To the Editor,The US manicuring industry boasted 196,900 jobs in 2022, with a 9% annual growth rate and a predicted global evaluation of $23.1 billion by 2031. 1,2 However, recent increases in popularity and complexity of nail care compromise hygiene standards and amplify risk. 2 Epidemiological data on manicuring injuries are sparse. Consequently, we investigated the epidemiology of manicuring cases presenting in US emergency departments (EDs) from 2013 to 2022.The National Electronic Injury Surveillance System (NEISS), which collects data from a nationally representative cohort of 100 EDs, was queried on October 29, 2023, using keywords "manicure," "manicures," "manicuring," "pedicure," "pedicures," and "pedicuring" and demographic data were collected. T value tests assessed differences between genders (P < .05).A total of 893 cases of injuries due to manicures/pedicures were analyzed, with mean age 42 years (range: 23-61), and 85.1% females, 24.4% Whites, and 23.5% Blacks. On average, cases increased by 8.56% annually, with a total 73% overall increase from 2013 to 2022 (Figure 1). White women were injured more often than White men (26.6% vs 12.0%, P < .001), and Black men were injured more often than Black women (32.3% vs 22.0%, P = .018).The most common diagnoses overall were paronychia, cellulitis, and laceration/avulsion, which had similar proportions across genders (all P > .05). On average, women experienced more severe injuries than men, particularly fractures (4.5% vs 0.0%, P = .045), strain/sprains (1.1% vs 0.0%, P = .0046), and punctures (0.5% vs 0.0%, P = .045). Dermatitis was more common among women versus men (2.6% vs 0.8%, P = .048; Supplemental Table S1).The toe was the most often injured body part for men and women (44.4% vs 45.9%, P = .74) followed by the finger (24.8% vs 29.9%, P = .22). The foot was the third most often body part injured, with men versus women more often affected (23.30% vs 13.20%, P < .0097).We found that manicuring injuries requiring ED visits increased by almost 75% over the past decade, with White women and Black men most at risk. Women versus men