A nail polish that doesn't chip is basically the Holy Grail of mani-pedis -- and the $6 billion nail salon industry claims to have found it in a gel.

Over the last couple of years, the gel manicure has grown in popularity: Two-thirds of salons now offer the service, which is supposed to provide the long wear of an acrylic without the accompanying nail damage.

Still, mixed in with all the hype are complaints that gel nails do still chip, the polish can only be taken off by visiting a salon and drowning one's fingers in acetone, and horror of horrors, the color selection is lacking. Worse yet, they may cause serious nerve damage and infections. If something seems too good to be true, it probably is (a gel manicure).

The Cost of Resilient Nails
A post on the Consumer Reports blog in April may further deter would-be gel adoptees. Neurologist Orly Avitzur, a medical advisor for Consumer Reports who practices in New York, scared the bejeezus out of salon-goers with the story of one of her patients. After visiting several physicians who could find no explanation for the electric shock-like pain the patient felt along her forearm every time she put any pressure on her thumb, the patient turned up in Avitzur's clinic. After taking a patient history, Avitzur concluded that the patient's gel manicure had caused nerve damage.

"This is likely a rare occurrence," says Avitzur, "Still, I doubt the number of these cases is being tracked."

According to Avitzur, there are several points in the gel process that could be associated with health risks. Improper use or overuse of a nail file to prepare the nail for layers of gel can expose sensitive skin to chemicals or infection. Also, some salons may be mixing acrylic products with gel products or purchasing cheap gel products from manufacturers with little quality control. One particularly dangerous ingredient, a chemical called methyl methacrylate, can cause shortness of breath and irritate the eyes and skin.

The Food and Drug Administration (FDA) has banned methyl methacrylate but they state on their website that "many nail products that contain potentially harmful ingredients are allowed on the market because they are safe when used as directed." The problem is that unlike prescription drugs and treatments, cosmetics and nail products do not have to undergo clinical trials before being sold on the market. Furthermore, nail salons are not required to list ingredients on labels unless the product is available for purchase. Salon-goers should be concerned if nail technicians can't answer questions about gel ingredients and if the liquids smell funny.

"This patient probably didn't have a true gel manicure," says Avitzur, "but I plan on avoiding them myself and would not recommend them to others at this point."

A Miniature Tanning Bed for Hands
Gel manicures also require drying with an ultra-violet, or UV, lamp in between each coat and at the end to set the gel. The ultra-violet light used in tanning beds has been associated with increased skin cancer risk, but is there a risk with gel manicures?

"Most cancers on the hands are found in people with extensive sun exposure," says Zoe Draelos, a dermatologist in High Point, North Carolina, "It's the cumulative lifetime exposure to UV light that is the risk."

A case study by Austin-based University of Texas researchers in the "Archives of Dermatology" in April 2009 reported that two women developed non-melanoma skin cancer - cancer that occurs in the outer layer of the skin - on the tops of their hands from exposure to nail lamps. Both women were middle-aged, otherwise healthy, and had no cancer history. This does not prove that UV nail lamps definitely cause skin cancer; larger clinical studies will be necessary to determine a link.

Still, Draelos recommends using UV nail lamps in as limited a fashion as possible.

Another option may be to look for a salon that uses LED (light emitting diode) instead of UV dryers. This month, the New York City-based Shizuka salon began using LED dryers made by the Japanese company Nail Labo.

To Gel or Not to Gel
For those who have their hearts set on a gel manicure, but would rather avoid the potential risks of nerve pain, cancer and fungal infections, there may be an alternative. This spring, a company called CND announced the first 'hybrid' gel manicure. Called "Shellac," the hybrid is a marriage between gel and traditional nail polish that may be more nail-friendly.

The treatment is only available at salons, but does not require the same level of skill to apply as a gel. Moreover, the process of removing the polish minimizes exposure to acetone.

Regardless of what type of manicure is desired, Avitzur says, "at the very least women should choose a well-established salon with experienced and licensed techs."

Amber Angelle is a freelance writer in Brooklyn, NY who cares entirely too much about what her nails look like.