Evaluation of the bacterial burden of gel nails, standard nail polish, and natural nails on the hands of health care workers

Background: Acrylic nails harbor more bacteria than natural nails, and wear is not recommended for health care workers (HCWs). Little is known about the new and popular gel nail products. This study sought to evaluate the bacterial burden of gel nails, standard nail polish, and natural nails on the hands of HCWs. Methods: The study was conducted at 3 health centers. Nails on the dominant hand of 88 HCWs were painted with gel polish and standard polish. Cultures were obtained on days 1, 7, and 14 of wear and before and after hand hygiene with alcohol hand gel. Results: A total of 741 cultures were obtained. Bacterial burden increased over time for all nail types (P ≤.0001). Reductions in the bacterial burden of natural nails and standard polish, but not gel polish, (P =.001, P =.0028, and P =.98, respectively) were seen after hand hygiene. All 3 nail types become more contaminated with bacteria over time. Standard polish and natural nails may be more amenable to hand hygiene than gel polish. Conclusions: This study did not show an increased number of microorganisms on nails with gel polish; however, gel nails may be more difficult to clean using alcohol hand gel.