Enamel Nail Polish Does Not Interfere With Pulse Oximetry Among Normoxic Volunteers

Objective.To determine if enamel nail polish interferes withpulse oximetry. Design. Laboratory investigation.Participants. 12 healthy nonsmoking volunteers. Methods.Spectrophotometry was performed on polystyrene cuvettes painted with 3uniform layers of nail polish enamel in triplicate. Absorbances werecompared at 660 and 940 nm for 10 colors across the visible spectrum anddocumented by the Institute of Electrical and Electronic Engineers colorcode against Pantone™ matches on a color scanner.Colors were then selected that had the greatestA660–A940 difference and pulse oximetry(Nellcor N-209A. Pleasanton , CA) was performed on nails painted withthese colors on 12 subjects using an unpainted digit as a control.Results. When tested by the oximeter, there were noSpO2 differences detected between nail polish colors, norwere there any differences between the painted and the unpainted controldigits across subjects (F = 0.51, ANOVA; p= 0.67). Blue (B),green (G), and lime green (G’) possessed the largestA660–A940 difference and potentially couldinterfere with pulse oximetry but did not do so in the clinical model.Conclusion. Enamel finger nail polish pigments do not interferewith pulse oximetry as previously reported, theA660–A940 difference must be greater than1.88 ± 0.23 SD AU in order to affect pulse oximetry.