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Nickel allergy is an inappropriate reaction of the immune system to the substance nickel. It is one of the most common forms of allergic contact dermatitis in which skin gets inflamed due to contact with an allergy causing substance.

Nickel allergy is not hereditary; rather it is acquired through intimate and prolonged exposure of skin to nickel containing items. An individual can become sensitized to nickel at any age.

Actually, the increasingly popular trend of body piercing is said to be responsible for the rising allergic reactions to nickel.

Signs and symptoms of nickel allergy

Symptoms of nickel allergy appear within 12 to 48 hours after exposure to nickel and may last up to two to four weeks. A red, itchy inflammation of the skin sometimes known as the “jewellery dermatitis” – is often the first presenting feature of a nickel allergy.

Thereafter it may manifest as tiny fluid-filled blisters that may drain making the skin moist and sometimes cause it to unpeel. Rash eventually dries out if the condition remains over a long period of time. The skin then becomes flaky and cracked, and looks like a burn.

Rashes and bumps usually begin at the site of contact, but can appear anywhere on the body. The common sites to be affected include hands, wrists, ear lobes and lower abdomen. Nickel traces can also be transferred from the fingertips to the eyelids, nose, ear lobes or other areas.

Treatment of nickel allergy

Initially, the affected area should be thoroughly washed to remove any residue of the irritant that may remain on the skin. Diluted vinegar compresses are given to dry up blisters.

Cool compresses applied to affected areas may help relieve itching, swelling, and redness. Antihistamines may be used to improve allergy symptoms, including red, itchy and inflamed skin. Commonly used non-prescription antihistamines include Diphenhydramine, Chlorpheniramine and loratadine among others. Commonly used prescription medications include desloratadine, fexofenadine and cetirizine among others. Emollient creams also known to act frequently to relieve itch and dry skin.

Common vitamins and over the counter products such as Aloe Vera, Vitamin E and Quercitin may be recommended to manage allergy symptoms. They are known to accelerate wound healing and to naturally soften the skin. Topical steroids may also be advised for this allergy. In severe cases, systemic steroids may be given to ease inflammation. Antibiotic creams or pills such as penicillin antibiotics may be administered for secondary infection.

Ironically, there is no known and proven treatment for this form of allergy. The above explained measures provide relief to the annoying symptoms and secondary problems related to allergy but are of no great help in providing a permanent cure to the allergy. Even desensitization techniques, such as allergy shots are not an effective modality of treatment, therefore avoidance of nickel is probably the best defence.

Avoidance of nickel

  • It is essential to avoid direct prolonged contact with nickel or nickel-containing metals. Try to create a barrier between the patient's skin and the product by using stuff like plastic or cotton gloves etc.
  • Test your metal items with a nickel-testing spot kit that you can get from your dermatologist or pharmacist. The kit is made up of two small bottles of clear fluid; one contains dimethylglyoxime and the other ammonium hydroxide. When mixed together in the presence of nickel, they produce a pink colour.
  • Ear piercing and other forms of body piercing should only be done with stainless-steel needles. Jewellery may contain nickel. Solid gold (18-karat), sterling silver jewellery or stainless steel should be safe. Nine carat gold and white gold alloy both often contain nickel. Plastic covers for earring studs should instead be obtained.
  • Nickel could simply be a constituent of many things that we use in our daily lives without us even knowing it. Everyday items such as metal zips, hair-pins, buttons, studs, spectacle frames and various other things are quite likely to contain nickel. Try to use substitutes for metal such as plastic, coated or painted metal, wood, glass, paper or fabric.
  • Lot of household stuff such as wardrobe handles, kitchen utensils, cutlery, scissors, needles, pins, bath plugs may contain nickel. To avoid nickel allergy, it is ideal to choose tools with plastic handles. Stainless steel also doesn’t cause allergy unless it is nickel-plated.
  • Coins may cause nickel allergy in the cashiers. For such people, it is wise to wear gloves to handle money or pay with a credit card or cheque.
  • Many medical implants and prostheses also contain nickel. So it is important for individuals with nickel allergy to inform their surgeons beforehand about the allergy. Patients should ideally carry a card in their wallet that categorizes their allergies.
  • If items made of nickel are covered with paint, nail polish, lacquer, varnish or masking tape, they do not produce an allergic reaction. This is because it prevents the nickel from coming into contact with the skin. However, if the coating whittles off, nickel may possibly come in contact with the skin again.

It is almost impossible to completely keep away from nickel because it is found in so many foods. Doctors usually recommend nickel-restricted diet to allergic patients. Foods that are allowed to allergic patients include meat, poultry, fish, eggs, milk, yogurt, cheese, butter, margarine, cereals, bread, flour, rice, pasta, small servings of wholemeal flour, wholegrain, most vegetables and fruits, small servings of beetroot, cabbage, cauliflower, leeks , parsnips, potatoes, spinach, tea, coffee, soft drinks, beer, and wine.

Allergic patients should avoid eating food that contains high amounts of nickel. It includes canned spaghetti and baked beans, salmon, shell fish, soy powder, broccoli, peas, pineapple, prunes, buckwheat, lettuce, tomato, linseed, chocolate, nuts, oats, grains, or canned fruits and nuts.