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Allergies Health Center

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Nickel (Jewelry) Allergy

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If earrings make your earlobes itch or your necklace leaves a rash around your neck, you may have a nickel allergy. It’s one of the most common skin allergies, in part because nickel is used in everything from jewelry to cell phones, coins, zippers, eyeglass frames, belt buckles, and keys.

Symptoms of Nickel Allergy

You’ll usually see symptoms 12 to 48 hours after you’re exposed. They include itching, redness, rash, dry patches, and swelling of the skin, sometimes followed by blisters. The blisters may break, leaving crusts and scales.

If left untreated, your skin may become dark, leathery, and cracked. Usually, the rash is only on the part of your skin in direct contact with the nickel. In serious cases, the rash may spread. Sweating may make it worse.

The skin can also become infected. If it does, it will become warm and redder or filled with pus. The infection requires immediate medical attention.

Test and Treatments

Often, your doctor can diagnose a nickel allergy by looking at your skin and asking if you’ve touched anything metal. A dermatologist also can do a simple skin patch test. The doctor puts tiny amounts of nickel and other allergens on patches, which are applied to your upper back. The patches must stay on for 48 hours. If you are allergic to nickel, your skin will likely show a reaction after 48 hours. In some cases, you'll need more tests.

Once a nickel allergy develops, it often lasts your whole life. But there are ways to ease your symptoms. The most important thing you can do is avoid contact with objects that can cause a reaction. For mild symptoms, a hydrocortisone cream and antihistamine pills you can buy at the drug store may help.

For more severe symptoms, you doctor may prescribe a steroid cream or an immunosuppressant drug. If the symptoms are very severe, treatment may also include oral steroids and antihistamine pills.

If your skin is cracked or blistered, you should take off any metal jewelry right away and see your doctor for treatment to prevent infection.

Here are tips to avoid a nickel allergy:

  • If you have your ears or other body parts pierced or tattooed, have it done with sterile, surgical-grade stainless steel instruments. It's a good idea to avoid piercing guns, as they may contain nickel and can cause bacterial infections.
  • Make sure your jewelry is made of surgical-grade stainless steel or either 14-, 18- or 24-karat yellow gold. White gold may contain nickel. Other nickel-free metals include pure sterling silver, copper, platinum, and titanium. Polycarbonate plastic is okay. If you must wear earrings that contain nickel, add plastic covers made specifically for earring studs.
  • Buy eyeglass frames that are nickel-free, made instead of titanium or plastic.
  • Buy clothes, including bras and other underthings, with buttons, snaps, rivets, or fasteners that are made of plastic or are plastic-coated or painted metal. If your clothes have nickel items, switch to plastic or plastic coated.
  • Wear watchbands made of leather, cloth, or plastic.
  • If a good piece of jewelry that you wear daily -- such as a wedding ring -- causes a reaction, ask a jeweler about having it plated in a less allergic metal, such as platinum.
  • If you are extremely sensitive to nickel, you may also need to avoid nickel-rich foods such as fish and chocolate.

WebMD Medical Reference

Reviewed by Debra Jaliman, MD on July 23, 2015
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