Brief overview
- Symptoms: Skin rash about one to three days after contact with nickel, sometimes digestive problems if the diet is too high in nickel
- Diagnostics: Epicutaneous test for allergic reactions
- Causes and risk factors: Contact with nickel is the cause; risk factors are, for example, activities in which those affected come into contact with a lot of nickel or water
- Treatment: alleviation of symptoms through skin care, sometimes ointments containing cortisone or UV therapy
- Progression and prognosis: symptoms usually disappear again if contact with nickel is avoided
- Prevention: Avoid contact with nickel, for example in jewelry or food, avoid smoking
What is a nickel allergy?
A nickel allergy is an allergic reaction of the body to contact with nickel. This contact allergy is caused by the immune system overreacting to nickel ions.
What are the symptoms?
In patients with a nickel allergy, skin contact with nickel causes so-called contact dermatitis in the affected areas. The symptoms are as follows:
- Reddening of the skin (erythema)
- Swelling (angioedema)
- Formation of weeping blisters and wheals
- Formation of crusts or scales
- Itching or burning
In principle, it is possible for a nickel allergy to manifest itself on all areas of the skin, including the face, the ears through jewelry or the eyes, for example through a nickel-containing spectacle frame.
How is a nickel allergy diagnosed?
If you suffer from an unexplained skin rash and suspect that you have a nickel allergy, it is best to consult a dermatologist. The dermatologist will first ask the patient about their medical history in detail, asking the following questions, for example:
- When did the symptoms first occur?
- Are the symptoms limited to one area of skin?
- Is there anything you can do to alleviate the symptoms, such as avoiding certain items of clothing or jewelry?
- Do you suffer from any allergies or neurodermatitis?
The doctor then examines the affected area of skin. He will look for possible changes such as redness, pustules or weeping areas.
Nickel allergy: patch test
What causes a nickel allergy?
In the case of an allergy, the body’s own defense system is directed against substances that are actually harmless. These substances are called allergens. In some cases, these are metals, as is the case with nickel allergy.
The first contact with nickel does not yet lead to an allergic reaction. Rather, the body is sensitized on first contact. This happens particularly often when piercing ears or piercing jewelry containing nickel. Certain cells of the immune system, so-called T-cells, absorb the nickel ions and transform into memory cells – the body “remembers” the supposed enemy.
If the skin comes into contact with nickel again, the memory cells release messenger substances that lead to an inflammatory reaction. This then manifests itself as a visible change in the skin. This usually occurs 24 hours to three days after contact with nickel. This is why doctors refer to it as a late-type allergy.
Nickel allergy: risk factors
In principle, it is possible for anyone to develop a nickel allergy. However, various risk factors favor the development of such a contact allergy. These include
- Predisposition to atopic diseases such as neurodermatitis or other existing allergies
How is a nickel allergy treated?
The cause of a nickel allergy cannot be cured. The sensitivity to the substance usually lasts a lifetime. However, the symptoms can be alleviated.
Moisturizing and care products help the skin to rebuild. Moisturizing creams, oils or baths are recommended.
In the case of severe allergic reactions, an ointment containing cortisone provides relief: cortisone inhibits the excessive immune response and thus reduces the inflammatory reaction of the skin. To avoid side effects, it is recommended that cortisone is only used for a short time and only on small areas of skin.
If the areas of skin affected by the nickel allergy do not heal sufficiently with ointment treatment, the doctor may prescribe tablets containing cortisone in some cases. Here, too, the following applies: if possible, only use for a short time and under medical supervision, as there is a risk of significant side effects.
UV light therapy
In the case of chronic eczema – especially chronic hand eczema – UV therapy often helps to alleviate the symptoms. UVB rays or PUVA (psoralen plus UVA rays) are used.
Skin care
Nickel allergy: avoid these foods
If patients suffer from a very severe nickel allergy, it is possible to try a low-nickel diet. This is best discussed in advance with a doctor or dietician.
The diet consists of limiting the consumption of foods with a high nickel content. These foods include, for example
- nuts
- chocolate
- pulses
- liver
- Mushrooms
- Asparagus
- spinach
- broccoli
- Cauliflower
- Tomato
- Onion
- Potato
- Whole grain cereals
- Black tea
When preparing acidic dishes such as salads with vinegar or fruit, it is important to avoid using kitchen utensils containing chromium-nickel. This is because there is a risk that the acid will dissolve nickel. Better alternatives are kitchen utensils made of ceramic, porcelain, glass or plastic.
It is advisable to stick to the diet for two to three months before success becomes apparent. Whether it is really helpful is controversial among doctors.
How does a nickel allergy develop?
A nickel allergy usually lasts a lifetime from the moment of sensitization. However, if those affected avoid nickel-containing objects, it is possible to live symptom-free in most cases. Any symptoms that occur usually disappear by themselves within two to three weeks.
In some cases, patients with a nickel allergy experience rejection reactions if foreign material is used. This happens, for example, when treating bone fractures with screws or nails.
Nickel allergy becomes problematic in the workplace, for example when the skin comes into frequent contact with water, as is the case with hairdressers, or is exposed to increased risk, as is the case in some healthcare professions. There is then a risk of the nickel allergy spreading, the skin changes becoming chronic and other contact allergies developing (cross-allergy).
In some people, a nickel allergy also manifests itself internally – for example in the intestines. People with a nickel allergy occasionally suffer from digestive problems if they include too many nickel-containing foods in their diet.
How can a nickel allergy be prevented?
It is not possible to prevent a nickel allergy from developing. However, those affected can take various measures to prevent the allergy and symptoms such as skin rashes from developing. The most important is to avoid contact with nickel.
Nickel is contained in, among other things
- costume jewelry
- Bra clasps
- jeans buttons
- Eyeglass temples
Nickel is also a component of tobacco smoke. Therefore, do not smoke if you suffer from a nickel allergy. It is possible that tobacco smoke can cause or worsen symptoms. Passive smoking should also be avoided.
If it is not possible to avoid nickel at work, doctors recommend that those affected wear protective clothing such as protective gloves.
