Introduction
A nickel allergy is a hypersensitivity reaction of the delayed immune response type (type IV). This type of allergy is also called “Delayed Type Hypersensitivity” (DTH). This means that after contact with the allergenic nickel, it takes hours to days for the immune cells to release messenger substances.
These then lead to an inflammation at the affected area. Typically, the body is first sensitized to the allergen (the allergy-causing substance, i.e. nickel). The first contact does not cause a rash, but repeated contact with nickel leads to allergic contact eczema after a few hours.
The symptoms at a glance
Symptoms of a nickel allergy typically occur at the site of skin that has come into contact with nickel. Nickel is contained in costume jewelry, for example, but also in some belt buckles and jeans buttons. The symptoms of a nickel allergy can also develop years later and persist for several days after skin contact with nickel.
The symptoms include: Redness Itching Swelling Formation of blisters or nodules Scaling Weeping
- Redness
- Itching
- Swelling
- Formation of bubbles or nodules
- Scaling
- Wetting
The eczema develops at the place that had the closest contact to the nickel. The skin reddens, swells and begins to itch. Blisters and small papules may also appear.
If the reaction is very strong, the eczema can spread on the skin, but the most severe symptoms form at the point of direct contact with the nickel. The longer the contact with the nickel is maintained and the higher the concentration of nickel in the object, the more severe the rash is. If the nickel-containing object is removed, the rash usually heals quickly.
However, if the contact with the nickel is maintained (e.g. if a watch with a nickel bracelet is still worn), chronic contact dermatitis can develop. The skin in the affected area thickens and scales and crusts are formed. This eczema (nickel dermatitis) is accompanied by sometimes severe itching and redness.
It is characteristic that the skin rash is limited to the exact spot where there was direct contact with nickel. Since nickel is water-soluble, it is released more frequently through perspiration, which is why symptoms of nickel allergy often manifest themselves more clearly in summer. If an allergic reaction to a substance containing nickel occurs inside the body, for example in implants or prostheses, it can lead to worse symptoms such as bone destruction, joint loosening and severe pain.
Food containing nickel can intensify these symptoms. Our next article may also be of interest to you: Nickel allergy and foodThe individual wheals are known as urticaria. If many wheals occur, as in hives, this is called urticaria.
Urticaria can have various causes and can occur, for example, as part of an allergic reaction or can be triggered by pressure, heat, cold, sunlight or chemical substances. The hives usually disappear after a few hours and then reappear in other parts of the body. A course of more than 6 weeks is called chronic urticaria.
In most cases, no cause for hives can be found. If the trigger is known, contact with the triggering substance/food etc. should be avoided.
Symptomatic therapy is carried out with antihistamines, which inhibit the release of histamine (a tissue hormone that is released during allergic reactions and is responsible for swelling). Since nickel allergy is a late type IV allergic reaction and is only triggered by permanent or frequent skin contact and only causes symptoms in these areas, hives usually do not occur in patients with nickel allergy. The contact of nickel with the skin triggers an allergic reaction.
In this process, histamine, a tissue hormone, histamine causes, among other things, the activation of small skin nerves, which causes itching. Typical of a rash in a nickel allergy is severe itching (pruritus) at the inflamed area. The inflammatory reaction releases, among other things, histamine, a tissue hormone, from mast cells and granulocytes, which are cells that belong to the immune system.Histamine dilates the blood vessels and leads to the characteristic skin changes such as blisters, redness and also to itching.
Although it is difficult, those affected should avoid extensive scratching. Scratching further damages the skin and delays the healing process. In addition, scratching can also allow germs to enter the wound and cause infections.
Frequent or prolonged contact with nickel leads to an allergic skin reaction in patients with nickel allergy, which in many cases can look very similar to an inflamed skin area. A contact eczema develops, consisting of small vesicles that may be filled with a clear liquid. The vesicles can burst open and a weeping rash develops.
The vesicles are usually accompanied by severe itching. The eczema may also be reddened, have very dry and scaly skin and itch. At the point of contact with nickel, the skin becomes inflamed and a non-infectious inflammation develops.
The skin reddens and swells. Doctors refer to the swelling as angioedema, a swelling that occurs suddenly and causes no pain. Fluid leaks from the blood vessels into the surrounding tissue, causing the swelling to form.
The skin over the angioedema begins to tighten. The swelling is harmless and will subside quickly on its own after the nickel is removed. In addition to vesicles and papules, small nodules (nodules) can also form in cases of nickel allergy.
These are elevations of skin with a diameter of more than five millimeters. The nodules can lie quite superficially in the skin and cause itching and burning. The contact of nickel with the skin triggers an allergic reaction.
Histamine, a tissue hormone, is released from mast cells and granulocytes, which are cells that belong to the immune system. In addition, messenger substances are released, which are also active during inflammation. These messenger substances trigger pain, among other things.
Frequent or prolonged contact with nickel leads to an allergic skin reaction in patients with nickel allergy, which in many cases can look very similar to an inflamed area of skin. A contact eczema develops, which can be very dry and flaky in the area that was previously in contact with nickel. The eczema may also be reddened, have weeping blisters and itch.
A wheal is a whitish or reddish swelling of the skin that can itch. A wheal is typically a few millimeters to a few centimeters in size. Hives are a typical symptom of immediate allergic reactions such as hay fever and food allergies.
They can then appear all over the body and change position again and again (see hives). Hives can also occur in late allergic reactions, which include nickel allergy. In this case, an allergic reaction only occurs through prolonged contact with nickel, which can be noticed by wheals at the point of contact with nickel.
The main characteristic of contact eczema, which develops with a nickel allergy, is reddening of the skin (erythema). The skin reddens or many red spots form at the contact site, which appear after a few hours or days. The immune cells in the body release messenger substances that lead to inflammation.
Reddening of the skin is a characteristic feature of inflammation and is caused by the dilation of the blood vessels and the resulting increased blood flow to the tissue. Burning and slight pain are further signs of a nickel allergy, in addition to swelling and redness. The allergic reaction causes skin irritation and the immune system releases messenger substances that lead to inflammation.
This leads to itching and a burning sensation in the affected skin areas. If contact with nickel is maintained over a long period of time, contact dermatitis becomes chronic. This causes the skin to thicken and the squamous epithelium to become increasingly cornified (hyperkeratosis).
The thickening of the skin is a sign of a permanent inflammation and can often change into leathery changes in the upper layers of the skin. Nickel is a typical contact allergen. This means that in the case of a nickel allergy, an allergic reaction with the above-mentioned symptoms only occurs where the skin or mucous membrane is in contact with nickel.Mucosal changes in the mouth and throat can occur in patients with nickel allergy if they have a tongue piercing, but not if, for example, nickel-containing earrings are worn. If mucous membrane changes in the mouth and throat area occur in patients with nickel allergy, although they do not wear a piercing in the mouth, then these changes have another cause.
