The global nail industry has expanded in recent years due to social media trends and the rising popularity of individualized nail art. As the nail industry continues to grow, awareness of both the aesthetic benefits and potential risks is essential. Understanding nail anatomy and physiology provides the foundation for evaluating how cosmetic practices affect nail health and function. Although manicures and pedicures are generally safe, repeated exposure to chemical agents, including formaldehyde, toluene, phthalates, and acrylates may lead to nail brittleness, pseudoleukonychia, and allergic contact dermatitis. Improper sterilization in salons can also predispose to bacterial and fungal infections. The United States Food and Drug Administration and the European Union Cosmetic Regulation No. 1223/2009 provide frameworks to ensure product safety and ingredient transparency. However, emerging allergens and the globalization of the cosmetics market may challenge consistent regulation. For patients with nail disorders, such as psoriasis, lichen planus or alopecia areata, cosmetic procedures may exacerbate underlying disease and tailored guidance is necessary for these patients. Safe nail practices, including proper hygiene, hypoallergenic formulations, and moderation in chemical use can help reduce adverse outcomes. Greater public education and research into long-term safety are needed to optimize both aesthetic and dermatologic outcomes.