Are you allergic to your jewelry?

You had your ears pierced a few months ago. And, you’ve just bought a new pair of earrings—finally, an alternative to the ones you’ve been wearing ever since the piercing! But now your ears are red and very itchy. What’s up?

DEFINING THE ALLERGY
The red, itchy skin you’re experiencing is contact dermatitis. These skin reactions are common symptoms of nickel allergy. Contact dermatitis is a sure sign that the new earrings you bought have some nickel in them. In the condition’s more severe form, blisters appear where the skin has come in contact with nickel.

A sensitivity—or allergy—to nickel develops with close and repeated skin exposure to nickel. This can happen at any age. Once the person has been exposed enough to nickel, sensitization can take place and an allergic response may develop.

Several factors may make nickel contact dermatitis worse than it would be otherwise. These include warm temperature, perspiration, and friction against the skin. The condition of a person’s skin also influences the reaction. If, for example, the skin is scratched or pierced it will be more open to the nickel. In addition, wearing gloves or other skin coverings over the nickel can intensify contact.

COMING IN CONTACT WITH NICKEL
Nickel is everywhere. Of course, 5-cent nickel coins contain nickel, but so do other coins. Most nickel we come in contact with is in jewelry. But there are other sources as well, such as eyeglass frames, belt buckles, and metal fasteners on clothing. Many medical supplies contain nickel, too. These include pacemaker parts, joint-replacement parts, heart-valve replacements, and wound staples, among others. Dental supplies are another source: fillings, braces, bridges, and crowns all may contain nickel.

Interestingly, nickel is found in some of our food. Some doctors advise a low-nickel diet for a few months for highly sensitive people to see if symptoms improve. Among the foods that contain nickel are:
• Canned fruits and vegetables
• Licorice
• Nuts
• Coca and chocolate
• Dried fruit
• Legumes
• shellfish

That some foods may cause nickel allergy is controversial, however. Further research is needed.

Another piece of advice: avoid high-acid foods such as tomato-based items that have been cooked in stainless steel cookware. The acid may draw the nickel from stainless steel.

MAKING THE ALLERGY CALL
If you suspect you may have a nickel allergy, your healthcare provider will take a thorough medical history and examine your skin. The diagnosis can be confirmed with a patch test—a skin test performed by an allergist or dermatologist. The test calls for a small amount of nickel to be applied to the skin. After 48 hours and 72 hours, the doctor checks the site where the nickel was applied to see if there’s evidence of a skin reaction. Swelling, redness, rash, and blisters are all signs of a positive reaction.

TAKING CARE
The first step in treatment is a careful cleansing to get rid of any nickel that might still be on the skin. To reduce inflammation, a topical corticosteroid medication may be applied. If the allergic reaction is more severe, oral corticosteroids may be needed to reduce inflammation. Other remedies include wet compresses and anti-itch or drying lotions to soothe the irritated skin.

Because so many medical devices contain nickel, anyone with a nickel allergy who’s facing surgery should take precautions. If you know you are allergic to nickel, don’t keep the information to yourself. Let your healthcare provider know. A care provider should query anyone planning to undergo a procedure to implant a device that contains nickel. Have they experienced skin reactions to jewelry, or other metal objects? If the answers suggest a nickel allergy, a patch test should be performed.