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Nickel Allergy

Nickel is a very versatile metal and is found throughout our natural environment. Common industrial uses for nickel include the mining, milling, smelting, and refining of metal ores; the production of stainless steel and nickel alloys; metal welding and cutting; nickel plating, chemical manufacturing; and the production of batteries, coinage, pigments, and powders.

Nickel is found in jewelry, metal tools and equipment, and metal-plated objects. Nickel may be found in metal clothing fasteners (buttons, zippers, snaps, hooks, rivets, buckles, etc.), in metal utensils such as scissors and keys, and in costume jewelry and watchbands, to name just a few examples. Nickel may be present in some white gold, 14-carat yellow gold, chrome, bronze, and brass.

Nickel is also used to make or coat coins, including American nickels, dimes, quarters, half-dollars, and dollars, as well as coins for 1 and 2 Euros. Fortunately, because coins are handled only intermittently, they are not a common cause of contact dermatitis. However, for individuals with a regular occupational exposure to coins, they may be a relevant source of nickel.

In industrial applications, nickel is found throughout metal manufacturing processes, including recycled machining oils used for grinding and cutting. Nickel forms 20% of stainless steel, but it is very tightly bound and unlikely to reach the skin. As a result, allergic reactions to stainless steel products are rare. Nickel alloys are used in dental appliances and occasionally have been reported to cause allergic reactions

Nickel can even be found in some foods such as chocolate, nuts, dried beans, peas, and certain grains. While a single food may not contain enough nickel to cause a reaction, allergic individuals may benefit by limiting their daily consumption of high-nickel foods. Low-nickel diets have been reported to reduce symptoms in some nickel-allergic individuals.

Other items that occasionally contain nickel include some eye cosmetics. In addition, some hair dyes can become contaminated with nickel from nickel-plated utensils.

Nickel contact allergy seems to occur more frequently in women than men, probably related to body piercing and to wearing jewelry and clothing with metal ornamentation. Men in metal processing and manufacturing occupations are also likely to develop a nickel contact allergy. Reducing your contact to sources of nickel can lower your chances of developing this allergy.

Nickel contact allergy is not inherited. However, a family or personal history of other allergies can indicate that you are more likely to have allergies, including reactions to nickel. Take care to maintain the health of your skin and to avoid exposing broken skin (rashes, piercing) to nickel.

The most common symptom is red inflamed skin at the site where nickel contacts the skin. This reaction is called dermatitis (also known as eczema) and can cause itching. Small, solid, raised, pimple-like eruptions called papules may be present on the skin. Sometimes individuals with a nickel contact allergy also may have symptoms outside the apparent contact area. If the symptoms are mild, infrequent, or have been attributed to other factors, some patients may not even recognize the symptoms of a nickel allergy.

If you suspect you have a nickel allergy, you should see our health care providers for an evaluation. To help us diagnose the problem, keep a “diary” of when your symptoms appear and disappear. Describe your symptoms in as much detail as possible, including where they occur–your fingers, hands, or elsewhere. Try to remember your activities and any metal products you have been using.

Our health care providers will take a detailed medical and occupational history. Depending on your symptoms and history, we may perform patch testing to accurately diagnose a nickel allergy.

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