Nickel Allergy Factsheet
What is Nickel Allergy?
Nickel Allergy is a skin reaction of the immune system to the substance nickel. It is one of the most common forms of allergic contact dermatitis in which skin gets inflamed due to the contact with nickel.
Nickel allergy is not curable and is not hereditary, it is caused by the prolonged and constant exposure of the skin to nickel. An individual can become allergic to nickel at any age.
Treatments can reduce the symptoms of nickel allergy; however, once you develop nickel allergy you will always be sensitive to the metal and should avoid contact.
What are the Symptoms of Nickel Allergy?
If you have nickel allergy and you are exposed to a nickel containing item, the allergic reaction (contact dermatitis) usually begins within 12 to 48 hours after exposed. 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 symptoms include:
- rash or bumps on the skin
- itching, which may be severe
- redness or change in the skin colour
- dry patches of the skin that may resemble a burn
- blisters and draining fluid in severe cases
Sweating at the point of contact with nickel may worsen the symptoms.
When to see a doctor
If you have a skin rash and don't know how you got it, talk to your doctor. If you have already been diagnosed with nickel allergy and are sure you are reacting to nickel exposure, use over the counter treatments and home remedies your doctor has recommended in the past. However, if these treatments don't help, call your doctor. If you think the area may have become infected, see your doctor right away. Signs and symptoms that might indicate an infection include pain, increased redness, warmth or pus in the affected area.
Cause of Nickel Allergy
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 a nickel allergy, your body reacts to nickel possibility to other metals, such as cobalt and palladium. In other words, it is a mistake 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. Once you have sensitized to nickel, the immune reaction is generally faster each time you are exposed to the metal.
The cause of nickel allergy is unknown, but sensitivity to nickel may, in part, be inherited (genetic).
Source of Nickel exposure
As nickel is a silvery metal resistant to corrosion, it is used extensively in the manufacturing industry.
Nickel allergy is most commonly associated with earrings and other jewellery for body piercings that contain some nickel.
Common sources of nickel exposure include:
- jewellery for body piercings
- other jewellery, including rings, bracelet, necklaces and jewellery clasps
- clothing fastener, such as zipper, snaps and bra hooks
- belt buckles
- eyeglass frames
- kitchen utensils
- paper clips
- tools, such as hammers and screwdrivers
- dental fillings
- artificial body parts (prostheses), such as artificial heart valves
- drinking water
- alkaline batteries
- cell phones
Nickel is also found in foods, such as oatmeal, chocolate, beans and dried fruit. Nickel may also be found in canned food. It you are allergic to nickel, ask your doctor if a low-nickel diet might be helpful.
Risk Factors for Nickel Allergy
Certain factors may increase your risk of developing a nickel allergy, including:
- having ear or body piercing: because nickel is common in jewellery, nickel allergy is most often associated with earrings and other body-piercing jewellery containing nickel. If the first jewellery you wear after a piercing contains nickel, your body is constantly exposed to the metal during the healing time. And people who have piercing often wear jewellery every day. The more piercing you have, the greater your risk of developing a nickel allergy.
- working with metal: if you work in an occupation that constantly exposes to nickel, your risk of developing an allergy may be higher than it is for someone who does not work with the metal. In addition, people who have a regular exposure to nickel while doing "wet work" - as a result of either sweat or frequent contact with water - may be more likely to develop nickel allergy. These people may include bartenders, people who work in certain food industries and domestic cleaners. Other people who may have an increased risk of nickel allergy include metalworkers, retail clerks and hairdressers.
- being female: women and girls are more likely to have a nickel allergy than are men and boys. This may be because females tend to have more piercings and get them at a younger age.
- being allergic to other metals: people who have sensitivity to palladium, cobalt or chromium may also be allergic to nickel.
Test and Diagnosis
Your doctor can usually diagnose nickel allergy based on your:
- skin's appearance
- recent history of contact with items that may contain nickel
If the cause of the rash is not 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 the patch test, very small quantities of potential allergens (including nickel) are applied to small patches, which are then placed on your skin to check for a reaction. 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 path 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.
Treatments and Drugs
There is no cure for nickel allergy. Once you develop a sensitivity to nickel you will develop a rash (contact dermatitis) whenever you come into contact with the metal. Once an allergic reaction to nickel exposure has begun, it will most likely continue for two to four weeks.
Your doctor may prescribe one of the following medications to reduce and improve the condition of a rash from nickel allergy reaction:
- corticosteroid cream
- oral corticosteroid
- oral antihistamine
The best strategy to prevent developing nickel allergy is to avoid prolonged exposure to items containing nickel, especially jewellery. If you have a nickel allergy, the best way to prevent an allergic reaction is to avoid contact with the metal.
However, it is not always easy to avoid nickel because it is present in so many products and is sometimes even products labelled hypoallergenic.
The following tips may help you avoid nickel exposure:
- wear hypoallergenic jewellery: purchase jewellery that is made of materials that are not like to cause allergic reactions. Look for jewellery 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 jewellery with nickel, as well as cobalt contain some nickel, but it is generally considered hypoallergenic for most people.
- choose a piercing studio carefully: tattoo and body piercing studio regulations differ state to state. Contact your health department to find out what rules apply to your area and be certain to choose a reputable studio with licensed piercers.
- use substitute materials: look for a safer substitute for common nickel-containing items:
- watchable made of leather, cloth or plastic
- zipper or clothing fasteners made of plastic or coated metals
- plastic or titanium eyeglass frames
- create a barrier: 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. If you need to cover buttons or snaps, or tool handles, covering these items with duct tape may help.
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