Nickel Allergy

Anybody can be allergic to nickel, but it usually begins in teenagers at the time they are beginning to wear cheap metal jewellery.

Nickel Skin Allergy  

Nickel sensitivity is common, especially in women, particularly after they have had their ears pierced. However, more men have piercings today, which is increasing the incidence of nickel allergy among males. It is also possible, but much less common, suddenly and without reason to suffer from nickel allergy later in life. 

Causes of Nickel Allergy  

It is not known why some people become allergic to nickel when others do not. But, people with jobs that require frequent contact with the metal — such as hairdressing, nursing and catering, as well as jobs that require one to handle cash and metal — are more likely to be sensitive to it. 

Nickel Allergy Symptoms  

A red, itchy rash under a jean stud, zip or watch strap buckle can be due to irritation and sweat, and often this rash, called “jewellery dermatitis”, is the first sign of nickel allergy. The allergy makes the skin red and itchy at first; later on, tiny water blisters can appear, making the skin moist and oozy; the skin may then peel off. 

This rash can start in one or more places simultaneously. If untreated, the skin will dry out and become red, scaly and cracked. Normally the rash appears wherever nickel is in close contact with the skin. However, it is possible for the rash to spread so that later, even areas which haven’t come into contact with the metal become red and itchy, though the rash is usually worse where the skin is in contact with nickel. 

Once the hands have become affected, it is important to protect them until the skin is properly healed; otherwise they will remain sore for a long time. Most people realise they are allergic to nickel because of where the rash is, for example under earrings. But if your rash is in an unusual place or really bad, the cause may not be clear. In this case your doctor might refer you to a dermatologist to carry out patch tests to see if you are allergic to nickel.

Risk of Infection

If the skin becomes moist — or broken and raw, perhaps because of scratching — it can become infected with bacteria. As the hands are most likely to come into contact with the metal, they are especially likely to become infected. Signs of infection include crusted and yellow skin that weeps or smells odd. You should see your doctor to get treatment as the rash will not improve on its own.

Which Parts of the Body are Most Often Affected? 

Any part of the body can develop a rash if something made from nickel comes into close contact with the skin. This is how they might become affected: 
Scalp — from hairgrips, metal hairbrush, curlers
Face — from curlers, hairpins, jewellery
Eyelids — from some eyeshadow, metal on the fingertips, make-up brushes, eyelash curlers
Nose — from spectacle frames
Lips — from pins held in mouth, metal lipstick cases, pens, pencil ends
Ears — earrings spectacle frames, pens
Neck — from necklaces, clasps, zips, perfume sprays
Chest — from brooches, medallions, chains
Breasts — from wire support in bras, necklaces
Back — from clip and strap adjusters on bras, zips
Stomach — from press studs (especially jeans), clothes fastenings
Arms — from bracelets
Wrists — from watches (back, strap buckle), bracelets, metal scent bottles
Hands — from coins, umbrellas, metal trim on handbags and purses, handles, buggy frames, taps, cutlery, scourers, cigarette lighters, filing cabinets, press studs, zips, taps, keys, saucepans
Fingers — from rings, thimbles, scissors, pins and needles, coins, pens, typewriter keys
Thighs — from coins in pockets, metal chairs 
Feet — from shoe buckles, metal studs

Is Nickel Allergy Permanent?  

Once you become sensitive to nickel you are likely to remain so for life. But not everything containing nickel will necessarily bring out a rash every time. It is more likely to happen if your skin is raw or broken. Some women may find they are more sensitive to nickel on certain days of their menstrual cycle. In addition, your sensitivity to nickel may in time reduce to become less troublesome.

Nickel Allergy Treatment

There are no medicines to cure nickel allergy and the best treatment is to avoid the metal. Some tips to do this are:
Look closely at everything at home and at work and decide whether it is likely to be made of nickel. Anything made of wood, plastic, glass, paper or fabric is safe, but check there isn’t a metal trim on these things
Try to find out if your metal objects contain nickel
If possible, coat nickel with a product such as paint, nail polish, lacquer or varnish to prevent your skin coming into direct contact with the metal; for example, a bra fastener or press stud can easily be painted and some metal objects can also be covered with masking tape
Some metal items can be backed with material, so a sweat band could be worn under a metal watch. And tucking a shirt into jeans so the metal stud doesn’t touch your skin may give sufficient protection
Keep money in a bag, purse or wallet, rather than loose in your trouser pocket
Jewellery can be covered with clear nail varnish to protect your skin but this is difficult to do and may spoil it. Watches are available that are made only from plastic or with plastic material
Eighteen- and 24-carat gold does not contain nickel but nine-carat gold and gold-plated jewellery does. Sterling silver is free of nickel. Good quality stainless steel has nickel, but this should be tightly bound to other metals and should not be released
As ear-piercing often triggers the allergy, it is best for the studs to be made of 18-carat gold, sterling silver or high-quality stainless steel 
Wear cotton gloves if you need to handle anything made of nickel at home or work, and rubber or PVC gloves with cotton liners for any wet work
If your skin becomes damaged after being in contact with nickel, look after it carefully until it is fully healed. Use a moisturiser frequently to stop the skin becoming dry and cracked, and watch out for signs of infection
A mild steroid cream or ointment, such as one percent hydrocortisone cream, may be prescribed by your doctor to clear up the rash and reduce itching. But use a steroid cream or ointment only for a few days until the rash clears

Nickel in Food 

Studies abroad have found that some people with severe hand eczema, thought to be due to nickel allergy, have improved following a nickel-free diet. Nickel can be released into food if anything acidic (rhubarb, apples, citrus fruit) is cooked in a stainless steel saucepan. Canned foods also contain nickel. Many foods, such as leafy green vegetables, naturally contain nickel.

More research needs to be done before it can be proved whether hand eczema really is helped by this diet. If you are considering modifying your diet to try to improve your skin, always consult your doctor first.

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