Did you know you can have an allergy to certain metals?
The most common cause of metal allergy is nickel, often found in jewelry or zippers. In fact, 18% of people in North America are allergic to nickel, according to the American Academy of Dermatology (AAD).
Nickel allergy can cause eczema symptoms, leaving the skin that touched the metal itchy, dry, and irritated. This form of eczema is called nickel allergic contact dermatitis.
You might even have this allergy without realizing it. Many people mistake this condition for its more well-known cousin — atopic eczema — due to a similarity in symptoms. But nickel allergic contact dermatitis flare-ups are often more preventable than atopic eczema, so it’s worth figuring out which type you have.
Read on to learn how nickel can affect your skin, plus some guidance on recognizing nickel-related eczema and tips to manage nickel allergy symptoms.
Eczema is an umbrella term for skin conditions that cause itchy, irritated skin.
Atopic and contact dermatitis are two common types of eczema.
With atopic dermatitis, also called atopic eczema, your skin becomes inflamed periodically, sometimes without an obvious trigger.
If you have contact dermatitis, your skin may become inflamed after contact with an allergen or irritant, such as nickel.
Atopic eczema and nickel allergic contact dermatitis have many of the same symptoms, but two key differences distinguish these types of eczema.
Atopic eczema can have many triggers. Any factor that affects your skin, such as temperature, stress, or hormones, can cause an episode. Atopic eczema is chronic and probably will not disappear fully, but treatment can make flare-ups less frequent.
To contrast, you’ll only notice nickel-related eczema symptoms after you’ve come into contact with nickel. Symptoms typically appear shortly after exposure and disappear once the exposure stops.
Atopic eczema can show up all over your body. Symptoms often appear around your joints — at your elbows, knees, wrists, ankles, and so on. Many adults also experience symptoms in the skin around the eyes.
On the other hand, symptoms of nickel eczema often only appear where your skin touched nickel.
That said, if you’re extremely sensitive to nickel, eating foods with nickel in them could cause a body-wide, or systemic, reaction. In those rare instances, you could develop eczema on skin that never touched metal.
Nickel allergic contact dermatitis happens when your skin has direct, prolonged contact with a piece of metal containing nickel.
Common triggers include:
- jewelry: including earrings, body piercings, bracelets, watches, and necklace clasps
- clothing fasteners: including snaps, zippers, buttons, buckles, and bra hooks
- metal furniture: including folding chairs, stools, and outdoor tables
Nickel by itself isn’t inherently bad for your skin. But when your skin rubs against nickel and corrodes it with sweat, some of the metal may dissolve into nickel ions.
The top layer of your skin absorbs these free-floating nickel ions, which sets off your immune system’s alarm bells. Nearby cells release inflammatory agents to attack the nickel ions. Within roughly 30 minutes, you may see eczema symptoms where the metal entered your skin, according to the American Academy of Pediatrics (AAP).
When this process is repeated enough times, your immune system may decide to assign permanent “lookouts” for nickel ions. Once these specialized immune agents enter the playing field, it can take less and less nickel to trigger an inflammatory reaction. Before you know it, you have nickel allergy, and your eczema might flare up after even brief contact.
Nickel allergy involves the same symptoms as other forms of allergy-induced eczema. Symptoms can vary, depending on the severity of your allergy and the amount of nickel you were exposed to.
Here are possible nickel-related eczema symptoms include:
- Skin dryness: may cause your skin to crack or flake
- Itching: could range from a mild distraction to an intense burning or stinging sensation
- Inflammation: can make your skin feel swollen, hot, and tender to the touch
- Discoloration: means lighter skin may become pink or red, and darker skin may become purple or ashen gray.
- Rash: can cause your skin to flare up in patches or distinct bumps
- Blisters: may leak fluid and crust over
These symptoms can be frustrating and uncomfortable, but they generally don’t pose a serious danger to your health. Unlike some other allergens, nickel cannot cause anaphylactic shock.
Can you have both atopic eczema and a nickel allergy?
It’s possible to have both atopic dermatitis and contact dermatitis. Children are
- 1 in 3 children with contact dermatitis also have atopic dermatitis.
- 1 in 9 adults with contact dermatitis also have atopic dermatitis.
Experts don’t know how common atopic eczema is among people with nickel allergic contact dermatitis, specifically.
However, they do know that when you have both conditions, you may experience more severe symptoms. Nickel-related rashes may itch more, for instance, and the atopic eczema flare-ups might spread out further across your body.
Research estimates suggest 10% to 15% of the human population has a metal allergy.
Nickel is by far the most common allergen, but other metals have been known to cause eczema too. Here are some examples:
- Cobalt is used in hard metal manufacturing and bricklaying.
- Chromium is used in leather tanning, dye production, and cement manufacturing.
- Zinc is used in some dental fillings. Since fillings sit in your mouth, zinc tends to cause a systemic reaction across your body rather than a reaction on a specific patch of skin.
These metals cause eczema in a similar fashion to nickel. In short, they agitate your immune system, causing it to overly respond. On rare occasions, metals in your diet can prompt a systemic reaction, but most metal-induced eczema happens due to physical contact.
Perhaps the best way to handle nickel allergy involves avoiding nickel in the first place.
If you wear jewelry, check to make sure an item doesn’t have nickel mixed in. Opt for pieces made of:
- surgical-grade stainless steel
- sterling silver (at least 92.5% pure silver)
- 18-karat yellow gold (at least 75% gold)
If most of your nickel exposure comes from clothing clasps, you can coat the buttons or zippers with clear nail polish. This creates a temporary barrier between the metal and your skin. Just keep in mind that you’ll need to reapply the nail polish after laundry day.
Generally, you don’t need to remove nickel from your diet unless you have a severe allergy.
The Food and Drug Administration (FDA) has not approved a specific treatment for nickel allergic contact dermatitis, but typical skin therapies should still serve you well.
Common eczema remedies include:
- topical steroids, like hydrocortisone, to soothe rashes
- emollients, such as oatmeal or coconut oil, to restore moisture to your skin
- vinegar compresses to dry up blisters
- antihistamines to help relieve itching
If your symptoms persist after trying all these remedies, you may want to consider visiting a dermatologist to explore prescription treatment options.
Nickel allergy is a common — and often preventable — cause of eczema symptoms. Replacing nickel-based jewelry and clothing clasps with nickel-free alternatives will usually protect you from most breakouts.
If you continue to notice eczema symptoms after making these swaps, a dermatologist can help you develop a treatment plan for your specific skin care needs.
Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.