Metal Allergy

1 What is a metal allergy?

If one starts to experience an itching sensation or the skin turning red, it could be due to contact with a metal.

A metal allergy is also called metal hypersensitivity. It is a disorder of the immune system and quite common among individuals. The symptoms of a metal allergy range from skin rashes, swelling, and pain to chronic fatigue syndrome and fibromyalgia.
A metal allergy reaction can be localized or generalized, wherein it spreads to other parts of the body. If the reaction is severe, it can lead to chronic fatigue and other skin reactions that would need to be treated by a doctor.

You may have encountered an itching sensation or the skin turning red the moment you come in contact with any metal, such as wearing a new set of earrings or an artificial necklace that leaves a rash on the skin. Such occurrences indicate your body is sensitive towards metal, or, in other words, you are allergic to metals. Being allergic to metal such as nickel, cobalt, copper, and so on is quite common, since these are available in so many day-to-day items.

A metal allergy is an immune system disorder. It is a common condition that affects almost ten to fifteen percent of the population. An individual suffering from a metal allergy experiences symptoms such as swelling, rashes on the skin, and pain in the affected area due to contact with a certain type of metal. Apart from these skin reactions, which are local, an allergy towards any metal substance can lead to more long-term or chronic conditions, such as fatigue and fibromyalgia. There are various local and systemic signs which can be considered when there is a metal allergy. An estimated study said about twenty percent of the female population and five percent of the male population is allergic to the metal nickel, whereas three to four percent of the population is allergic towards other metals, such as chromium or cobalt. In most cases, the reactions caused by the allergy are more localized, wherein it is limited to a certain region of the body, but there can also be reactions which are more generalized and tend to affect other parts of the body.

2 Causes of a metal allergy

Individuals who have an overly sensitive immune system usually suffer from allergies. In the case of metal allergies, the symptoms will start to show up when the body’s immune system reacts to any slight contact with a metal ion. For the immune system, these metal ions are foreign invaders that can harm the body, even though they are most likely harmless. The cells which make up the immune system kill any bacteria or viruses through inflammation, and the same process is used for metal ions as well. The moment the metal ions come into contact with the body through touching, inhaling particles, orally, or through an implanted metal in the body, the immune system starts to produce a variety of reactions leading to metal allergy symptoms. In our day-to-day life, we come across a variety of potential metal allergens that can trigger a metal reaction. A few such sources are coins and everyday jewelry, such as chains, earrings, watches, and so on. However, apart from these metals, there are also other types of allergens which are not easily noticed, but can trigger a reaction in a fraction of a second. Some of those items include cosmetic products and contact lens solution.

One of the most common metal allergens is nickel. Contact with nickel for certain individuals can lead to the skin turning red and an itching sensation. Other allergens include cobalt, copper, and chromium. These metals are commonly found in a variety of clothing items, jewelry, and mobile phones. Medical devices also contain metal allergens such as titanium and chromium. In the past, dental implants and teeth fillings were made of metals as well. Certain IUDs (intra-uterine devices) used for birth control and are also made up of metal such as copper and thus leads to an allergy. There are various implanted devices which are required for surgery in case of the replacement of any body part to keep the body functioning. A few examples of such implanted devices are pacemakers, artificial hips, artificial knees, and in the case of fracture, fracture plates and rods or pins. All of these medical items contain metal and so can lead to hypersensitivity. When these implanted devices or any other medical devices are implanted, the nature of the reaction tends to be very severe, and the sensitivity lasts for a longer duration.

The risk of a metal allergy increases for those who have an autoimmune disorder, since the immune system tends to become overactive. In such individuals, the immune system is in a constant state of activity.

3 Symptoms of a metal allergy

The symptoms of a metal reaction start to appear within twelve to forty-eight hours after exposure. The symptoms can range from mild to severe and can be either local (on a certain part of the body) or more generalized, wherein it starts to show on other parts of the body as well. Once the metal comes in contact with the body, the immune system thinks it is a harmful substance and causes inflammation. This then leads to rashes on the affected area and the skin turning red and appearing swollen. One may also feel a constant urge to itch. In certain cases, there can be hives as well.

The longer the exposure to metal, the greater the severity of the reaction. This mostly happens with body implants after any metal ions are inhaled or taken orally. The severe form of a metal reaction leads to chronic pain in the joints and muscles, lack of energy, chronic fatigue, inflammation, and swelling. The reactions can also be more generalized, affecting other parts of the body. Apart from these, an individual may suffer from chronic fibromyalgia and fatigue syndrome as well. However, these conditions mostly occur in individuals who suffer from chronic metal allergies.

Below are a few of the symptoms experienced due to a metal allergy:

  • Joint pain
  • Skin turning red
  • Chronic fatigue
  • Skin blisters
  • Hives
  • Chronic inflammation, which can be local or generalized
  • Depression
  • Swelling
  • Muscle pain
  • Skin rash
  • Cognitive impairment
  • Fibromyalgia

A skin blister can break and leave behind crusts and scales. If no treatment is carried out and the skin is left as is, it can become cracked, dark, and leathery. Sweating can also lead to further worsening of the existing reactions.

Certain medical conditions have been known to be linked with metal allergies, so tell the doctor if there are any unusual symptoms experienced, such as:

4 Diagnosing a metal allergy

There are various methods the doctor can use to identify and confirm a metal allergy. These include a combination of examining the symptoms and asking questions pertaining to one’s personal and family medical history. First, the doctor will ask questions regarding any past cases of allergies or any other medical conditions experienced. The doctor will also ask questions about the family medical history and if there are any allergies in the family, such as in the parents or siblings, since it can be passed to the individual through the genes. The doctor will cross-examine the symptoms in the various parts of the body, whether it is localized or general, along with checking the possible causes of exposure to metals in the form of implants, use of cosmetics, any surgery carried out recently, if the individual smokes or has been in any industrialized location that had metal particles in the air, and so on.

Once the questioning and examinations are carried out, the doctor will ask for a blood test to confirm the allergy as well as rule out any other causes. The blood test checks white blood cell activity against any metal ions. This is done using radioisotopes and checking for any kind of reaction or physical changes in the cells with the help of a microscope. The metal allergy is confirmed when there is an increase in the activity of the white blood cells the moment they come in contact with metal ions.

A blood test called a Metal LTT is carried out to test the response of the immune system to various types of metals. This test can identify which individuals are more prone to metal hypersensitivity. It also helps the doctor pinpoint the exact material causing the sensitivity responses and which metals do not produce any kind of excessive immune response.

One can also reach out to a dermatologist to conduct an allergy test, wherein metal ions are exposed to the skin to test for a reaction. This test is very similar to a test called the “scratch test,” and is often carried out as a “patch test.” In the case of a patch test, the metal ions thought to be causing the metal allergy are applied to a patch, and this patch is then placed on the skin. The patch is left on the skin for a period of forty-eight hours, after which time the doctor will ask for a follow-up visit. The doctor then removes the patch, and if the individual suffers from a metal allergy, the skin would be red and irritated.

If the allergy is caused due to nickel, it would last for a long time or may be an entire lifetime. There are treatments available which provide relief from the troublesome symptoms.

5 Metal allergy treatment

The treatment for a metal allergy is based on the individual, so it varies from person to person. The best treatment for a metal allergy is to avoid contact with that particular metal as much as possible. However, if the reactions tend to worsen, it is best to consult a doctor who can suggest ointments or corticosteroids to provide relief from pain and inflammation. To reduce the effect of the allergy, the doctor can also prescribe antihistamines. In very rare cases, the doctor can prescribe oral corticosteroids, but they also have their own side effects which can worsen the scenario. If the reaction is system-based, it becomes very difficult to resolve them, since they are often caused by implants. If there is a non-metal replacement implant available, doctors will suggest removing the metal implants and replacing them with the non-metal ones. One of the most common examples is plastic filling, which is now available in place of metal dental filling.

However, the replacements cannot always happen, since there are no non-metal implants available for implants such as artificial knees or hip replacements. In such conditions, the doctor will usually provide topical and oral medications to mellow symptoms and provide relief for the patient. Hence, when it becomes difficult to treat systemic reactions or metal allergies, the doctor will recommend metal hypersensitivity tests prior to any implants.

If the allergy has caused the skin to crack or if blisters start to appear, it is advisable to take off any jewelry or stop using any material with metal and visit the doctor immediately.