Cuticle remover poisoning

The ingredients in cuticle remover that can be harmful are:

• Potassium hydroxide
• Sodium hydroxide

Various cuticle removers contain these ingredients.

Symptoms of cuticle remover poisoning include:

• Collapse
• Chest pain
• Diarrhea
• Drooling
• Eye pain and redness
• Eye ulcer formation and decreased vision if product touched the eyes
• Inability to breathe because the throat swells shut
• Rapid drop in blood pressure
• Severe abdominal pain
• Severe pain in the mouth
• Severe pain in the throat
• Vomiting

Seek medical help right away. Do not make the person throw up unless poison control or a health care provider tells you to.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the person swallowed the cuticle remover give them water or milk right away, unless a provider tells you not to. Do not give anything to drink if the person has symptoms that make it hard to swallow. These include:

• Vomiting
• Convulsions
• A decreased level of alertness

Have this information ready:

• Person's age, weight, and condition
• Name of product (ingredients, if known)
• Time it was swallowed
• Amount swallowed

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.

The person may receive:

• Blood and urine tests
• Breathing support, including tube through the mouth and breathing machine (ventilator)
• ECG (electrocardiogram or heart tracing)
• Chest x-ray
• Fluids through a vein (by IV)
• Endoscopy (camera placed down the throat to see burns in the esophagus and the stomach)
• Medicine to treat the effects of the poison
• Surgery to remove burned skin (debridement)
• Washing of the skin, perhaps every few hours for several days

How well someone does depends on how much cuticle remover they swallowed and how quickly they receive treatment. The faster medical help is given, the better the chance for recovery.

Extensive damage to the mouth, throat, and stomach is possible from this type of poisoning, but it is not likely. How someone does depends on how much of this damage there is. This damage can continue to develop in the esophagus (food pipe) and stomach for several weeks after the product is swallowed. If a hole forms in these organs, severe bleeding and infection can occur. Surgery may be needed to correct these and other complications.

Hoyte C. Caustics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 143.

Thomas SHL. Poisoning. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 10.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.