• Rajani Katta MD

If You Are Allergic to Nickel, Try This Kind of Jewelry

Updated: Aug 16

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Nickel Allergy and Jewelry

I hear it from my patients all the time: the case of the itchy earlobe. In many cases, these red, itchy rashes are due to an allergy to earrings. Specifically, the metal used in the earrings.

Allergy to jewelry is extremely common, because allergy to a particular metal is very common. That metal is called nickel, and it's one of the most common allergy-producing substances in America. ​

While costume jewelry often contains nickel, it's important to recognize that even expensive jewelry can contain nickel. That's because nickel is very strong (and inexpensive).

Nickel is widely used, in all sorts of objects. Nickel is cheap and it's strong, so it's used in many types of jewelry. It’s also used in all sorts of personal and household items, such as watchbands, snaps and buttons on jeans, eyelash curlers, cell phones, and scissors. It's even used in some implantable medical devices.

How can you tell if you have an allergy to nickel?

When people are allergic to nickel, they’ll develop a rash right at the site of contact. With time, that rash may spread. A common scenario is when women wear earrings and start to develop a red itchy (and sometimes oozing) rash on their earlobes.

With this type of allergic reaction, the rash is delayed – it usually takes 2 to 3 days before the rash shows up, although it may take as few as hours or as long as one week.

This rash isn't only delayed--it can also be long-lasting. In fact, once the rash is there, it can take up to 8 weeks for it to go away.

While you may suspect an allergy to nickel, patch testing is required to confirm this allergy.

You can't tell if an object contains nickel just by looking at it, and you can't rely on price either.

If you think you may be allergic to nickel, what kinds of jewelry can you wear?

1. You could try to use a protective lacquer to help prevent the release of nickel from an object. Eventually the lacquer wears off, so you'll have to reapply it periodically. You could use clear nail polish, although you have to make sure the nail polish itself doesn't trigger an allergic reaction. You can also buy a commercially available solution, such as Nickel Guard (available at www.nickelsolution.com), to provide a protective lacquer that's similar to nail polish but without potential allergens.

2. For an expensive jewelry item, like a wedding ring, you can take it to your jeweler and have them apply a coating (NOT a plating) on the inner surface of the ring. Platinum or rhodium are hard metals, and would provide a layer of protection.

If you suspect an allergy to your wedding ring, there are several strategies that you can use to limit skin reactions. You could try using a protective lacquer, or you can ask your jeweler to add a coating of rhodium or platinum.

3. If you're purchasing jewelry, and you're not sure if it contains nickel, you can purchase a nickel test kit. This kit contains a chemical (in solution) called dimethylglyoxime. The use of this chemical does not harm the object being tested.

When applied to a metal object with a cotton swab, the solution will turn pink in the presence of nickel. This test may not pick up miniscule amounts of nickel, but it's usually a good screen for jewelry. One company that sells the test kit is www.nickelsolution.com.

4. You can look for costume jewelry that’s labeled as "nickel-free". One company that sells nickel-free costume jewelry is www.SimplyWhispers.com. They sell a wide variety of costume jewelry, including accessories such as earring posts.

You do have to be careful, though, in general, with costume jewelry that's marketed as "nickel-free." At this time, there's no US standard to define this term. In the US, some manufacturers define the term "nickel-free" as being free of nickel in the plating or top layer. When this plating wears thin, which happens over time, nickel may be released. As a general rule, be careful with plated jewelry, and pay attention to any rashes that develop after wearing so-called "nickel-free" jewelry.

Since there's no standard definition of "nickel-free" jewelry in the United States, be cautious.

5. You may be able to use "medical plastic" earrings, as some are certified to contain "0% nickel". One example is "medical plastic" earrings sold by www.BlomdahlUSA.com.

What about more expensive jewelry or items made from precious metals?

Even expensive gold and titanium jewelry can sometimes have nickel mixed in, so you can't rely on price.

This is what to look for when you're choosing other types of metal jewelry:

1. Many sterling silver items will be fine, although not all. Some sterling silver items contain nickel mixed with the silver. It's best to look for makers of sterling silver who certify that their items contain no nickel. James Avery, for example, certifies their silver as nickel-free.

2. What about German silver or alpaca or nickel silver? These terms refer to the silver color of the item, not to actual silver. These items actually do contain nickel. DO NOT choose these items.

3. 18 karat gold and above is usually fine. The exception is white gold. In order to make white gold, yellow gold is usually mixed with either palladium or nickel. Unless you know for sure that your white gold is free of nickel, don't choose it.

Even titanium and gold jewelry may contain nickel. Be especially careful with white gold, and check with your jeweler: while some use palladium to create the white color, others use nickel.

4. Can you rely on titanium objects? Not necessarily. Titanium is often mixed with nickel. Some jewelry manufacturers will specify that their titanium items are fee of nickel, so make sure you look for that information before purchasing. One example is titanium jewelry sold by www.BlomdahlUSA.com.

The rate of nickel allergy in the United States continues to remain high, and the American Academy of Dermatology is urging regulations to limit the amount of nickel used in personal items.

Until that happens, remember that a big risk factor for nickel allergy is piercing. If you or your child are getting pierced, use nickel-free earrings or body jewelry, and definitely don't use any nickel-containing jewelry until the skin is completely healed over.

Dr. Rajani Katta is the author of Glow: The Dermatologist's Guide to a Whole Foods Younger Skin Diet. To receive future updates on preventive dermatology and the role of diet, sign up here.

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