Nickel Allergy

What is nickel allergy?

Nickel allergy is a skin rash or irritation that occurs when you come into contact with nickel. This condition is a form of allergic contact dermatitis. Allergic contact dermatitis happens when your skin touches or comes near an ordinarily harmless substance. Nickel allergy is the most common type of contact dermatitis related to metal.

The skin rash from nickel allergy may be itchy or painful. Allergic contact dermatitis causes delayed reactions, so your symptoms may not appear for up to 72 hours after nickel exposure.

Nickel allergy can develop at any time. Once you have a nickel allergy, it never goes away. But you can treat it by avoiding nickel or using medications.

What items contain nickel?

Nickel is a metal commonly found in jewelry, like:

• Bracelets
• Clasps for jewelry, including earring backs
• Earrings
• Necklaces
• Rings
• Watchbands

Nickel can also be in other items you wear, like:

• Clothing fasteners like belt buckles, bra hooks, buttons, snaps and zippers
• Dental braces
• Eyeglasses

Nickel may also be inside items you use every day, such as:

• Chalk
• Coins
• Cooking equipment and eating utensils
• Keys
• Paper clips
• Razors
• Tech and accessories, like laptops, tablets, cell phones and batteries

Nickel also makes up parts of items inside:

• Bathroom fixtures
• Furniture
• Machinery
• Medical devices
• Metal tools
• Musical instruments

High levels of nickel can also be present in foods, including:

• Beans and legumes
• Chocolate and cocoa
• Fruits, including figs, prunes and raspberries
• Grains, including buckwheat, multigrain breads and cereals, oats and whole wheat
• Licorice
• Nuts
• Shellfish and seafood, including clams, crawfish, mussels and shrimp
• Soy products
• Tea
• Vegetables, including cabbage, kale, lettuce, leeks, peas and spinach

What are the symptoms of nickel allergy?

Symptoms of nickel allergy range from mild to severe. They usually appear within 12 to 72 hours of coming into contact with nickel. Most people with nickel allergy only have a reaction on the part of their skin exposed to nickel. Common nickel allergy symptoms include:

• Bumpy skin (hives)
• Cracked skin
• Itching or burning sensations
• Patches of dry skin
• Rash
• Red or discolored skin

More serious nickel allergy symptoms (systemic nickel allergy syndrome) may occur if you eat foods that contain nickel or have a metal device implanted in your body. This can cause symptoms that affect your entire body. These symptoms may include:

• Blisters
• Diarrhea
• Fatigue
• Headaches
• Swelling

What causes nickel allergy?

Researchers don’t know the exact cause of nickel allergy. It happens when your immune system sees nickel as harmful. 

A nickel allergy may develop the first time you’re exposed to nickel or after many times. Once your body has a first allergic reaction to nickel, you’ll likely continue to be allergic every time you’re in contact with it.

How is nickel allergy diagnosed?

To diagnose nickel allergy, a healthcare provider will ask about your symptoms, along with:

• Your family history of allergies
• Your medical history, including allergies, autoimmune diseases and skin issues
• The medications you take
• New foods or supplements you’ve tried recently

If your provider suspects a nickel allergy, they’ll do an allergy test (patch test). During the patch test:

1. Your provider places tiny amounts of substances that may cause an allergic reaction, including nickel, on patches.
2. They place the patches on the skin on your back. The patches stay on your skin for 48 hours.
3. After 48 hours, your provider removes the patches. They then look to see if your skin has reacted to any of the patches, which shows an allergy to that substance.

How is nickel allergy treated?

There’s no cure for nickel allergy. The best treatment is to avoid substances containing nickel. But as that can’t always happen, your provider may suggest medications, including:

• Corticosteroid creams to reduce skin irritation
• Nonsteroidal creams to lessen itching or burning
• Oral antihistamines to help ease itching
• Oral corticosteroids for serious allergic reactions or rashes covering a large area

If medications don’t help relieve your symptoms, your provider may recommend light therapy (phototherapy). This therapy uses ultraviolet (UV) light on your skin. It can take months of phototherapy treatment to show improvement.

How do I treat myself at home with nickel allergy?

You can do many things at home to help relieve nickel allergy symptoms. You can try treatments like:

• Moisturizing creams or lotions to treat dry, cracked skin
• Oatmeal baths to reduce itching
• Over-the-counter steroid cream, but talk to your healthcare provider if you feel like you need it for more than a few days

Don’t use over-the-counter antibiotic treatments at home. These may make your symptoms worse.

How can I prevent nickel allergy?

Steps you can take to prevent nickel allergy include:

• Carefully check products you use.
• Avoid foods rich in nickel if you’re highly sensitive.
• Choose jewelry that doesn’t contain nickel. Wear jewelry made from copper, platinum, sterling silver, surgical-grade stainless steel, titanium or 14-, 18- or 24-karat yellow gold. White gold may include nickel.
• Opt for household items like kitchen tools, keys, pots and pans, and razors that don’t contain nickel. Brass, silicone, stainless steel and titanium are good alternatives.
• Place protective covers on cell phones, laptops and tablets.
• Select watchbands made from cloth, leather or plastic.
• Use plastic belt buckles, bra hooks, buttons, snaps and zippers.

You also can take steps to prevent nickel allergy by talking with service providers:

• Ask your orthodontist if your braces may contain nickel before getting them. 
• Ensure that piercing or tattoo providers use surgical-grade stainless-steel instruments that don’t contain nickel.
• Make sure your eyeglasses don’t contain nickel before you buy them. Purchase glasses made from plastic or titanium instead.

What can I expect if I have nickel allergy?

If you get a rash from a nickel allergy, it may last from two to four weeks. Your skin is more likely to react if it’s:

• Broken
• Raw
• Wet

Without treatment, your skin may become:

• Cracked
• Darkened
• Leathery

What is the outlook if I have nickel allergy?

Nickel allergy usually isn’t life-threatening. Because there’s no cure, avoiding symptoms can be a lifelong challenge. But you can manage the allergy by staying away from items and food containing nickel and/or with proper treatment.

How do I take care of myself with nickel allergy?

If you have a nickel allergy, you may want to keep a list of items with nickel so you can avoid them. You can also buy testing kits to test objects for nickel.

If you come in contact with nickel, avoid scratching the area of contact, as this can increase infection risk. You can also try washing and moisturizing any areas of contact.

When should I see my healthcare provider?

See your provider if the treatments you use aren’t helping or worsen your symptoms. Contact your provider immediately if you see signs of infection (cellulitis) such as:

• Fever
• Increasing redness or skin discoloration
• Pain
• Pus around the rash
• Rapidly spreading rash
• Rash around your eyes