Today we will discuss nickel allergy which is quite common across the world. Many people across the world are allergic to jewelry. You may have noticed skin rashes when you wear expensive jewelry.
This is exactly what we are discussing. It is a nickel allergy. It is a form of allergy and especially the contact allergy.
What is allergy?
We all have an immune system to protect us from the environment and attacks from the environment. When we come in contact with various factors in the environment our system tries to protect us from them using our immune mechanism.
Our immune system does this process by producing various chemicals by our cells that are specialized to do so. When these chemicals are produced more than needed we suffer instead of helping us.
So allergy is also called a hypersensitive reaction in which our own system makes us suffer when we come in contact with allergy inducing agents in the environment. These allergy inducing agents are called allergens.
What is allergic contact dermatitis?
Allergens can come in our system in various ways. Some are inhaled while breathing, some are eatables and some induce allergies when they come in contact with skin.
When we get a reaction on skin when the skin comes in contact with an allergen we call it allergic dermatitis. Actually the meaning of dermatitis is inflammation of the skin. So inflammation of the skin caused by allergen coming in contact with it is called allergic contact dermatitis.
What is nickel allergy
Nickel is a metal. It is used in creating or extracting other metals from the environment. So, many metal objects contain the traces of nickel in them.
Even an extremely small amount of nickel is able to cause allergies in some people. Here nickel is an allergen. Allergy induced by nickel is allergic dermatitis.
This is a form of allergic contact dermatitis. It occurs when someone comes in contact with nickel containing materials. After using such materials the skin coming in contact may show signs of allergy and inflammation in some people.
What are objects that may contain nickel?
Common items that may expose you to nickel include:
- Jewelry for body piercings
- Other jewelry, including rings, bracelets, necklaces and jewelry clasps
- Clothing fasteners, such as zippers, snaps and bra hooks
- Belt buckles
- Eyeglass frames
- Metal tools
- Military “dog-tag” ID
- Medical devices
- Laptops or computer tablets
In practice that is made up of metal containing nickel cau induce local allergic contact dermatitis reaction.
What are symptoms of nickel allergy?
This condition of nickel allergy shows symptoms like any other contact dermatitis. These symptoms tend to occur in areas of contact usually. These symptoms include one or may of the following:
- Itching: Those who have a tendency of nickel allergy may develop itching in the area of contact with the object containing nickel. That itching may come after some time of wearing these objects containing nickel.
- Wheal: The area of skin that comes in contact with these objects of ornaments containing nickel may show mosquito bite like blebs. Tit is called wheal.
- Redness: The area that comes in contact with nickel containing objects may show redness along with itching and flare.
- Excoriation: Because of itching and scratching efforts by patients the area may show the excoriation marks.
- Pus: With allergic dermatitis and frequent itching the pus may develop in the local area. It may be because of infection caused at the site of the dermatitis. It usually occurs in an area which was pierced for the ornaments.
- Changes in skin colour: Repeated use of offending agents and repeated mild allergic episodes lead to darkening of the skin after some days.
- Blisters: Some people may get blisters that may rupture draining fluid from the local area. They may be painful when the blister ruptures.
What are risk factors for nickel allergy?
Nickel allergy is common in following groups of people. Though anyone can get this allergy but is more common in the following groups of people.
Those with a family history of allergies are more likely to have nickel allergy or any form of contact dermatitis. Literally people from a family with members who have allergies may suffer contact dermatitis more frequently.
Nickel allergy is more common in females may be because they use metal ornaments more commonly and their skin pierced more commonly too.
Allergy to other metals
Those people who are allergic to other metallic objects are more likely to have allergies to nickel. Actually nickel traces are useful in making other metal objects too.
Those people who get skin pierced are more likely to have allergies to metals and nickel.
What is patch test?
Patch test is also called as skin patch test is useful to detect allergies.
In this test small amount of allergy inducing agent that is allergen is applied to a small area of skin and that area is covered with the patch to cover it.
It remains in place for up to 2 days.
When the patch is removed local inflammation on skin under the skin is helpful to know the allergic status of the person.
Patch test is not very effective to diagnose the nickel allergy and cannot be relied upon for the diagnosis of the same.
How to diagnose nickel allergy?
Diagnosis is mainly based on history of the person.
You doctor may ask you about appearance of the symptoms in past.
The symptoms are useful to know that it was allergy due to contact that is contact dermatitis.
If these symptoms occurs regularly after using the objects containing nickel it indicates that you have nickel allergy.
What is treatment of nickel allergy?
Best measure to reduce allergic reaction is stopping contact with allergy. Following are the treatment principles based on which nickel allergy is treated:
For any contact dermatitis therapy to become successful, you should avoid contact with the offending object. Stop using the object or ornaments that cause allergy and contact dermatitis immediately.
Local treatment with steroids
Mild local steroid creams are useful to reduce the symptoms of the local allergic reaction. Depending on the need of the situation mild to potent to extremely potent steroids can be selected for local applications. Those are generally available on prescription and use them only with medical consultation.
Antihistaminic drugs are anti allergic drugs and they can be useful in nickel contact dermatitis. First generation antihistamine drugs are sedating drugs like hydroxyzine, promethazine and they are useful in children if they have disturbed sleep because of symptoms.
Medical practitioners advice to take antihistaminic orally or by injection.
Some of the antihistaminic drugs are available as OTC drugs if but you take them in improper doses, they can be harmful. Use them with medical consultation.
The skin has become dry and there are itchy local moisturizers may help to reduce the symptoms. There are mild to very powerful moisturizers available in the market. Appropriate moisturizer is useful with medical advice.
If local medicines are helpful and the condition is severe, oral steroids are useful to treat the allergies and contact dermatitis.
Use these drugs only as per suggestions of your doctor or it may cause more harm than any benefit to you.
Wet compresses can reduce the burning sensation of the inflamed skin. Get it with medical advice. It may cause maceration if taken in a wrong way. Macerated skin may get super infection by bacteria causing another problem.
For contact dermatitis use of desensitization therapy is rare and is useful in very few patients.
How to prevent nickel allergy?
Like any other allergy, nickel allergy is best prevented by avoiding the contact with offending agents, Nickel allergies are also prevented by similar manner.
Following are the ways to prevent nickel allergy:
Preventing or avoiding wearing objects and ornaments containing nickel is the best way of preventing nickel contact dermatitis.
Covering the metal with other material that is non allergic is another way of preventing nickel allergy.
Postponing piercing of the skin to age preferably more than 10 years old is another way of preventing nickel contact dermatitis. Earlier the age of prevention more are the chances of getting nickel allergy.
Avoid cooking food in pots that may contain nickel or metal that cause allergy like stainles steel metals.
Hypoallergenic jewelry can reduce the incidences of the allergic contact dermatitis. People with nickel allergy may have allergy to multiple metallic agents and they may react even to hypoallergenic jewelry.
You can further read about atopic dermatitis here.