Nickel allergy

Dear Alice,

Where can I find some information on nickel allergies? Perhaps, you can suggest some treatment.

Dear Reader, 

You ask a great question. Much like the namesake US currency found in the bottom of bags, couch cushions, and pockets, nickel — the metal — is found in a lot of items as well. Nickel is a silvery-white metal that can be mixed with other metals to produce a wide variety of items, including coins, jewelry, bra fasteners, zippers, snaps, buttons, hairpins, eyeglass frames, pens, utensils, paper clips, keys, and tools. Talk about a long list! More to your question though, an allergy to nickel is a contact allergy which typically results in a skin reaction after exposure to nickel or nickel-containing items. Depending on the individual's susceptibility, what constitutes as an allergy-inducing exposure could range from a brief touch to prolonged contact. The affected area is usually restricted to the site of contact, although it could also be found on other parts of the body. For those concerned that they may be allergic to nickel, it’s great to learn more about prevention and treatment — so keep reading for more on those strategies. 

First, it’s good to know what to look for when it comes to a nickel allergy. The degree of allergic reaction varies by person. A nickel allergy can occur at any age and often develops after repeated or prolonged exposure to nickel. Typical symptoms, which include itching, burning, a rash, redness, dry skin patches, or even blisters, manifest a within a few hours or days after contact. The symptoms can last about two to four weeks. Once a nickel allergy has developed, it usually signifies a chronic (lifelong) condition. In that case, it’s advised that exposure to nickel be avoided. Getting tested for nickel allergy by a health care provider can confirm that diagnosis and rule in or out other possible allergies as well. 

For those who suspect they may have a nickel allergy, a diagnosis can often be made by a visual examination of symptoms following exposure to the metal. Alternatively, if it’s difficult to determine whether a rash is the result of contact with nickel, a patch test may be administered. This is where a health care provider applies very small amounts of an allergen to a patient’s skin to see if a reaction develops within a few days. Once confirmed, treatments for an allergic reaction to nickel can range from the do-it-yourself variety to provider prescribed strategies and medications — all of which depend on the severity of symptoms. For at-home care, methods to treat a rash include:   

  • Compresses with tap water and Burow’s solution (an over-the-counter medication containing aluminum acetate), which can help dry up blisters and relieve some itching 
  • Emollients, such as petroleum jelly or mineral oil, to help alleviate the dryness and itch of dermatitis when applied frequently 
  • Calamine lotion or oatmeal baths to reducing itching 

However, if the rash doesn’t respond to those treatments, corticosteroids (in either oral or ointment form), nonsteroidal cream, or an antihistamine may be prescribed to treat a rash. Those who don’t respond to prescription treatments may undergo phototherapy, which exposes skin to artificial ultraviolet (UV) light. 

Because many folks would rather avoid a rash all together, making prevention a priority is wise when it comes to a nickel allergy. Identifying, covering, or avoiding the metal seems to be key to minimizing exposure and risk for a reaction. There are at-home kits to test for nickel in unidentified metals and methods of covering nickel to reduce exposure (e.g., covering nickel tools or handles with duct tape or coating jewelry with clear nail polish). For clothing and other accessories, choose fasteners and materials made of plastic, coated or painted metal, or some other material. Also, a nickel allergy doesn’t mean a person can’t wear jewelry anymore — it may just mean they have to be more selective in their choices. Ensuring that any jewelry is either nickel-free, stainless steel, surgical grade stainless steel, titanium, 18 karat yellow gold, sterling silver, copper, or platinum may help minimize irritation. Lastly, as nickel allergies are common, some jewelry packaging will state that the jewelry is nickel-free or hypoallergenic. 

Hopefully this information helps provide a wealth of knowledge! 

Take care, 

Last updated Jun 04, 2021
Originally published Jan 31, 1997

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