Pollen, dust, pets, and food are common allergens. But these aren’t the only things that can trigger an itchy nose, a rash, or sneezing. Skin contact with gold also triggers an allergic reaction in some people.

It’s unknown how many people experience a reaction to gold. But out of 4,101 people tested for a gold allergy in a 2001 study, about 9.5 percent tested positive, with more women testing positive than men.

To be clear, though, a reaction to gold isn’t necessarily due to the gold itself, but rather metals in the gold, such as nickel. Some gold contains trace amounts of nickel. So if you have a metal or nickel allergy, contact with certain types of gold may cause a skin reaction.

The symptoms of a gold allergy are similar to those caused by other allergies. The body reacts differently to allergens, yet typical symptoms can include:

  • swelling
  • a rash
  • redness
  • itching
  • peeling
  • dark spots
  • blistering

Symptoms can range from mild to severe. They can develop shortly after contact with gold or after long-term exposure.

If you wear a gold ring, you might develop redness, discoloration, or itchiness on your finger. You might also develop symptoms on your ear or around your neck after wearing gold earrings or a gold necklace.

It can be hard to distinguish a gold allergy from other allergies, so you might attribute symptoms to eczema or another type of contact dermatitis. With a gold allergy, you’re likely to have the same reaction every time you expose your skin to gold.

The exact cause of a gold allergy is unknown, but symptoms occur when your immune system becomes sensitive to the metal. Being allergic to other types of metal, as well as having a family history of a nickel or metal allergy, can make you more likely to have a gold allergy.

It’s also possible that you’re reacting to gold jewelry or other gold items because of other metals that are mixed in. Nickel is one of the most common metal allergens and is often alloyed, or mixed, with gold.

So, while gold jewelry can trigger an allergic reaction, keep in mind that other items contain gold or nickel. You may react when exposed to the following:

  • Gold sodium thiomalate: a gold compound used to reduce pain and inflammation in people with rheumatoid arthritis
  • Gold dental crown: a dental cap or fixed prosthetic used to restore a damaged tooth
  • Gold-containing oral supplements: these can include vitamin and mineral supplements, so be sure to read the ingredients label
  • Gold-plated stents: tiny tubes used to open up blocked passageways in the body, such as blood vessels
  • Edible gold: trace amounts of gold pressed or brushed into or over chocolate and other sweet treats
  • Tattoo ink: this may be more likely if you’re allergic to nickel
  • Cellphones: these can contain nickel
  • Cosmetics: these products may contain nickel and other metals

Keep in mind, though, that not all gold contains traces of nickel.

So if it’s actually nickel you’re sensitive to, a reaction might only happen when wearing certain types of gold.

Typically, the more pure gold in a piece of jewelry, the less nickel it contains.

Therefore, you might not react to 24 karat gold (pure gold), which has 99.9 percent of gold. It has less than 0.1 percent of nickel and other metals.

Similarly, your chance of a reaction might decrease with 18 karat gold, which is 75 percent gold. But if you wear gold that’s only 12 carats or 9 carats — thus containing a higher amount of nickel or another metal — you might be more likely to have a reaction.

You’re also more likely to react to white gold. Yellow gold can contain nickel but is typically alloyed, or combined, with silver or copper. White gold is mostly alloyed with nickel.

If you have symptoms like itching, swelling, redness, and blistering after wearing gold jewelry, the best way to treat the reaction is to use an over-the-counter topical corticosteroid cream. To reduce itching, be sure to keep your skin moisturized and apply a cool compress.

For a severe reaction, see your doctor, as you may need a stronger medication. To avoid future allergic reactions, you may want to stop wearing the jewelry altogether.

The best way to prevent a reaction is to wear jewelry that doesn’t irritate your skin. You can avoid gold jewelry altogether, or only wear 18 or 24 karat gold. Since the underlying cause is often a nickel allergy, though, you’ll probably need to avoid other types of jewelry as well. This includes costume jewelry.

Look for jewelry that’s hypoallergenic, or nickel-free. You can also prevent a skin reaction by wearing stainless steel or titanium. Another tip is to switch out metal watchbands for those made of cloth, plastic, or leather.

If your job requires contact with nickel or gold, wear gloves to reduce your likelihood of a reaction.

Keep in mind that nickel is found in many everyday items, too, which can cause a reaction with skin to skin contact. These items include eyeglass frames, tools, keys, coins, belt buckles, razors, and even bra hooks. You might, for example, consider switching out your metal eyeglass frames for plastic or titanium frames.

If you suspect a gold or nickel allergy, see your doctor. Your doctor will perform a skin examination and ask about your medical and family history.

Some doctors can make a diagnosis based on the appearance of your skin. But you’ll likely receive a referral to an allergist or a dermatologist for further testing.

These specialists can use a patch test to confirm or rule out a nickel or metal allergy. This involves exposing a small patch of skin to the allergen and then checking the skin for a reaction.

There’s no cure for a gold or nickel allergy. But you can manage symptoms by avoiding jewelry that contains the metal. It also helps to familiarize yourself with other items containing gold or nickel and then avoid contact with these, too.