If I had a nickel for every time I got itchy

Moving beyond molds, dust, food and plant-based allergens that we ingest or inhale – especially in the spring and early summer – another entire allergy realm exists . . .  and the culprits are likely to be dangling from our ears or adorning our wrists, fingers or other body parts.

Allergies to metals that we wear or come into contact with regularly are extremely common, and often overlooked or misdiagnosed. Women tend to wear more jewelry and suffer in higher numbers, but men are far from immune. Often, the problem is that the metals we may be allergic to aren’t only in rings, necklaces or piercings – they’re also found in zippers, buttons on jeans, cooking and eating utensils, coins, cell phones and even eyeglass frames.

Sometimes metal allergies are sneaky. We may find that we get itchy or develop a rash when we wear jewelry made of silver, gold or platinum, but silver and gold allergies are pretty rare — the actual cause is the far more common, cheaper and utilitarian metal, nickel.

Nickel allergies have been on the rise in North America in recent years and now affect 24 percent to 36 percent of women and 7 percent to 15 percent of men. Nickel allergy is one of the most common causes of allergic contact dermatitis – an itchy rash that appears when our skin touches a usually harmless substance.

Nickel allergy can affect people of all ages, and usually develops after repeated or prolonged exposure. Treatments can reduce the symptoms of nickel allergy; however, once someone develops a nickel allergy, they will always be sensitive to the metal and need to avoid contact.

Normally, our immune system reacts to protect our body against bacteria, viruses or toxic substances. If we have a nickel allergy, our body reacts to nickel and possibly to other metals, such as cobalt and palladium. Essentially, our bodies mistakenly identify nickel as something that could harm us. That means anytime we come into contact with nickel, our immune system will respond and produce an allergic response.

Our immune system’s sensitivity to nickel may develop after our first exposure or after repeated or prolonged exposure. The cause of nickel allergy is unknown, but sensitivity to nickel may, in part, be inherited (genetic).

When someone with a nickel allergy is exposed to a nickel-containing item, the allergic reaction (contact dermatitis) usually begins within 12 to 48 hours after exposure. The reaction may persist for as long as two to four weeks. The features usually appear only where our skin came into contact with nickel, but they may appear elsewhere on our body. Nickel allergy signs and symptoms include:

  • Rash or bumps on the skin
  • Itching, which may be severe
  • Redness or changes in skin color
  • Dry patches of skin that may resemble a burn
  • Blisters and draining fluid in severe cases

Common sources of nickel exposure

Nickel allergy is most commonly associated with earrings and other jewelry for body piercings that contain some nickel.  By looking at a piece of jewelry it is very difficult to determine whether or not it contains nickel. Common sources of nickel exposure include:

  • Jewelry for body piercings
  • Other jewelry, including rings, bracelets, necklaces and jewelry clasps
  • Watchbands and belt buckles
  • Clothing fasteners such as zippers, snaps and bra hooks
  • Eyeglass frames and cell phones
  • Coins, metal tools and keys

Testing for metal allergies is easy. There are over-the-counter tests available, and testing is done by dermatologists and allergists. Small quantities of potential allergens (including nickel) are applied to our skin and covered with patches, usually for two days. If we have a nickel allergy, the skin under the nickel patch will be inflamed when the patch is removed or in the days after removal of the patch.

There is no cure for nickel allergy. Once we develop a sensitivity to nickel, we will develop a rash whenever we come into contact with the metal. Once a particular site, such as an earlobe, has reacted to nickel, that site will react even more when re-exposed to nickel.

How to protect ourselves from metal allergies

It’s best to 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-karat yellow gold, or nickel-free 14-karat yellow gold, sterling silver, copper and platinum. Avoid jewelry with nickel, as well as cobalt and white gold, which may contain nickel and trigger allergic reactions. Surgical-grade stainless steel may contain some nickel, but it’s generally considered hypoallergenic for most people.

Be sure that your earring backings also are made of hypoallergenic materials. Wear gloves, if possible, when working with metals that cause an allergic reaction, and try to determine the composition of the items you will come in contact with on a regular basis. However, since it’s virtually impossible to completely avoid exposure, there are a variety of common remedies doctors can prescribe to reduce irritation and improve the condition of a rash from a nickel allergy reaction. Most involve corticosteroid creams or oral medicines, or oral antihistamines.

If these treatments don’t help or the rash worsens, contact your doctor. Home remedies include the following:

  • Use soothing lotions,such as calamine lotion, which may ease itching.
  • Moisturize regularly.Our skin has a natural barrier that’s disrupted when it reacts to nickel and other allergens. Using emollient creams or lotions, such as petroleum jelly or mineral oil, could reduce our need for topical corticosteroids.
  • Apply wet compresses,which can help dry blisters and relieve itching. Soak a clean cloth in Burow’s solution, an over-the-counter medication containing aluminum acetate; diluted white vinegar (one ounce of white vinegar to 16 ounces of water); or tap water. Place the compress over the rash for 15 to 45 minutes. You can repeat this process several times a day.
  • Apply over-the-counter topical corticosteroids (hydrocortisone),which may lessen itching and improve the rash. You can apply to the affected area before applying a wet compress to allow better penetration into the skin. Talk to your doctor about how long you can safely use the product.
  • Try over-the-counter oral antihistamines,such as diphenhydramine (Benadryl), which may help relieve itching for a short time.

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