Did you know that you can be allergic to certain metals?
The most common cause of metal allergy is nickel, which is often found in jewelry or zippers. In fact, 18% of people in North America are allergic to nickel, according to the American Academy of Dermatology (AAD).
Nickel allergy can cause symptoms of eczema, leaving skin that has touched the metal itchy, dry and irritated. This form of eczema is called nickel allergic contact dermatitis.
You might even have this allergy without realizing it. Many people confuse this condition with its better-known cousin – atopic eczema – due to a similarity in symptoms. But outbreaks of nickel allergic contact dermatitis are often more preventable than atopic eczema, so it’s worth determining which type you have.
Read on to find out how nickel can affect your skin, as well as tips on recognizing nickel-related eczema and tips for managing nickel allergy symptoms.
Eczema is an umbrella term for skin conditions that cause itchy and irritated skin.
Atopic dermatitis and contact dermatitis are two common types of eczema.
With atopic dermatitis, also called atopic eczema, your skin flares up periodically, sometimes with no obvious trigger.
If you have contact dermatitis, your skin may become inflamed after contact with an allergen or irritant, such as nickel.
Atopic eczema and nickel allergic contact dermatitis have many of the same symptoms, but two key differences set these types of eczema apart.
Atopic eczema can have many triggers. Any factor that affects your skin, such as temperature, stress, or hormones, can cause an episode. Atopic eczema is chronic and probably won’t go away completely, but treatment can reduce the frequency of flare-ups.
In contrast, you will only notice nickel-related eczema symptoms after coming into contact with nickel. Symptoms usually appear soon after exposure and disappear once exposure stops.
Atopic eczema can appear all over your body. Symptoms often appear around your joints – in the elbows, knees, wrists, ankles, etc. Many adults also experience symptoms from the skin around the eyes.
On the other hand, symptoms of nickel eczema often only appear where your skin has touched the nickel.
That said, if you are extremely sensitive to nickel, eating foods containing nickel could cause a systemic or systemic reaction. In these rare cases, you could develop eczema on skin that has never touched metal.
Nickel allergic contact dermatitis occurs when your skin is in direct and prolonged contact with a piece of metal that contains nickel.
Common triggers include:
- jewelry: including earrings, piercings, bracelets, watches and necklace clasps
- clothing fasteners: including snaps, zippers, buttons, buckles and bra hooks
- metal furniture: including folding chairs, stools and outdoor tables
Nickel by itself is not inherently bad for your skin. But when your skin rubs against the nickel and corrodes it with sweat, some of the metal may dissolve into nickel ions.
The top layer of your skin absorbs these floating nickel ions, which sets off your immune system’s alarm bells. Neighboring cells release inflammatory agents to attack the nickel ions. In about 30 minutes, you may see symptoms of eczema where the metal has entered your skin, according to the American Academy of Pediatrics (AAP).
When this process is repeated enough times, your immune system may decide to assign permanent “watchers” for nickel ions. Once these specialized immune agents kick in, it may take less and less nickel to trigger an inflammatory response. Before you know it, you’re allergic to nickel and your eczema can flare up even after brief contact.
Nickel allergy involves the same symptoms as other forms of allergic eczema. Symptoms may vary depending on the severity of your allergy and the amount of nickel you have been exposed to.
Here are the possible symptoms of eczema related to nickel:
- Skin dryness: may cause cracking or peeling of the skin
- Itching: can range from mild distraction to an intense burning or tingling sensation
- Inflammation: can make your skin swollen, warm and sensitive to the touch
- Discoloration: means that lighter skin can turn pink or red, and darker skin can turn purple or ash gray.
- Eruption: can cause your skin to break out into distinct patches or bumps
- Blisters: may leak liquid and form a crust
These symptoms can be frustrating and uncomfortable, but they usually pose no serious threat to your health. Unlike some other allergens, nickel cannot cause anaphylactic shock.
Can you have both atopic eczema and a nickel allergy?
It is possible to have both atopic dermatitis and contact dermatitis. The children are
- 1 in 3 children with contact dermatitis also have atopic dermatitis.
- 1 in 9 adults with contact dermatitis also have atopic dermatitis.
Experts don’t know how common atopic eczema is in people with nickel allergic contact dermatitis, in particular.
However, they know that when you have both conditions, you may experience more severe symptoms. Nickel-related rashes can itch more, for example, and flare-ups of atopic eczema can spread further into your body.
Research estimates suggest that 10% to 15% of the human population has a metal allergy.
Nickel is by far the most common allergen, but other metals have also been known to cause eczema. Here are some examples:
- Cobalt is used in the manufacture of hard metals and masonry.
- Chromium is used in leather tanning, dye production and cement manufacturing.
- Zinc is used in some dental fillings. Since the fillings are in your mouth, the zinc tends to cause a systemic reaction throughout your body rather than a reaction on a specific area of skin.
These metals cause eczema in the same way as nickel. In short, they agitate your immune system, causing it to overreact. On rare occasions, metals in your diet can trigger a systemic reaction, but most metal-induced eczemas occur due to physical contact.
Perhaps the best way to manage nickel allergy is to avoid nickel in the first place.
If you wear jewelry, make sure an item does not contain mixed nickel. Opt for parts in:
- surgical grade stainless steel
- sterling silver (at least 92.5% pure silver)
- 18 karat yellow gold (at least 75% gold)
If most of your nickel exposure comes from clothing clasps, you can coat buttons or zippers with clear nail polish. This creates a temporary barrier between the metal and your skin. Remember that you will need to reapply the nail polish after laundry day.
Generally, you don’t need to remove nickel from your diet unless you have a severe allergy.
The Food and Drug Administration (FDA) has not approved any specific treatment for nickel allergic contact dermatitis, but typical skin therapies should still serve you well.
Common remedies for eczema include:
- topical steroids, such as hydrocortisone, to soothe rashes
- emollients, such as oatmeal or coconut oil, to restore moisture to your skin
- vinegar compresses to dry up blisters
- antihistamines to help relieve itching
If your symptoms persist after trying all of these remedies, you may want to consider seeing a dermatologist to explore prescription treatment options.
Nickel allergy is a common — and often preventable — cause of eczema symptoms. Replacing nickel-based jewelry and clothing clasps with nickel-free alternatives will generally protect you from most rashes.
If you continue to notice eczema symptoms after performing these exchanges, a dermatologist can help you develop a treatment plan for your specific skin care needs.
Emily Swaim is a freelance writer and writer specializing in psychology. She has a bachelor’s degree in English from Kenyon College and a master’s degree in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of his work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find it on Twitter and LinkedIn.