Everything you need to know about the nickel allergy including what it is, what are symptoms of a nickel allergy, treatment, what to avoid, and how to stay safe.
Nickel allergies are a very common allergy affecting up to 20% of people around the world. In the US, up to 18% of people have a nickel allergy, including about 11 million children.
If you’ve ever had a reaction of being itchy after wearing jewelry or touching metal objects (like coins) you may have a nickel allergy.
Nickel itself is a metal element that is commonly found all over the planet. It is naturally occurring and plays an important role in the biology of plants and our own bodies.
People with a nickel allergy can have both external symptoms (like a rash) or internal symptoms (like an asthma attack). They are primarily mild symptoms, however, some nickel allergies can be very severe.
This article walks you through all aspects of a nickel allergy, including what nickel is, symptoms of a nickel allergy, what to avoid, what types of metals are safe, and how to best manage your nickel allergy.
- Nickel allergies affect up to 20% of the population
- Common symptoms include skin rashes, eczema, gastrointestinal issues, and asthma attacks.
- Jewelry, watches, coins, phones, and computers are common everyday sources of nickel and can be causing symptoms.
- Nickel allergies are easy to diagnose and manage so if you have a suspected or known allergy, it is manageable.
What is a nickel allergy?
A nickel allergy is a response of the body’s own immune system thinking that nickel is a threat. This triggers an autoimmune response known as an allergic reaction.
Nickel allergies are one of the oldest allergies recognized by doctors. If you are allergic to nickel, it is also possible you are allergic to mercury, cobalt, chromium, or gold.
Some people are more likely to have a nickel allergy than others. These people include:
- Being female
- Family history of nickel or metal allergies
- Having multiple ear or body piercings
- Occupational hazards
- Metal workers
- Tailors / Seamstresses
- Jewelers / Jewelry store workers / Pawn shop workers
- Smokers or being around second hand smoke
- Being allergic to other metals
What is nickel?
Nickel is a common silver-white metal found naturally on Earth. On the periodic table it’s Nickel (Ni) element #28.
Nickel is combined with other metals (an alloy) to make a variety of different products; think things like stainless steel appliances and even the phone or computer you use or the car you drive.
However, nickel isn’t all bad. Scientists have discovered that nickel is found in the biology of plants and in the physiology of our own bodies. It’s in every cell in our body. Research has shown that nickel assists in breaking down glucose, metabolizing energy, helps the body build strong bones, and is used in the production of specific enzymes.
Note that nickel is found only in trace amounts in the body, therefore if you have a nickel allergy, you don’t need to worry about being allergic to yourself.
If you are allergic to nickel you can have one or more of the following reactions. Note that reactions can occur minutes or hours after exposure.
- Anaphylactic reactions (rare)
- Asthma attacks / breathing problems
- Weakness, lack of energy
- Gastrointestinal issues
- Nausea, vomiting, or diarrhea
- Rash or bumps on the skin
- Itching, skin stinging or burning
- Swollen lips or tongue
- Swollen and/or watery eyes
- Dry or cracked skin
- Eczema on the hands or feet (pompholyx eczema)
In addition to these symptoms, there is also something called Systemic Nickel Allergy Syndrome (SNAS).
SNAS is an allergic reaction that is a more systemic reaction than just a skin reaction. Meaning that more than one system of the body has an allergic reaction at the same time. A combination can include a rash, headaches, gastrointestinal issues, or respiratory symptoms.
It is rare that nickel will cause an anaphylactic reaction, however, it still can happen.
If you have an autoimmune disorder, it is more likely that you will have a severe nickel reaction.
If an anaphylactic reaction happens, call 911 or your local emergency number immediately.
Signs and symptoms of an anaphylactic reaction include:
- Swelling and tightening of the throat
- Difficulty breathing
- Chest pain or tightness
- Trouble swallowing
- Dizziness or fainting
- Change of the normal coloring of the skin and in the mucous membranes (inner lips, gums, around the eyes, and the nail beds)
- Light skin, check for signs of a dark blue tint in the mucous membranes
- Medium skin, check for signs of a gray-green tint in the mucous membranes
- Dark skin, check for signs of a gray or white tint in the mucous membranes
If you have had an anaphylactic reaction in the past, talk with your doctor and/or your healthcare provider about receiving an epinephrine auto-injector (Epi Pen). If you have been given one and are allergic to nickel, it is important that you still use the Epi Pen even if the needle possibly contains nickel. This is a life saving medical device and should not be avoided if it is needed.
A diagnosis begins by sharing your history and suspicions with your doctor or healthcare provider.
A dermatologist or allergist are the most frequent doctors to diagnose nickel allergies. They can perform specific allergy diagnostic tests to determine if you have a true allergy or not. A common allergy test is the skin prick test. Your doctor may order other tests as well to help best diagnose you.
Skin prick test: Called Patch or Prick tests. This is where a small sample of the suspected allergen in a purified form is placed into the top layer of skin with a small poke (not a needle).
Being Your Own Allergy Advocate
If you are certain something is wrong, don't give up! My (old) primary care physician was unconvinced I had developed a new allergy in my late 20s. He was sure I was eating too much fast food and needed an anti-acid medication.
However, I was adamant in my knowing something was wrong and went to a new allergy specialist. I had my blood checked and my IgE levels were off the charts! As a result we did an elimination diet and saw immediate improvements in my health.
Be your own advocate at the doctor's office and make sure to take someone with you to help navigate if you need. And never be afraid to ask for a second opinion.
How to Manage
The best way to manage your nickel allergy is to avoid any and all forms of nickel and nickel related products to the best of your abilities.
As with most allergies, the more frequently you are exposed to the allergy, the worse your reaction will be over time.
In particular, wet or sweaty skin can leach the nickel from things more quickly, making the reaction that much quicker.
If you are having symptoms and are unsure of the cause, it can be helpful to keep a food and life journal to mark down what you eat and what you encounter to track if any patterns emerge.
Treatment for Nickel Allergies
If your reaction is just a rash or other skin reaction, it can be treated at home with over the counter solutions.
- Topical corticosteroid creams
- Calamine lotion
- Wet compresses to soothe itching and blisters
Avoid over the counter antibiotic creams (similar to Neosporin) which can worsen the allergic reaction.
It is possible that skin reactions can become infected. Signs of a possible infection include increased redness, warmth in the skin, blisters, pus, and pain.
If you have a reaction that is internal or more severe, please seek treatment right away.
What to Avoid
With a nickel allergy there is a long list of things that contain nickel in large amounts. These include jewelry, household items, and even some foods.
- Jewelry, watches, eyeglasses
- Costume jewelry is especially high in nickel
- Any jewelry that is silver and shiny
- Clothing fasteners
- Zippers, snaps, bra hooks
- Belt buckles
- Dog tags
- Kitchen utensils
- Tattoo inks
- Cosmetics and soaps
- Especially eyeliners, eye shadow, and some soaps that contain chromates
- Artificial joints
- Joints, plates, screws, rods can contain nickel
- Laptops and computer tablets
- Medical devices (some, check with your doctor)
- Orthodontic metal braces
- Cigarettes and E-cigarettes
- Metal tools
Foods that contain higher amounts of nickel include:
- Canned products
If you are experiencing a lot of nickel allergy symptoms, you may want to cut back on including these in your diet.
Other foods that contain a moderate amount of nickel include:
- Flours and grains
- Oats, buckwheat, whole wheat, wheat germ multigrain breads and cereals, brown rice
- Sunflower, sesame, alfalfa
- Shrimp, mussels, and crawfish
- Chickpeas, lentils, peanuts, soybeans
- Peas, leeks, cabbage, kale, spinach, lettuce, bean sprouts
- Figs, pineapples, prunes, pear, raspberries, bananas
What is Safe
These foods contain little to no nickel:
- corn meal, tortilla, cornflakes, cornstarch all safe
- Beef, chicken, pork, turkey, lamb, sausages, ham, organ meats
- Berries, apples, grapes
- White rice
- Root vegetables
- Potatoes, carrots, beets, sweet potatoes, onions, garlic
Cross Reactions with a Nickel Allergy
When you have a nickel allergy, it is possible to have another metal allergy. If you have tested positive for nickel, you should also get tested for chromium, gold, mercury, and cobalt.
It’s important to note that if you are reacting to metals, like in your jewelry, it is possible that you are not allergic to nickel, but rather, one of the other metals in the jewelry. That’s why it’s so important that you visit your doctor to get accurately diagnosed.
Top Nickel Allergy Tips
- Inform your doctor and dentist before any procedures of your nickel allergy so that you don’t have a reaction to anything used.
- Wear hypoallergenic jewelry
- Nickel-free stainless steel, titanium, gold 14 karat or higher, nickel free yellow gold, copper, sterling silver
- Verify with the jewelry store the nickel content of any jewelry you wish to purchase
- Use other materials
- Watch bands made of leather, cloth, or plastic
- Plastic or coated metal clothing fasteners (zippers)
- Plastic or titanium eyeglasses
- Create a barrier between you and the nickel
- Cover buttons, snaps, zippers, etc with duct tape or clear nail polish
- There is something called Nickel Guard that works well
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