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

The 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 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.

You can also get online poison help now at Poisonhelp.org. Just enter the product, poison, or medicine to get expert help.

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

Your provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• Electrocardiogram (ECG)
• Endoscopy -- camera placed down the throat to check for burns in the esophagus and stomach

Treatment may include:

• Breathing support, including tube through the mouth into the lungs and connected to a breathing machine (ventilator)
• Fluids through a vein (by IV)
• Medicine to treat symptoms
• Washing of the skin (irrigation), every few hours or for several days
• Surgery to remove burned skin (debridement)

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.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Nelson LS, Calello DP. Acute poisoning. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 96.

Theobald JL, Corcoran JN. Poisoning. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 94.

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.