How to manage a nickel allergy

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A nickel allergy occurs when a person has an adverse reaction to a food or object containing nickel.

Allergic contact dermatitis occurs when a red, itchy rash develops on skin that has touched an allergen. An allergy to nickel is among the most common causes of this reaction.

Rashes often occur on the earlobes or wrists, because many earrings and watches contain nickel. The reaction may occur immediately after contact, or it may develop after repeated exposure.

When a person with a nickel allergy comes into contact with the metal, their immune system mistakenly believes that it is causing harm. The immune system produces a hormone called histamine in response. This can cause a rash to develop, as well as other symptoms.

Here, we look into the everyday objects and foods that contain nickel and provide detailed information about the allergy, including symptoms, methods of diagnosis, and treatment options.

Fast facts about nickel allergies:

  • The medical community is unsure why people develop allergies to nickel.
  • An increasing number of people in the United States are allergic to nickel.
  • This allergy is more common in women than men.
  • The allergy can appear at any age.
  • The only way to prevent an allergic reaction is to avoid contact with products containing nickel.

What are the symptoms?

scratching wrist

 Watches containing nickel may cause a rash on the wrist.

An allergic reaction usually occurs within 24–48 hours of contact with nickel.

Symptoms include:

  • a rash
  • reddening of the skin
  • dry patches that may resemble a burn
  • itching
  • blisters, when the reaction is severe

Often, the reaction will only affect the area of skin that touched the item containing nickel.

  • extreme itching
  • skin that is thick, raw, or scaly
  • skin that is dry or rough
  • discolored skin
  • skin that feels warm and tender to the touch
  • fluid-filled blisters

A rash resulting from an allergic reaction tends to last 2–4 weeks. Broken or wet skin is more likely to react.

If an allergic reaction to nickel is very severe, it can cause inflammation of the nasal passages or an asthma attack.

What to avoid

The best way to manage a nickel allergy is to avoid anything containing the metal.

Nickel is commonly found in items such as:

  • jewelry
  • fasteners on clothing, such as zippers
  • money
  • cell phones
  • pens
  • paper clips
  • keys
  • glasses frames
  • stainless steel cooking equipment

A person with an allergy may have to carefully read labels or contact manufacturers to ensure that these types of items do not contain nickel.

The following foods may also be problematic:

  • black tea
  • some seeds and nuts
  • soy milk
  • chocolate and cocoa powders
  • some canned, preserved, and processed foods
  • oats
  • buckwheat, whole wheat, and wheat germ
  • multigrain bread and cereals
  • asparagus, broccoli, and sprouts
  • beans
  • spinach
  • bananas and pears

Risk factors

hairdresser using nickel scissors

People who work in certain industries are more likely to develop allergies to nickel. At particular risk are:

  • hairdressers
  • nurses
  • caterers
  • people who regularly handle cash
  • people who work with metals

Anyone working in an industry that involves frequent exposure to nickel and other metals should notify their employer of an allergy.

It is also essential that people with nickel allergies inform their doctor before surgery.

Treatment and prevention
antihistamine capsules

A rash caused by a nickel allergy can be treated with antihistamines.

There is no cure for an allergy to nickel. The best way to prevent a reaction is to avoid the allergen.

Several medications can help to treat a rash that results from an allergic reaction. These medicines control inflammation and reduce the body’s histamine response.

Common medications include:

  • corticosteroid creams
  • nonsteroidal creams
  • oral corticosteroids, such as prednisone
  • oral antihistamines, such as fexofenadine

Antihistamines are available over the counter and can be bought online. Mild-strength corticosteroid creams are also available online. A doctor may prescribe stronger versions of these medications.

Some home remedies may help to soothe and calm the skin. These include:

  • calamine lotion
  • hydrating body lotion
  • cool, wet compresses

Seek advice from a doctor as soon as possible if treatments do not relieve symptoms or make them worse.

If reactions to nickel are severe, see a doctor as soon as possible. Severe symptoms may include pain or blisters that leak pus, and they can indicate an infection that requires treatment with antibiotics.

Diagnosis

Anyone unsure of the cause of a rash should contact a doctor or dermatologist for a diagnosis.

After asking questions about possible causes, the doctor will usually perform a patch test. This involves placing a small amount of nickel on the skin. The doctor will diagnose a nickel allergy if the skin reacts within 48 hours.

This type of test is usually safe and causes a severe reaction only in extremely rare cases.

Takeaway

A person with a nickel allergy will continue to be sensitive to the metal for the rest of their life. Raw, broken, or wet skin is more likely to react.

Symptoms will improve if a person avoids the everyday items and foods that contain nickel.