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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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Needle-Free Option for Severe Allergic Reactions Expanded for Use in Children

Doctors at the Oklahoma Allergy and Asthma Clinic call the FDA approval a game-changer

Parents now have a needle-free, life-saving option should their child experience a severe allergic reaction.

The U.S. Food and Drug Administration this week approved neffy nasal spray in a one milligram dose, expanding its use to younger children. Neffy is a nasal spray for the emergency treatment of severe allergic reactions, including anaphylaxis. The FDA action means neffy may now be used in children ages four years or older, weighing between 33 and 66 pounds.

The drug was originally approved as a two-milligram dose for individuals over 66 pounds back in August of 2024.

“The approval of one milligram neffy is a game-changer for our young patients who suffer from severe allergies and asthma-related anaphylaxis,” said Dr. Maya Gharfeh, allergy and asthma specialist at the Oklahoma Allergy & Asthma Clinic. “As a physician, I’ve seen firsthand the hesitation and fear that children and parents experience when faced with the need for an epinephrine injection. With neffy, we now have a needle-free alternative that can provide the same life-saving benefits in a less intimidating way.”

Neffy provides a convenient and effective solution for managing life-threatening allergic reactions without the need for injections.

“Anaphylaxis is life-threatening, and some people, particularly children, may delay or avoid treatment due to fear of injections,” said Dr. Kelly Stone, Associate Director of the Division of Pulmonology, Allergy, and Critical Care at the FDA’s Center for Drug Evaluation and Research. “The availability of epinephrine nasal spray may reduce barriers to rapid treatment of anaphylaxis.”

According to the the Asthma and Allergy Foundation of America, anaphylaxis occurs in about one in 50 Americans and some estimates place it as high as one in 20.

“As allergy specialists, we know that some parents of small children may hesitate to use traditional epinephrine auto-injectors due to needle anxiety. Now, we have another option for them,” Gharfeh added.

Neffy is expected to be available in the United States by the end of May 2025.

For more information about the Oklahoma Allergy & Asthma Clinic, visit at www.oklahomaallergy.com or for an appointment, call 405-235-0040.

The post Needle-Free Option for Severe Allergic Reactions Expanded for Use in Children appeared first on Oklahoma Allergy and Asthma Clinic.

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