nickel allergy

Nickel allergy: description

Nickel allergy is an allergic reaction of the body to contact with nickel. This contact allergy is an overreaction of the immune system to nickel ions.

Nickel allergy: symptoms

In patients with a nickel allergy, skin contact with nickel causes so-called contact dermatitis at the affected sites, about one to three days after nickel contact. This shows the following symptoms:

• Skin redness (erythema)
• Swelling (angioedema)
• Formation of weeping blisters and wheals
• Crusting or dandruff
• Itching or burning

If skin contact persists, chronic contact dermatitis develops. The skin thickens and horny, the skin fields become coarser (lichenification). In addition, contact dermatitis can not be limited only to the skin site that came into contact with the metal but spreads to the entire skin.

Nickel Allergy: Causes and Risk Factors

In an allergy, the body’s defense system is directed against substances that are actually safe. These substances are called allergens. These are often metals such as nickel allergy.

The first contact with nickel does not lead to any allergic reaction. Rather, the body is sensitized on first contact. This is especially often the case when piercing in front of earholes or when piercing, if then nickel-containing jewelry is worn. Certain cells of the immune system, called T-cells, take up the nickel ions and transform themselves into memory cells – the body “remembers” the alleged enemy. When the skin comes into contact with nickel again, the memory cells release messenger substances that lead to an inflammatory reaction. It then shows up as a visible skin change. This usually occurs 24 hours to 3 days after the nickel contact. Therefore, doctors also speak of a late-type allergy.

Nickel allergy: risk factors

A nickel allergy can occur in anyone. Various risk factors may, however, favor the development of such a contact allergy. These include:

• Predisposition to atopic diseases such as neurodermatitis or other existing allergies
• often damp skin due to sweat or water contact at work: The moisture causes cracks in the skin that allow more nickel ions to penetrate the skin.

Nickel allergy: examinations and diagnosis

If you have an unexplained rash, see your dermatologist. First, he asks you in detail to your medical history (anamnesis), where he can ask the following questions, for example:

• When did the symptoms first appear?
• Are the symptoms limited to a skin area?
• Is there something that will ease the discomfort, for example, if you avoid certain garments or jewelry?
• Do you suffer from any allergies or atopic dermatitis?

Subsequently, your doctor will look closely at the affected skin area. He pays attention to possible changes such as redness, pustules or weeping spots.

Nickel allergy: patch test

After that, your doctor will perform a so-called epicutaneous test. In this allergy skin test, samples of nickel and other common allergens are applied to the back of the patient and covered with patches. After one to two days, the doctor removes the patches and examines the skin. If skin redness or wheals have formed at the site where nickel has been applied, this indicates a nickel allergy.

Nickel allergy: treatment

A nickel allergy can not be completely cured. Sensitization to the substance usually lasts a lifetime. The symptoms can be alleviated. It is particularly important to avoid contact with nickel – if this is not possible due to work-related reasons, those affected should wear protective clothing (such as protective gloves).

The affected skin should also be well cleaned to aid the healing process. Nickel is included in:

• Fashion Jewelry
• Bra closures
• Jeans buttons
• eyeglass temples

Also in gold jewelry is often a small amount of nickel contained. However, many nickel allergic people can easily carry it.

Nickel is also part of tobacco smoke. Do not smoke if you have a nickel allergy. The symptoms can be caused by the tobacco smoke and worsened. Even passive smoking should be avoided.

Nickel allergy: medicines

Moisturizing and care products help the skin to rebuild. We recommend moisturizing creams, oils or baths.

In severe allergic reactions, a cortisone-containing ointment may be applied to the skin. Cortisone inhibits the excess immune response and thus reduces the inflammatory response of the skin. To avoid side effects, cortisone should be used only for a short time and only on small areas of skin.

If the skin areas affected by the nickel allergy do not heal enough due to the ointment treatment, the doctor may also prescribe cortisone tablets in some cases. Again, apply as short as possible and under medical supervision, as significant side effects may occur.

UV light therapy

Chronic eczema – especially chronic hand eczema – can be helped by UV therapy. UVB rays or PUVA (psoralen plus UVA rays) are used.

skin care

Good skin care with hydrating basic therapies accelerates the regeneration of the skin. Let a doctor or pharmacist advise you on the choice of preparations. If you use preparations with an unsuitable water and fat content or those with allergenic ingredients, this may delay the healing process or increase the effect of skin-damaging substances.

Nickel Allergy: Foods You Should Avoid

If patients are suffering from a very severe nickel allergy, a low-nickel diet can be tried (a completely nickel-free diet is not possible). This should be discussed in advance with a doctor or nutritionist.

The diet is to limit the consumption of foods high in nickel. These foods include, for example:

• nuts
• chocolate
• legumes
• liver
• mushrooms
• asparagus
• spinach
• broccoli
• cauliflower
• tomato
• onion
• potatoes
• Whole grains
• Black tea

For the preparation of acidic foods (such as salads with vinegar, fruit) you should not use chrome-nickel-containing kitchen appliances, because the acid can dissolve nickel. Better alternatives are kitchen utensils made of ceramic, porcelain, glass or plastic.

The diet should be followed for two to three months before it can be successful. Whether it really helps is controversial among medical professionals. However, it should be considered for severe nickel allergy.

Nickel allergy: disease course and prognosis

A nickel allergy usually lasts a lifetime from the moment of sensitization. If those affected avoid using nickel-containing objects, they can usually live without pain. Symptoms usually disappear by themselves within two to three weeks if nickel is avoided.

If nickel allergy symptoms persist for a long time, the affected skin is more susceptible to fungal or bacterial attack. The skin then becomes warm, is severely reddened or swollen and hurts. An infection is treated depending on the pathogen with antifungals or antibiotics.

In some cases, in patients with a nickel allergy, rejection reactions may occur when using exogenous material. This can be the case, for example, in the treatment of bone fractures with screws or nails.

The allergy to nickel can become a problem in the workplace, especially if the skin is often in contact with water (hairdressers, etc.) or is exposed to an increased risk (occupations in the health sector, etc.). The nickel allergy can then spread, the skin lesions can become chronic and it can develop further contact allergies.