Diagnosis
Your healthcare professional may be able to diagnose a nickel allergy based on your symptoms and a history of exposure to certain metals or other substances.
For additional tests, your health professional may refer you to a medical specialist in allergies, called an allergist, or a specialist in skin care, called a dermatologist.
Patch testing
During a patch test, tiny amounts of things that commonly cause allergic reactions, called allergens, are applied to your skin and covered with a patch. The patches remain on your skin for two days. If you have a nickel allergy, the skin under the nickel patch will be irritated when the patch is taken off or in the days afterward.
Because of the low concentrations of allergens used, patch tests are safe even for people with severe allergies.
Treatment
The first step in treating nickel allergy is avoiding contact with the metal. There is no cure because you will always have an allergic reaction when you are exposed to nickel.
Medications
Your healthcare professional may prescribe one of the following medicines to reduce irritation and improve the rash from a nickel allergy reaction:
- Corticosteroid creams are applied to the irritated skin for 2 to 4 weeks. Prolonged use of a corticosteroid cream can cause thinning of the skin.
- Nonsteroidal creams, such as tacrolimus (Protopic), may be used instead of corticosteroids. The most common side effect of tacrolimus is short-term burning or stinging. Other nonsteroidal creams include ruxolitinib (Opzelura) and crisaborole (Eucrisa).
- Oral corticosteroids, such as prednisone, treat severe or widespread symptoms. These medicines can be taken only for limited times because of serious side effects with long-term use.
- Oral antihistamines may provide some relief from itching.
Phototherapy
This treatment involves exposing the skin to controlled amounts of artificial ultraviolet light. It's generally reserved for people who haven't gotten better with topical or oral steroids.
Self care
You may use some of the following treatments at home to soothe a rash. If these treatments don't help or the rash worsens, contact your healthcare professional. Home remedies include the following:
- Moisturize regularly with creams and lotions to soothe and protect the skin.
- Use wet compresses to soothe rough or itching skin. Use an aluminum acetate or colloidal oatmeal solution on a damp cloth. These products are generally available at a pharmacy.
Preparing for your appointment
You're likely to see your primary healthcare professional if you're experiencing an itchy rash that may be related to nickel allergy. Preparing for your appointment can help you make the most of your time with your healthcare professional.
What you can do
- Write down a description of your symptoms, when they first appeared and whether they occur in a pattern.
- List any metal products that may touch your skin.
- Make a list of all medicines you take, including vitamins and dietary supplements, their doses, and the reasons for taking each.
- Prepare a list of questions for your healthcare professional.
Questions that you might want to ask your healthcare professional include:
- What's the most likely cause of my rash?
- What else might cause it?
- What side effects can I expect from treatments?
- Can I use nonprescription medicines to treat the condition?
What to expect from your doctor
Your healthcare professional is likely to ask you questions:
- When did your symptoms begin?
- Where is the rash?
- What other symptoms do you have?
- What kind of jewelry do you wear?
- What do you do for work?
- Have your symptoms changed over time?
- What at-home treatments have you used?
- What effect did those treatments have?
- What, if anything, appears to worsen your symptoms?
