16 18 18 16
Average pH 5.43 (0.13) 5.77 (0.17) 6.18 (0.48) 6.72 (0.63)
Minimum pH 5.21 5.49 5.55 5.79
Maximum pH 5.77 6.00 7.00 8.56

Figure 7 The pH values of nails depending

on application of each nail decoration
procedure

nail drill machine and nail file causes the greatest destruction of
nail plates. On the basis of the pH test results, it was found that
the biggest effect on the pH change has the gel polish hybrid,
gel nail, and acrylic nail powder. They were causing the pH
value of nail plates to rise above 6.0, which may be associated
with susceptibility to the infection and greater tendency to dam-
age. Whereas after the application of the nail polish, the pH of
the plates was on average 5.8, which is closest to the normal
value, assumed as skin but physiological. The most popular
methods of hand nails decoration are the nail polish and gel
polish hybrid.
Noteworthy is the fact that 50% (68 of 162) of participants
declared to be eager to take a break in the application of vari-
ous preparations used for nail decoration, as they themselves
observed their negative influence on the nail plates.
Acknowledgments
The study was supported by the Medical University of Lodz
(Poland) statutory research activity no.: 503/3-066-01/503-31-
001.
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