When Zainab Danjuma got her first manicure, a gift for her 16th birthday, she worried about what the nail technician might think and say about her hands; her skin showed the marks of the atopic dermatitis she’d had since birth.
“When I was younger, my hands were the most affected part of my body, so I felt nervous about the nail tech seeing the backs of my hands as they were scarred, thickened and dark,” said the London-based Danjuma, now 30.
Danjuma was lucky. The tech made the shy teenager feel secure and relaxed, and her well-groomed hands gave her self-assurance a lift.
“It was a good experience, and it was a confidence booster,” she said. “I’ve come to terms with my dry skin and scarring now, and my skin is doing a lot better than when I was younger, but it’s still molded me to be quite shy about how I look.”
Danjuma is working to overcome her lingering insecurity by sharing her eczema-related challenges on her YouTube channel — “being open about something that’s usually hidden” — as well as tips for caring for her curly hair, an inheritance from her Asian and African heritage.
Not every person with eczema leaves the salon feeling better about their appearance. In a social media discussion, Kelly Goodin wrote about a nail technician who turned down her request for a pedicure for her young daughter because the technician worried the child’s eczema was contagious.
“She refused to touch my child, then age 5, [even though] we tried to assure her it was not contagious,” Goodin wrote.
JiaDe (Jeff) Yu, MD, a board-certified dermatologist at Massachusetts General Hospital in Boston, said that, unfortunately, patients with visible skin diseases sometimes face stigma like that experienced by Goodin’s daughter.
Along with the possibility of embarrassment and shame, people with eczema also risk allergic reactions when they enter a product-laden salon atmosphere.
We asked Yu and salon-goers with eczema to share their advice for getting professional grooming services that leave both the mind and the skin calm and clear.
Take a confident approach
Conquer salon-related apprehension by being up-front and forthright about your eczema. If you’re scheduling a first-time visit at a salon or with a stylist, mention your skin condition and allergies when you make the appointment, and ask if someone on staff has experience with eczema.
“Always tell your nail tech or hairstylist about your skin,” Danjuma advised. “They have seen it all before, but you want to prepare them. Also, try not to be embarrassed of scars or discolored skin. You shouldn’t miss out on pampering because of that.”
If you do find yourself with someone who’s not familiar with eczema, remember that education is the best way to combat stigma and to lower your risk for an allergic reaction, Yu said.
“The most important thing to convey to the technician or hairstylist is that the condition is not infectious. This is what most people are worried about,” he said. “Once you establish that, it can open up a broader conversation about the condition and how to be careful with your skin.”
You can also ask your dermatologist for a letter that details your eczema-related issues and suggests some ways to avoid triggering reactions, something Yu has done for his patients. Another option is to bring a NEA education brochure to the salon to help educate and raise awareness about what eczema is and isn’t.
Like any other personal service, having a satisfying salon experience also depends on finding the right fit between the stylist or technician and the client. Goodin, for example, now takes her daughter to a nail salon with owners who have a child with eczema.
“They are so tender and sweet,” she wrote. “They always ask to be sure all products are OK for my daughter’s skin and try to ensure she has a great visit. My advice is to find someone you can be comfortable with. Don’t stick with someone if they don’t make you feel welcome.”
Pay attention to products
When you have eczema, just walking into a salon, which may have allergy-triggering chemicals wafting through the air, can cause your skin to flare.
The good news is that rising awareness of the potential dangers of chemicals used in salon treatments means many beauty shops are emphasizing less-toxic options and environments that minimize chemical exposure.
Google “non-toxic hair salon” or “organic nail salon” and you’ll likely find several businesses in your area that offer hair and nail color and care products without some of the ingredients known to cause allergic reactions or other health problems. Organic salons may be more sensitive to your skin issues, but Yu warned that they can still harbor allergens and other potentially irritating substances.
“There is little correlation between how natural or organic a salon sounds and whether it’s likely to cause an individual with atopic dermatitis to flare,” he said. “People are just as likely to react to organic preservatives and products, such as essential oils, coconut-derived preservatives and ‘natural’ fragrances, as they are to synthetic fragrances.”
He suggested focusing on the ingredients in products and how you react to them.
“It’s important for people with atopic dermatitis or eczema to know that they may react to products the general population doesn’t,” said Yu. “People can also tolerate one product fine for years and develop new allergic reactions at any point in their life.
“The best thing to do is to be vigilant about the skin and pay attention to flares,” he continued. “If the skin flares within three to four days of exposure, there’s a good chance you may be allergic to a product used.”
Here are some key caveats and solutions in several salon service categories:
Watch out for:
- Hair color. It’s one of the most common salon-related causes of skin irritation and allergic contact dermatitis. “Paraphenylenediamine, or PPD, is one of the top 10 most common allergens used in personal products in the United States. It’s in almost all hair dyes, especially various shades of brown and black dye,” Yu said. PPD reactions include itching of the scalp, swelling of the eyelids, and rash behind the ears, forehead and the back of the neck.
- Most shampoos and conditioners include preservatives and fragrances. These tend to cause fewer scalp reactions than hair color because they aren’t left on for long periods but can irritate the side of the face, forehead, and back of the neck in a “rinse-off” pattern, said Yu.
- Hair sprays. They release allergens into the air. Small particles land on the skin and can trigger irritation or allergic reactions. Eyelids are the most common location for reactions to hairspray because of their thin, ultra-sensitive skin, according to Yu.
- Asking for PPD-free hair color. “Goldwell Elumen, for example, makes hair dyes that don’t contain PPD and are thus tolerated by those with PPD allergy,” said Yu, adding that he has no financial or professional relationships with any personal product manufacturer.
- Using fragrance-free shampoo and conditioner. If your salon doesn’t offer this option, ask if you can bring your own products for the stylist to use. Yu recommends Free & Clear shampoo and conditioner.
Watch out for:
- Nail polish. Many polishes contain chemicals, such as toluene sulfonamide and formaldehyde resin, that can provoke allergic reactions and rashes.
- Gel or shellac nails, dipped nails and acrylic nails. Chemicals in these products are also common causes of irritation or allergic reactions, said Yu.
- Finding a salon that uses polishes without many of the most common allergens. Nail polishes labeled 3-, 5-, 7-, 9- and 10-free eliminate that number of potential allergens. Yu recommends choosing a 5-free or above polish.
- Skipping acrylic, dipped or gel nails.
Watch out for:
- Beeswax and propolis, or “bee glue.” This resinous substance is made from tree sap by honey bees. These waxes are the most common sources of allergic reactions to this treatment, though waxing doesn’t commonly cause allergic reactions. All types of waxing will temporarily irritate the skin, however, said Yu.
- Skipping beeswax and propolis waxes or getting a pre-service patch test.