Nickel allergy is one of the most common causes of allergic contact dermatitis — an itchy rash that appears when your skin touches a usually harmless substance.
Nickel allergy is commonly associated with earrings and other jewelry, particularly jewelry associated with body piercings. But nickel can be found in many everyday items — from coins to zippers, from cellphones to eyeglass frames.
Nickel allergy can affect people of all ages. A nickel allergy usually develops after repeated or prolonged exposure to items containing nickel. Treatments can reduce the symptoms of nickel allergy. Once you develop nickel allergy, however, you will always be sensitive to the metal and need to avoid contact.
If you have nickel allergy and you're exposed to a nickel-containing item, the allergic reaction (contact dermatitis) usually begins within 12 to 48 hours after exposure. The reaction may persist for as long as two to four weeks. The features of contact dermatitis usually appear only where your skin came into contact with nickel, but they may appear elsewhere on your body. Nickel allergy signs and symptoms include:
An allergic reaction is somewhat like a case of mistaken identity within your body's immune system. Normally, your immune system reacts to protect your body against bacteria, viruses or toxic substances.
If you have nickel allergy, your body reacts to nickel and possibly to other metals, such as cobalt and palladium. In other words, it's mistakenly identified nickel as something that could harm you. Once your body has developed a reaction to a particular agent (allergen) — in this case, nickel — your immune system will always be sensitive to it. That means anytime you come into contact with nickel, your immune system will respond and produce an allergic response.
Your immune system's sensitivity to nickel may develop after your first exposure or after repeated or prolonged exposure. The cause of nickel allergy is unknown, but sensitivity to nickel may, in part, be inherited (genetic).
Nickel allergy is most commonly associated with earrings and other jewelry for body piercings that contain some nickel. Common sources of nickel exposure include:
Your doctor can usually diagnose nickel allergy based on your:
If the cause of your rash isn't apparent, however, your doctor may recommend a patch test (contact hypersensitivity allergy test). He or she may refer you to an allergy specialist (allergist) or a skin specialist (dermatologist) for this test.
During a patch test, very small quantities of potential allergens (including nickel) are applied to your skin and covered with small patches. The patches remain on your skin for two days before the doctor removes them. If you have a nickel allergy, the skin under the nickel patch will be inflamed when the patch is removed or in the days after removal of the patch.
Because of the low concentrations of allergens used, patch tests are safe even for people with severe allergies.
The best strategy to prevent developing nickel allergy is to avoid prolonged exposure to items containing nickel, especially jewelry. If you already have a nickel allergy, the best way to prevent an allergic reaction is to avoid contact with the metal.
However, it's not always easy to avoid nickel because it's present in so many products. Home test kits are available to check for nickel in metal items. The following tips may help you avoid nickel exposure:
Purchase jewelry that's made of materials that aren't likely to cause allergic reactions. Look for jewelry made from such metals as nickel-free stainless steel, surgical-grade stainless steel, titanium, 18-karat yellow gold, or nickel-free 14-karat yellow gold, sterling silver, copper and platinum. Avoid jewelry with nickel, as well as cobalt and white gold, which may contain nickel and trigger allergic reactions. Surgical-grade stainless steel may contain some nickel, but it's generally considered hypoallergenic for most people.
Get rid of jewelry that contains nickel or has caused an allergic reaction. Be sure that your earring backings also are made of hypoallergenic materials.
Tattoo and body piercing studio regulations differ from state to state. Contact your state or local health department to find out what rules apply to your area and be certain to choose a reputable studio with licensed piercers.
Visit a studio before getting a piercing to make sure that the piercer:
Look for safer substitutes for common nickel-containing items:
If you have to be exposed to nickel at work, creating a barrier between you and the nickel may help. If your hands have to touch nickel, wearing gloves may help. Try covering buttons, snaps, zippers or tool handles with duct tape. Clear nail polish on jewelry may help, but may have to be reapplied often.
You may use some of the following treatments at home to treat contact dermatitis due to nickel allergy. If these treatments don't help or the rash worsens, contact your doctor. Home remedies include the following:
Avoid certain over-the-counter ointments, such as antibiotic creams, which may contain ingredients — particularly neomycin — that can worsen an allergic reaction.
Certain factors may increase your risk of developing a nickel allergy, including: