Nickel Allergy

1 What is Nickel Allergy?

Nickel allergy is a very common form of skin allergy in which the immune system launches an abnormal response on contact with nickel. Nickel accessories may not cause any allergic reaction in other people. 

Nickel is a silvery white metal used in combination with other metals in making jewelry, coins, keys, eyeglass frames, pens, orthodontic braces, and cooking equipment. It is also present in some food materials like certain grains, fruits, and vegetables.

Allergy to this metal may develop at any age, but is more common among women when compared to men. Avoiding contact with this element is the best way to treat nickel allergy.

2 Symptoms

The typical symptoms of nickel allergy develop within a day or two. Exposure to nickel-containing materials like jewelry or coins result in an allergic reaction.

The symptoms that usually appear at the point of contact with the metal may remain for more than two weeks. Most common symptoms of this allergy are: 

In some rare cases the symptoms may appear in some other parts of the skin too. Some respiratory problems that arise due to nickel allergy is characterized by:

  • Running nose
  • Sneezing
  • Asthma
  • Nasal inflammation

3 Causes

Nickel allergy is caused by an abnormal reaction of immune system to nickel. Immune system is responsible for warding off disease-causing agents and other foreign substances. In some people, the immune system considers nickel as a foreign substance and produces antibodies against it when exposed to substances containing this metal. 

On further exposure, the antibodies trigger the production of certain chemicals responsible for the allergic reaction. These chemicals, called histamines, lead to the production of typical symptoms like rashes and itching.  

The sensitivity to this metal persists and an allergic reaction is launched each time the body comes in contact with it. Some of the common sources of nickel include

  • jewelry,
  • coins,
  • frames,
  • zippers,
  • metal tools,
  • keys,
  • belt buckles.

Some foods including grains, fruits and vegetables may also contain nickel.

4 Making a Diagnosis

Your doctor can often diagnose a nickel allergy by looking at your skin and asking if you've touched anything metal.

Symptoms like rashes at the point of contact reveal allergy to nickel. History of exposure to the metal is important to check the timing of appearance of symptoms. 

Patch testing is often used to confirm contact allergy. In this test, a small quantity of the metal is applied on the skin as patches. This is left on the skin for two days to observe the reaction. Presence of inflammation on the skin at the test patch indicates nickel allergy.

The inflammation may develop immediately or in a day after removal of patch from the skin.

5 Treatment

As with any other forms of allergy, avoiding the allergen is the best way to treat nickel allergy. Medications are recommended to reduce skin irritation caused by allergy. Some of the common medications used are: 

  • Corticosteroid creams like clobetasol and betamethasone dipropionate
  • Non-steroidal creams like pimecrolimus and tacrolimus
  • Oral corticosteroids like prednisone
  • Antihistamines like cetirizine and fexofenadine 

6 Prevention

The best strategy to prevent developing nickel allergy is to avoid prolonged exposure to items containing nickel.

Limiting exposure to the metal prevents allergic reaction. Opting for accessories that are made of substitute materials prevent exposure to the allergen. In case of jewelry opt for stainless steel, gold, titanium, copper, and white gold. 

Body piercing and tattooing increase the chances of exposure to nickel-containing substances. Choose a center that use nickel-free tools and jewelry. If exposure to nickel is at the workplace, use gloves. At home, cover buttons and zippers with a duct tape or transparent nail polish.

7 Alternative and Homeopathic Remedies

A few alternative remedies exist for managing the symptoms of nickel allergy.

Wet compress, calamine lotion, and moisturizing lotion help to reduce itching and reddishness at the affected area. Bromelain, butterbur, calendula, jewelweed, onion, and tea tree oil are suggested in controlling allergic symptoms. 

One should use these methods with care as there are no clear scientific evidence regarding the same. Acupuncture is also used commonly to control allergies, including nickel allergy.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with nickel allergy.

Limit exposure to nickel containing substances and food as much as possible at home.

Replace nickel with substitutes like stainless steel.

Cover nickel-containing substances like door knob, zipper, button, and buckle with duct tape.

9 Risks and Complications

People with nickel allergy is shown to have a higher risk for recurrent infections. 

10 Related Clinical Trials