What Is a Nickel Allergy?
Nickel is a silver-colored metal found naturally in the environment. It is often mixed with other metals and used to make various items, including:
- cell phones
- eyeglass frames
- paper clips
- orthodontic braces
- stainless steel cooking equipment and eating utensils
- clothing fasteners, such as zippers, snap buttons, and belt buckles
Small amounts of nickel are also found in many foods, including certain grains, fruits, and vegetables.
A nickel allergy is an adverse immune response that occurs when someone comes into contact with a product containing nickel. Normally, the immune system defends the body against harmful substances, such as viruses and bacteria, to ward off illnesses. In people with nickel allergies, the immune system mistakes nickel as a dangerous intruder. The immune system begins to produce chemicals to fight against the substance, triggering an allergic reaction. An allergic reaction to nickel is one of the most common causes of an itchy skin rash. It can also cause other changes in the skin, such as redness and blistering.
Nickel allergies are increasing in the United States. The allergy may develop at any age, but it is more common in women than men. About 16 percent of men and 36 percent of women under the age of 18 have a nickel allergy in the United States. Once it has developed, a nickel allergy is unlikely to go away. The only way to treat a nickel allergy is to avoid all items and foods containing nickel.
What Are the Symptoms of a Nickel Allergy?
People with a nickel allergy usually begin to develop a skin reaction within 12 to 48 hours after coming into contact with an item containing nickel. The symptoms of a nickel allergy include:
- skin rash or bumps
- redness or other changes in skin color
- dry patches on the skin that resemble a burn
- blisters (in very severe cases)
Nickel is also one of the main causes of a skin rash known as allergic contact dermatitis. Someone with a nickel allergy will almost always have a localized response following exposure to objects containing nickel. This means that the allergic reaction only affects the part of the skin that comes into contact with nickel.
Eating foods containing small amounts of nickel may also trigger an immune response that causes changes in the skin.
Allergic contact dermatitis causes the following symptoms:
- severe itching
- scaly, raw, or thickened skin
- dry, discolored, or rough skin
- warm, tender skin
- fluid-filled blisters
The rash usually lasts between two and four weeks after exposure.
In rare cases, a nickel allergy can also lead to respiratory problems, including:
- runny nose
- nasal inflammation
People with this type of reaction should take preventive measures immediately.
What Causes an Allergic Reaction to Nickel?
The immune system is responsible for promoting chemical changes in the body that help fight off harmful invaders, such as viruses and bacteria. In people with allergies, the immune system mistakes a typically harmless substance as an intruder. The immune system begins to produce chemicals to ward off the substance. In people with a nickel allergy, the immune system is reacting to the object or food containing nickel. The reaction leads to various symptoms, including rashes and itching.
This adverse reaction may occur after the first exposure to nickel or after repeated and prolonged exposure. The exact cause of a nickel allergy isn’t known. However, researchers believe that the sensitivity to nickel may be genetic, or inherited from a relative.
How Is a Nickel Allergy Diagnosed?
Your doctor or dermatologist can diagnose a nickel allergy. Call them right away if you have a skin rash and don’t know what caused it. Your doctor will first ask you about your symptoms, including when they started and what appears to make them worse. Be sure to tell your doctor about any medications, supplements, or new foods and products you’ve tried recently.
A patch test is often performed if a nickel allergy is suspected. During the patch test, your doctor will apply a small amount of nickel over a patch. The patch will then be placed on your skin. Patch tests are usually very safe and shouldn’t cause a major allergic reaction. They will only cause a minor response in people who are allergic to nickel.
Your doctor will observe your skin for about 48 hours after the patch test and check for signs of an allergic reaction. If the skin looks irritated, then you may be allergic to nickel. In some cases, the results aren’t clear and further testing is needed.
How Is a Nickel Allergy Treated?
There’s no cure for a nickel allergy. As with other allergies, the best treatment is to avoid the allergen.
Your doctor may prescribe one of the following medications to help reduce the skin irritation caused by a nickel allergy:
- corticosteroid cream
- nonsteroidal cream
- oral corticosteroid, such as prednisone
- oral antihistamine, such as fexofenadine (Allegra) or cetirizine (Zyrtec)
Make sure to follow your doctor’s instructions carefully when using these medications.
The following home treatments might also help:
- calamine lotion
- moisturizing body lotion
- wet compresses
Tell your doctor if treatments aren’t helping or if they’re making symptoms worse. You should also contact your doctor immediately if you experience increased redness, pain, or pus in the affected area. These symptoms may be a sign of infection and will need to be treated with antibiotics.
How Can an Allergic Reaction to Nickel Be Prevented?
While the allergy itself can’t be prevented, the best way to prevent an allergic reaction to nickel is to avoid all objects containing it. Always check with the manufacturer, retailer, or label to find out if an item has nickel before you buy or use it.
Nickel is also present in a surprisingly large number of foods and food products, including:
- black tea
- nuts and seeds
- soy milk and chocolate milk
- chocolate and cocoa powders
- certain canned and processed foods, including meat and fish (check labels)
- certain grains, including:
- whole wheat
- wheat germ
- whole wheat pasta
- multigrain breads and cereals
- certain vegetables, including:
- Brussels sprouts
- all canned vegetables
- certain legumes, including:
- soy products, such as tofu
- certain fruits, including:
- all canned fruits
Talk to your doctor about avoiding these foods if you’re allergic to nickel. People with a nickel allergy should also:
- abstain from using stainless steel cooking equipment
- avoid wearing jewelry containing nickel or getting a body piercing
- wear clothing with plastic or coated zippers and buttons
- check with an orthodontist about nickel before getting orthodontic braces
- ask an ophthalmologist if eyeglasses contain nickel before buying them
- tell doctors about a nickel allergy before having any surgeries
If you have a nickel allergy and work in an industry where you are frequently exposed to nickel, talk to your employer and your doctor. They can help you determine a plan moving forward for avoiding nickel and preventing an allergic reaction.