Many people who live with eczema learn to look out for their triggers — factors that set off their flares. The wide range of possible culprits includes illness, cuts, and contact with certain substances, such as nickel.
A number of MyEczemaTeam members are allergic to nickel and find that this metal triggers their eczema symptoms. One said, “I have an allergy to nickel and anything with a scent to it.”
“After doing some research, I think I might have an allergy (or sensitivity perhaps) to nickel. Has anybody else found this?” asked another member.
Exposure to nickel could trigger flares or acute contact dermatitis (a sudden onset of this form of eczema) in some people with eczema. If you suspect a nickel allergy or you’re having flares you don’t understand, here’s what you should know about this metal and testing yourself for this particular allergy.
Up to 18 percent of North Americans, including 11 million U.S. children, have a nickel allergy. It’s unknown whether these numbers are higher among people diagnosed with eczema.
Nickel is most commonly found in jewelry such as necklaces, rings, earrings, and bracelets. It can also be found in other items, including coins, electronics, knee replacements, zippers, batteries, and cell phones. Even some foods contain nickel, a trace element found in soil, water, and the air.
One MyEczemaTeam member said, “I am doing better. My dermatologist did a biopsy. It came back as an allergy! Last November I had my right knee replaced, and I’ve read that a percentage of patients have a sensitivity to the nickel in the knee.”
“I also found out I was allergic to nickel and there is some in foods like whole wheat, whole grains, most vegetables, chocolate, and canned goods,” shared another member.
When a nickel allergy shows up, it may trigger allergic contact dermatitis — an allergic reaction that shows up on your skin when you come into contact with something that irritates your body. This condition differs from atopic dermatitis (the most common subtype of eczema), but having atopic dermatitis makes you more susceptible to contact dermatitis. That’s because atopic dermatitis affects the barrier your skin provides between you and the outside world.
It can be difficult to distinguish between contact dermatitis and atopic dermatitis, and some dermatologists refer to both just as “eczema” because the rashes appear similar. This is complicated by the fact that a contact dermatitis rash can linger, becoming more like traditional atopic dermatitis. The exact relationship between contact and atopic dermatitis isn’t well known or understood. Contact dermatitis may stem from an isolated case of atopic dermatitis that goes away when triggers are avoided, at least in some people.
People who are sensitive to nickel will notice symptoms within 72 hours of contact with something that contains this allergen. Their skin may change color, become itchy, dry out, develop a rash, or — in severe cases — blister. This usually happens at the site of contact with nickel. The most common offender is jewelry, and many people experience nickel allergies on their hands, wrists, or earlobes or around their necks.
It can be difficult to know if you have a nickel allergy, especially since symptoms can take up to three days to appear. If you get an eczema-type skin reaction during or after wearing jewelry, you may have a nickel allergy. If you’re getting exposed in some other way, it can be harder to know for sure.
Your dermatologist or an allergist can test you for a nickel skin allergy, among other possible allergies. You can also perform a simple test at home.
First, buy a test kit that’s specific to nickel allergies — you can usually find these kits at your local pharmacy or online. Then test items that regularly come into contact with your skin, such as jewelry you wear or coins you carry. Specific instructions vary among test kits, but generally, you’ll apply a drop of a substance to the object and then rub the area with a cotton ball or swab. If the cotton comes up pink, the item contains nickel and is likely to cause a contact allergy.
Next, expose your body to the object. This is easiest with a piece of jewelry — wear it for a day or two, then take it off and see what happens.
Note that having no reaction doesn’t necessarily mean that you don’t have a nickel allergy. You may show symptoms only if you are exposed to a certain amount of nickel or touch it for a particular amount of time.
If you do show signs of contact dermatitis, you should test other items, too, so you know what to avoid to keep symptoms at bay.
You can take several steps to manage a nickel allergy.
The best way to manage your nickel allergy is to completely avoid this trigger. That’s easier said than done, though, because nickel turns up in so many places. You may not be able to get rid of nickel at work or in your body, and it may also lurk in your diet even if you work hard to eliminate it. However, the more nickel you can avoid, the less likely it is that your allergy will show up and the better you’ll feel.
You can still use electronics and wear jewelry. Cover your devices, and choose hypoallergenic jewelry and body piercings, like those made of plastic, stainless steel, sterling silver, or other nickel-free materials.
Gold jewelry often contains small amounts of nickel — enough to trigger a reaction. If you have pieces that you really want to wear, you might want to try the suggestion of one MyEczemaTeam member: “You can put clear nail polish on jewelry, and it helps when you are allergic to nickel.” First check with a jeweler to make sure you won’t ruin your items.
A wide variety of treatments can help manage a nickel allergy, though you’ll need to talk with your health care provider to access some of these. Possible treatments include topical (applied to skin) corticosteroids and allergy creams, oral (taken by mouth) antihistamines and steroids, and phototherapy. Your doctor will help you figure out which one is appropriate for you and monitor your condition to make sure it’s improving.
If you know you’re allergic to nickel but you don’t have a good way to determine if an item contains it, try a patch test. Expose a small area of your skin to the object for up to 48 hours, then see if you react. If you don’t, there’s a good chance that it doesn’t contain nickel.
Of course, if the item is something you plan to expose yourself to for a long time, like a favorite piece of jewelry, an allergy may show up later. Still, you can save yourself a lot of discomfort by using patch tests and talking with your doctor if you begin to suspect you’re allergic to nickel.
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Are you trying to figure out if nickel triggers your eczema? How has having a nickel allergy affected what you wear, eat, or do? Share your experience in the comments below, or start a conversation by posting on your Activities page.