Nail Polish Still Has No Place in Clinical Care, Review Concludes

Healthcare workers should continue to keep their nails bare, according to a narrative review published in the journal Antimicrobial Resistance & Infection Control. The review, led by Alexandra Peters and colleagues, examined whether recent laboratory studies could justify changes to long-standing recommendations that prohibit nail polish in clinical settings, and concluded that they cannot.

The authors note that some national guidelines and healthcare practices have recently been relaxed to permit nail polish. These changes were based on a small body of recent laboratory studies that challenged the traditional rule that only unadorned nails are acceptable in healthcare. The review team set out to examine that literature in detail and to determine whether it genuinely supports a change in policy.

The review took a narrative approach, analysing the recent laboratory studies on which the changed recommendations rest. The authors also gathered information on how gel manicures are applied in practice, and on the complications that would arise in implementing and monitoring any rule that allowed only short, freshly painted nails in clinical care.

According to the review, the recent body of literature presents a number of methodological issues as well as practical ones. The authors found that the studies underpinning the relaxed guidance were not sufficient to overturn the existing recommendations, and that the evidence base for allowing polished nails was not adequate.

Beyond the laboratory findings, the review identified practical and implementation problems that would make the use of nail polish in healthcare unacceptable, even if short, freshly polished nails were acceptable from a microbiological standpoint. These problems concern how any such policy would be enforced and maintained in day-to-day clinical practice.

One central concern is visibility. When nails are covered with polish, infection prevention staff cannot see the length or the cleanliness of healthcare workers’ nails.

The review also points to practical difficulties in keeping nails short and in good condition under a polish-permitting policy, as well as potential resource issues for infection prevention and control departments. The review also notes potential resource issues for infection prevention and control departments in ensuring adherence to correct application and nail health among staff.

The authors conclude that there is not enough evidence to change the current recommendations that nail polish should not be allowed in healthcare, and that permitting its use would be a risk to patient safety. In their view, implementation issues must be weighed alongside the microbiological evidence before any policy change could be considered.

As a narrative review, the article synthesises and interprets the existing literature rather than reporting new experimental data.

The review’s message for healthcare institutions is that the traditional rule remains in force: nails used in direct patient care should be short and free of polish. Any future relaxation of this rule would require stronger evidence and a workable plan for monitoring compliance, neither of which the current literature provides.

Subject of Research: Whether nail polish should be permitted in clinical care, based on a narrative review of recent laboratory studies and implementation issues.

Article Title: Nail Polish remains inappropriate for clinical care: a narrative review

Article References: Peters, A., Brois, P., Mocenic, M., Haidegger, T., Bansaghi, S., Maillard, J.-Y., Assadian, O., Teixeira, B., & Boyce, J. M. (2026). Nail Polish remains inappropriate for clinical care: a narrative review. Antimicrobial Resistance & Infection Control. https://doi.org/10.1186/s13756-026-01833-5

Image Credits: AI Generated

DOI: 10.1186/s13756-026-01833-5

Keywords: nail polish, infection prevention, hand hygiene, healthcare workers, narrative review, patient safety, clinical care, guidelines, gel manicures, implementation, Nail, Polish