Common and uncommon reactions to formaldehyde-containing nail hardeners

A spectrum of reactions to free formaldehyde containing nail hardeners is presented. These include inflammatory and noninflammatory onycholysis, paronychia, chromonychia, nail plate shedding, and pterygium inversum unguis as well as satellite reactions on the skin and mucous membranes. Primary irritants are more common than allergic reactions. Nail cosmetic products containing free formaldehyde are available to the consumer, but federal guidelines dictate their labeling, acceptable concentration, and usage.