Nickel, the metal found in nickel coins and many other everyday items (earrings, watchbands), is a common trigger for allergic contact dermatitis.
A nickel allergy usually develops after a person's skin has repeated and prolonged contact with items containing nickel.
Items with Nickel
Nickel is a silver colored metal that is often mixed with other metals to create silver alloys. The following items contain nickel alloys that have been reported to trigger allergic contact dermatitis.
- Nickel coins
- costume jewelry (earrings, ear studs, necklaces, jewelry clasps)
- bra hooks
- snaps, such as on jeans
- metal buttons
- eyeglass frames
- paper clips
Nickel is also combined with iron to create stainless steel, but this is unlikely to trigger allergic contact dermatitis because the nickel is tightly bound to the iron.
Nickel Allergy Symptoms
A person may be exposed to nickel for months or years before the first allergic rash develops. The rash may appear in a myriad of ways, but the primary complaint is itching.
The rash may first appear as dry, red, and itchy skin, similar to eczema. It may develop small bumps or watery blisters. At times the inflammation can lead to a yellow crust to develop on the skin.
The rash usually appears only on the area of skin that has had contact with nickel or nickel metal alloys. However, the rash will sometimes appear in other locations that have not come into contact with nickel.
Nickel Allergy Diagnosis
An allergy to nickel can often be diagnosed by the appearance and location of the rash, combined with the patient's story about how the rash started.
For instance, a nickel allergy can often be made if a very itchy red rash appears on the ear lobes of a girl who started wearing new earrings a few weeks earlier. Similarly, a nickel allergy might be made for a woman with an itching rash on her back between the shoulder blades where the skin comes into contact with a bra hook.
Patch testing may also be performed to make the diagnosis. Patch testing involves placing a small amount of suspected skin allergens (substances that trigger skin rashes) onto the skin and left in place for 48 hours. The concentrations of these allergens don't usually cause a skin reaction unless the person is sensitive.
Nickel Allergy Treatment
There is no cure for nickel allergy. Once you develop a skin sensitivity to nickel, you will always remain sensitive to the metal. The only effective long-term treatment is to avoid contact with nickel and nickel alloys. (see below helpful tips on nickel avoidance)
Some treatments may be used to alleviate the itch and reduce the skin inflammation. These include:
- Topical corticosteroids
- Soaks with Burow's solution diluted with water
- Moisturizers, particularly ointments or thick emollient creams
Tips for Avoiding Nickel
The practical steps may help prevent developing an allergy to nickel, or having a recurrence of nickel allergy symptoms.
- Choose jewelry that is marked as hypoallergenic, made of stainless steel, solid gold (at least 12 carat), pure sterling silver, or polycarbonate plastic
- Choose clothing with fasteners made of cloth, plastic, coated or painted metal, or some other non-metal
- Make sure the first pair of earrings used are made with stainless steel or high quality 18-karat gold studs, which is worn until the skin is completely healed.
- If earrings must be worn that contain nickel, consider placing plastic covers or applying clear nail polish over the metal.
Although "cheap jewelry" is often blamed as the source of nickel allergy, it is important to remember that even expensive jewelry may contain nickel. Paying a high price alone does not mean that the item does not contain nickel.
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