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Nickel Allergy

Nickel allergy is a very common form of Allergic Contact Dermatitis (ACD). A rash develops after contact with nickel and may have the following characteristic(s): redness, itching, swelling, hives and/or cracks.

Nickel Allergy

Piercing is a major cause of nickel allergy. When the skin is injured, prolonged contact with nickel causes an allergic reaction. Nickel salts from the jewelry penetrate the skin and cause sensitization. Once an individual is sensitized to nickel, symptoms will appear after contact with nickel.

Nickel allergy is considered a delayed Type IV allergy meaning an allergic reaction may occur up to 48 hours after nickel contact.

Allergy relief

For immediate relief, your doctor may recommend a steroid cream to help reduce inflammation and redness. Nickel allergy rashes usually clear once contact with nickel is stopped. It is important to identify the source of nickel and avoid it.

How to avoid nickel

The key to avoiding nickel is to identify it before your skin does.

All metal items suspected of containing nickel may be tested with a dimethyl glyoxime test called Nickel Alert. Nickel alert quickly, safely, and easily tests jewelry and other metal items for the presence of nickel.

Where nickel is found

Nickel is frequently found in metal and metal objects including gold because it is inexpensive, durable, and lustrous.

Often when it is difficult to identify the nickel source because a rash might not appear for two days. It is critical to test all metal items since there are often multiple sources of exposure.

Commons items that may contain nickel:

  • Earrings
  • Necklaces
  • Rings
  • Bracelets
  • Costume and heirloom jewelry
  • Buttons and snaps
  • Belt buckles
  • Zippers
  • Fasteners
  • Hand tools and scissors
  • Keys and coins
  • Eyeglass frames
  • Watches and bands
  • Gold-white and yellow, especially 10 and 14 ct
  • Brass or chrome fixtures
  • Kitchen utensils—silverware
  • Bra hooks
  • Suspender clips
  • Hair pins
  • Handbags / clutches
  • Cigarette lighters
  • Jean studs
  • Razors
  • Pocket knives
  • Pens
  • Lipstick holders
  • Powder compacts
  • "Hypoallergenic and "Nickel-free" jewelry

Nickel allergy Facts

  • The most common sites for nickel allergy are earlobes, neck, and wrist where metal touches the skin. In children, one of the most common signs of nickel allergy is a rash on the central abdomen from snaps/buttons.
  • Nickel allergy can develop at any age and often last a lifetime.
  • Nickel allergy is the second most common form of allergic contact dermatitis after poison ivy, oak and sumac.
  • 15% of the women in the U.S. are nickel allergic.
  • There is no cure for nickel allergy.

Nickel-free and hypoallergenic jewelry

There are no government standards or regulations for using the terms "nickel-free" or "hypoallergenic".

Jewelry labeled "nickel-free" or "hypoallergenic" often refers only to the plating. The base metal may contain nickel. Once the plating wears thin, even microscopically, nickel salts will come in contact with your skin and symptoms can occur.

Expensive jewelry may contain nickel in the base metal.

Test your jewelry regularly, even the "safe" items, using the dimethyl glyoxime test – Nickel Alert.

Metals that often contain nickel

  • Gold-white and yellow
  • Silver, sterling silver, silver plate
  • Palladium
  • Chrome (or Chromate)
  • Cobalt

Suitable replacements for nickel

  • Aluminum
  • Titanium
  • Platinum
  • Plastic
  • Wood

When avoidance of nickel is not possible

Avoiding nickel is ideal, but not always possible. When avoidance of nickel is not possible, coat the metal that contacts your skin (jean studs, eyeglass frames, etc.) with a clear coating. Avoid generic nail polishes; they often contain toluene, formaldehyde and dibutyl phthalate which can lead to further sensitization for nickel allergic individuals. Use Nickel Guard as a safe alternative. Also, if possible, wear protective clothing (gloves, long sleeves, etc.) for larger areas.

Additional considerations

  • Weather: In summer, perspiration aids the transfer of nickel salts to the skin, increasing symptoms.
  • Diet: Severely allergic individuals may choose to avoid foods which are rich in nickel. Dietary intake of some foods has been shown to aggravate dermatitis, especially hand dermatitis. Your doctor may instruct you to avoid some foods which typically contain higher amounts of nickel, including asparagus, chocolate, peanuts, beans, peas, rhubarb, cabbage, oysters, spinach, herring, tea, mushrooms, whole meal flour, pears, sprouts, corn, raisins, onions, tomatoes, and baking powder.
  • Medical: Tell your physician that your are nickel allergic. Verify all dental appliances and surgical implants are nickel-free prior to implantation.
  • Work: For specific occupational sources of nickel, visit www.athenaallergy.com

Easily avoid nickel with Nickel Solution featuring Nickel Alert and Nickel guard.

You may order Nickel solution via:
Web: www.nickelsolution.com
Phone: (704) 947-1917
FAX: (857) 588-8765
Mail: PO Box 1294
Huntersville, NC 28070

Recent News

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American College of Allergy, Asthma, and Immunology (ACAAI) Guidance on Risk of Allergic Reactions to the Pfizer-BioNTech COVID-19 Vaccine

Allergic reactions to vaccines, in general, are rare with the incidence of anaphylaxis estimated at 1.31 in 1 million doses given. With the emergency use authorization of the Pfizer-BioNTech COVID-19 vaccine by the FDA on December 11, 2020, the ACAAI COVID-19 Vaccine Task Force recommends the following guidance for physicians and other providers related to risk of an allergic reaction on vaccination. These recommendations are based on best knowledge to date but could change at any time, pending new information and further guidance from the FDA or CDC. 
 
1. The Pfizer-BioNTech COVID-19 vaccine should be administered in a health care setting where anaphylaxis can be treated. All individuals must be observed for at least 20-30 minutes after injection to monitor for any adverse reaction. All anaphylactic reactions should be managed immediately with IM epinephrine as the first line treatment.
 
2. The Pfizer-BioNTech COVID-19 vaccine should not be administered to individuals with a known history of a severe allergic reaction to polyethylene glycol as it is a component of this vaccine known to cause anaphylaxis.
 
3. Data related to risk in individuals with a history of allergic reactions to previous vaccinations and/or mast cell activation syndrome/idiopathic anaphylaxis is very limited and evolving. A clinical decision to administer the Pfizer-BioNTech COVID-19 vaccine should be undertaken by the physician or other provider administering the vaccine using their professional judgment and in consultation with the patient, balancing the benefits and risks associated with taking the vaccine.
 
4. Individuals with common allergies to medications, foods, inhalants, insects and latex are no more likely than the general public to have an allergic reaction to the Pfizer-BioNTech COVID-19 vaccine. Those patients should be informed of the benefits of the vaccine versus its risks.
 
5. The Pfizer-BioNTech COVID-19 vaccine is not a live vaccine and can be administered to immunocompromised patients. Physicians and other providers should inform such immunocompromised patients of the possibility of a diminished immune response to the vaccine.
 
6. Anyone with questions related to the risk of an allergic reaction to the Pfizer-BioNTech COVID-19 vaccine should contact their local board-certified allergist/immunologist.
 
 
References
 
McNeil MM, Weintraub ES, Duffy J, et al. Risk of anaphylaxis after vaccination in children and adults. J Allergy Clin Immunol. 2016;137(3):868-878.
 
Dreskin et al. International Consensus (ICON): allergic reactions to vaccines
World Allergy Organization Journal (2016) 9:32.
 
Wylon, K., Dölle, S. & Worm, M. Polyethylene glycol as a cause of anaphylaxis. Allergy Asthma Clin Immunol 12, 67 (2016).

Stone CA, Liu Y, et al. Immediate Hypersensitivity to Polyethylene Glycols and Polysorbates: More Common Than We Have Recognized.  J Allergy Clin Immunol Pract. 2019; 7(5): 1533–1540.

The post American College of Allergy, Asthma, and Immunology (ACAAI) Guidance on Risk of Allergic Reactions to the Pfizer-BioNTech COVID-19 Vaccine appeared first on Oklahoma Allergy and Asthma Clinic.

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