Are You Allergic to Nickel?

Nickel allergy is one of the most common causes of contact dermatitis, a rash or irritation when the skin comes into contact with an allergen.

Although nickel allergies usually are caused by jewelry such as earrings, the metal also is commonly found in coins, cell phones, clothing fasteners, and keys, all of which can cause reactions if you are allergic to nickel.

Nickel allergies are lifelong. If you have a nickel allergy, you will experience an allergic reaction whenever you are exposed to the metal.

This article examines the symptoms, causes, diagnoses, and treatment of nickel allergy.

What Causes a Nickel Allergy Rash?

Nickel is a silver-colored metal often mixed with other metals to make items. It is the most common cause of metal allergy. A nickel allergy rash occurs when someone allergic to the metal comes into contact with it, resulting in an inflammatory response.

The exact cause of nickel allergy is unknown, but, like other allergies, it develops when the body’s immune system reacts to a normally harmless substance. A nickel allergy can happen after your first exposure to nickel or after repeated or prolonged exposures.

For a nickel rash to occur, there must be direct, prolonged contact between the skin and an item containing nickel, and enough nickel must be released from the item and absorbed into the skin to cause a reaction.

Nickel is commonly found in many items, including:

• Jewelry (body piercings are the most common cause of nickel allergy rash)
• Watches
• Electronics (cell phones, tablets, and computers)
• Clothing (zippers, belt buckles, and bra hooks)
• Coins
• Keys
• Eyeglass frames
• Dental materials (braces and crowns)
• Orthopedic surgical implants

Nickel Allergy Symptoms

Nickel allergy symptoms usually begin within hours after touching the metal but can happen up to two days after exposure and last up to a month.

Symptoms usually only occur on areas of the skin that come into contact with nickel but can also occur elsewhere on the body. Symptoms include:

• A red rash or bumps on the skin
• Itching, which may be severe
• Dry patches of skin that can look like a burn
• Blisters and draining fluid (in severe cases)

Nickel allergies are not life-threatening and do not cause anaphylactic shock.

How Is Nickel Allergy Diagnosed?

A nickel allergy is diagnosed by a healthcare professional based on your medical history, including the history of substances you’ve come into contact with, and a physical exam that assesses the location and appearance of any rashes. A patch test may be needed to identify the cause of the allergic reaction.

Nickel Allergy Treatment

There is no cure for nickel allergy. The only way to avoid symptoms is to avoid contact with the metal.

Treatment is designed to relieve symptoms and can include at-home remedies such as applying cool compresses, oatmeal baths, or over-the-counter (OTC) anti-itch medications.

Sometimes, healthcare providers will prescribe a corticosteroid or other medication applied to the skin (topical medication). An oral corticosteroid such as prednisone might be prescribed in some severe cases.

Nickel Allergy Risk Factors

A nickel allergy is not inherited but acquired after direct, prolonged contact with items that release nickel onto the skin. Once you have your first allergic reaction to nickel, your body will continue to respond to the metal, and it will take less nickel exposure to cause future reactions.

Things that can raise your risk of nickel allergy include:

• Prolonged exposure or high contact with nickel
• Certain occupations, such as working in the bar or restaurant industry, construction
  workers, metal workers, electricians, and retail workers
• An allergy to other metals

If you are allergic to nickel, you also have an increased risk of allergic contact dermatitis on the hands (hand eczema).

Ways to Avoid Nickel

Avoiding nickel is the only way to prevent a nickel allergy reaction. However, it can be difficult to do so because nickel is in so many everyday objects. Although regulations to prevent nickel from being in items such as jewelry and cell phones have been introduced in China, and some European countries, the United States and most other countries do not regulate the use of nickel in consumer items.

There are steps you can take to avoid coming into contact with nickel. They include:

• Look for and wear jewelry that is nickel-free, hypoallergenic, or made from other metals, such as surgical-grade stainless steel, yellow gold, or pure sterling silver. (note that some 18 karat, or 18K, white gold may contain nickel).
• Look for watch bands made of cloth, plastic, or leather.
• Paint over the nickel with clear nail polish to create a barrier, making sure to reapply
  frequently.
• Put a protective cover on electronic devices that may contain nickel.
• Look for alternatives to nickel, such as brass keys, titanium-coated or stainless steel razors, and titanium or plastic eyeglass frames.

When to See a Healthcare Provider

You should see a healthcare provider if your rash, itching, or blistering becomes severe, which can all be signs of infection. Also, seek care if your rash doesn’t go away within a couple of weeks after you no longer come into contact with nickel to determine if something else may be causing your symptoms.

Summary

Nickel allergies are one of the most common causes of contact dermatitis and are typically easy to treat. The most common symptom is a red, itchy rash. If you are allergic to nickel, you will be for life. The best way to avoid or stop a nickel allergy rash is to avoid contact with items containing the metal. However, nickel is found in many everyday items, such as jewelry, keys, tools, and eyeglasses, and it can be difficult to avoid contact altogether.

However, you can find alternatives to nickel, such as stainless steel or brass, or take steps to avoid contact with nickel, like painting clear nail polish on the areas of jewelry that touch your skin.