Allergic Contact Dermatitis to Nickel

Allergic contact dermatitis (ACD) to nickel is a common skin condition with symptoms ranging from mild to completely debilitating. Nickel is the most common cause of ACD in the western world, and its incidence is increasing in the United States, but in Europe its incidence is decreasing because of steps taken by the European Union to decrease the amount of nickel people are exposed to.

Nickel is a bane for many earring wearers because it requires guesswork and expense to find which earrings cause problems and which do not. Even gold less than 24k has enough nickel in it to bother many women. Symptoms commonly include redness, irritation, itching, and swelling at the earlobe where the earring touches the skin. Treatment generally includes some combination of avoidance and topical steroids (like hydrocortisone cream or triamcinolone). Since 24k gold is fairly expensive and a little too soft to make good earrings, some companies make 24k gold-plated earrings, which some people use without getting any reaction.

Dimethylglyoxime is a commercially available chemical that can help people who have nickel allergy decide which earrings to buy. The potential buyer puts a couple of drops of the chemical on a cotton ball and touches the metal in question. If it turns pink then the metal contains nickel, and another pair of earrings will have less of a chance of causing ACD.

Nickel allergy does not just affect the ears of earring wearers. An itchy rash in the middle of the lower abdomen might be "jean dermatitis" caused by the nickel in the button of jeans and other pants. Nickel is in door handles, coins, and countless other things we touch every day. Often the skin of our hands is so thick that it does not react, but the thin skin around eyes and mouth will. In some cases the disease is so debilitating that people get a "systemic contact dermatitis" with the whole body reacting with violent itch and redness to even small amounts of nickel in foods like chocolate, nuts, oatmeal, canned foods, tea, and anything cooked in stainless steel pots and pans.

Dermatologists can do something called "patch testing," where s/he applies some patches to the back and then "reads" the results a few days later. Sometimes chemicals beyond what one expects are the culprit of what can be a very miserable condition.