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If you live with eczema, you probably know how important it is to avoid your triggers — anything that might cause your skin to react. For some, that could mean stress or illness. For others, contact with nickel found in jewelry, buttons, or coins might cause flare-ups. In some cases, this contact triggers acute contact dermatitis, a sudden, itchy rash caused by an allergen or irritant.
Several 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.” Another wrote, “After doing some research, I think I might have an allergy (or sensitivity, perhaps) to nickel. Has anybody else found this?”
If you think nickel is to blame for your eczema flares, here’s what you should know about the metal, including how to test for nickel allergy.
More than 18 percent of North Americans have a nickel allergy. According to the American Academy of Dermatology, this estimate includes 11 million children in the U.S. It’s not clear whether nickel allergies are more common in people with eczema.
Nickel is found in jewelry such as necklaces, rings, earrings, and bracelets. It’s also in other items like coins, electronics, knee replacements, zippers, batteries, and cell phones. Some foods even 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. This skin rash is an allergic reaction — your immune system responds when something touches your skin and causes irritation. Although contact dermatitis is different from atopic dermatitis (the most common type of eczema), having atopic dermatitis can make you more likely to develop contact dermatitis. That’s because atopic dermatitis weakens the barrier your skin provides between you and the outside world.
It can be hard to tell the difference between contact dermatitis and atopic dermatitis. Some dermatology providers may call both “eczema” because the rashes can look alike. To make it more confusing, a rash from contact dermatitis can stick around and look like regular atopic dermatitis. The exact relationship between contact and atopic dermatitis isn’t well understood. In some people, contact dermatitis might just be a one-time flare of atopic dermatitis that clears up once the trigger is avoided.
People who are sensitive to nickel usually develop symptoms within 72 hours of touching something that contains it. The skin might become itchy, change color, feel dry, or develop a rash. In more serious cases, blisters can form. This usually happens at the site of contact with nickel. The most common offender is jewelry, which causes many people to have nickel allergies on their hands, wrists, or earlobes or around the neck.
It can be hard to know if you have a nickel allergy versus eczema, especially since allergy symptoms can take up to three days to appear. If you develop an eczema-type skin reaction during or after wearing jewelry, it may be easier to notice a nickel allergy. But if you're coming into contact with nickel through everyday items like clothing fasteners or electronics, it can be harder to tell what’s triggering the reaction.
Your dermatologist or allergist can test you for a nickel skin allergy, along with other possible allergies. The most reliable way to diagnose a nickel allergy is a patch test performed by a healthcare provider. During the nickel allergy test, your doctor will place a small amount of nickel onto a patch and apply it to your back. The patch is left on your skin for two days. If your skin reacts after the patch is removed, it may mean you’re allergic to nickel. Keep in mind that even if you touch or wear an item for a while without any reaction, an allergy can still develop later.
You can also try an at-home test to figure out which items you come into contact with that contain nickel.
To find out if something contains nickel and might be causing your skin reactions, you can buy a nickel-testing kit. You can usually find these at your local pharmacy or online. Then, test metal items that often touch your skin, like jewelry, coins, or belt buckles. Instructions can vary depending on the kit, but usually, you’ll put a drop of liquid on the object and rub the spot with a cotton ball or swab. If the cotton turns pink, the item has nickel and could be causing your nickel allergy symptoms. Keep in mind that this test only shows if nickel is there. It can’t diagnose a nickel allergy.
Once you find out that an item contains nickel, you might feel tempted to test it on your skin. But this isn’t a safe way to check for a nickel allergy. Touching something that contains nickel can make your symptoms worse and make it harder to know whether nickel is the cause. If you think you’re allergic to nickel, see your healthcare provider to get a proper diagnosis.
Some people only react to nickel if they’re exposed to a high enough amount or for a longer time. If you have a confirmed allergy to nickel, make sure to test all metal objects you regularly touch. This helps you know what to avoid so you can prevent future symptoms.
You can take several steps to manage a nickel allergy. Avoiding nickel and treating flare-ups can help reduce symptoms.
The best way to manage your nickel allergy is to completely avoid this eczema trigger. That’s easier said than done, though, because nickel is found in a lot of everyday things. You may not be able to get rid of nickel at work or in your body, as it may lurk in your diet even if you adopt a low-nickel diet. Some people may have severe symptoms from food that contains nickel or an implanted metal device, called systemic nickel allergy syndrome. This serious condition, which has become more recognized, can cause symptoms like diarrhea, blisters, and swelling and may require diet changes. But, in general, 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. Use covers on your devices, and choose hypoallergenic jewelry and body piercings, like those made of plastic, stainless steel, sterling silver, or other materials that don’t contain nickel.
White gold jewelry often contains small amounts of nickel, which can be enough to cause a reaction. If you have pieces that you 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.” Be sure to check with a jeweler to make sure you won’t damage your items.
There are many ways to treat a nickel allergy, although some options may only be available through your healthcare provider. Some medications may be used to manage itch and irritation caused by nickel allergy and eczema, such as topical (applied to skin) corticosteroid creams and oral (taken by mouth) antihistamines.
Other nickel allergy treatment options include oral steroids for severe allergic reactions and phototherapy (light therapy). Oral steroids are used for short-term relief rather than long-term treatment, so it’s important to follow your doctor’s instructions for use. Light therapy is more commonly used for eczema and may also help with a nickel allergy if other treatments don’t work.
Your doctor will help you figure out which treatment is right for you and will monitor your progress to make sure your condition is improving.
Nickel can be a hidden trigger for people with eczema, but learning how to test for it and avoid it can make a big difference. If you think this trigger might be behind your symptoms, talk to your doctor and take steps to limit your exposure. With the right information and support, you can reduce flares and protect your skin.
On MyEczemaTeam, the social network for people with eczema and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with eczema.
Are you trying to figure out if nickel triggers your eczema? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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