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Overview
Nickel allergy is an immune system reaction to nickel that usually causes an itchy rash where the metal comes in contact with the skin.
Nickel allergy is usually related to earrings and other jewelry. But nickel can be found in many everyday items, such as coins, zippers, eyeglass frames, metal toys, cosmetics, cellphones, laptops and other objects.
Nickel allergy happens after exposure to the metal triggers the immune system to act as if nickel is a harmful substance. Treatments can reduce the symptoms of nickel allergy. Avoiding nickel prevents repeat allergic reactions.
Symptoms
An allergic reaction usually begins within a couple of days after contact with nickel. Skin conditions related to nickel allergy may spread out from the point of contact. Less often, skin conditions may be more widespread on the body.
Nickel allergy symptoms affecting the skin include:
- Rash or bumps on the skin.
- Severe itching.
- Changes in skin color.
- Thickened, leathery, cracked skin.
- Blisters and draining fluid.
Allergic reactions other than widespread skin conditions are uncommon. But symptoms also may include upset stomach, nausea, headache or difficulty breathing.
Exposure to nickel from dental or medical devices touching the skin may result in damage to nearby tissues, pain or problems with the devices.
When to see a doctor
Talk with your healthcare professional if you don't know how you got a skin rash or if your symptoms are not getting better with treatments you can buy without a prescription.
If you think the area may have become infected, see your health professional right away. Signs and symptoms that might indicate an infection include:
- Swelling.
- Warmth.
- Pus in the affected area.
- Pain.
Get emergency care if you have trouble breathing.
Causes
A nickel allergy develops when the immune system reacts to nickel as if it were a harmful substance. After exposure to nickel, the immune system may trigger a reaction to nickel that can cause a rash.
After this happens, the immune system triggers disease-fighting activities wherever the body is exposed to nickel. The immune system activities that are supposed to protect the body actually harm the body's own tissues.
Sources of nickel exposure
Common items that may expose you to nickel include:
- Jewelry for piercings, rings, bracelets, necklaces and watches.
- Clothing fasteners, such as zippers, snaps, bra hooks and belt buckles.
- Eyeglass frames.
- Coins.
- Keys.
- Metal tools and kitchen utensils.
- Metal toys.
- Electronic devices, including cellphones, laptops and computer tablets.
- Medical and dental devices.
- Cosmetics.
- E-cigarettes.
A small number of people with nickel allergy may have an allergic reaction to nickel that's in foods. But the vast majority of people with nickel allergy have no reaction to nickel in foods.
Nickel allergy
Nickel allergy usually causes an itchy rash where nickel comes in contact with skin. The top photo shows a positive patch test (on the left) from a patch containing nickel that was left on the skin for 48 hours. The lower photo shows a nickel allergy rash from metal in clothing, such as a clasp or belt buckle.
Risk factors
Certain factors may increase your risk of developing nickel allergy, including:
- Having ear or body piercings. Nickel allergy is most often associated with earrings and other body-piercing jewelry containing nickel. Women have a higher rate of nickel allergy, probably because they are more likely to have piercings.
- Working with nickel-containing products or tools. If your job constantly exposes you to nickel, your risk of developing an allergy may be higher. This higher risk also is linked to work that requires getting your hands wet or washing your hands often. People at risk of nickel allergy include metal workers, hairdressers, food handlers, housekeepers and healthcare workers.
Prevention
The best strategy to prevent nickel allergy is to avoid prolonged exposure to items containing nickel. 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:
Wear hypoallergenic jewelry
Avoid jewelry that contains nickel. 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-, 22- or 24-karat yellow gold, nickel-free white gold, or sterling silver.
Choose a piercing studio carefully
Before getting a piercing, check to be sure the studio uses sterile, nickel-free or surgical-grade stainless steel needles in sealed packages. Check that the studio only sells hypoallergenic jewelry and can provide documentation of the metal content in the products for sale.
Use substitute materials
Look for safer substitutes for common nickel-containing items:
- Watchbands made of leather, cloth or plastic.
- Zippers or clothing fasteners made of plastic or coated metals.
- Plastic or titanium eyeglass frames.
Create a barrier
Use barriers to protect you from common nickel-containing items:
- Wear gloves to prevent contact with tools or products with nickel.
- Cover electronic devices with a protective barrier.
- Use a clear barrier, such as Nickel Guard, or clear nail polish to cover snaps, buttons, zippers and clasps.
- Use duct tape or iron-on patches to cover nickel on clothing.
