Who gets nickel allergy?
Nickel sensitivity is common, especially in women. Anyone can become allergic to nickel, but most cases begin during teenage when girls in particular start to wear cheap metal jewellery. Ear piercing often starts up a nickel allergy which is why it’s more common in women than in men. As more men have their ears pierced, the number of men with nickel allergy is increasing rapidly. It’s possible, but much less common to become allergic to nickel later on in life. People who have been in contact with nickel for many years can become allergic to it for no reason - this can cause problems if your work involves handling nickel. Babies and children are rarely allergic to nickel. People with atopic eczema are no more likely to develop nickel allergy than others with normal skin. But if you have sore broken skin and you’re allergic to nickel, you are more likely to develop a rash whenever you touch anything made of it.
Irritation
The commonest cause of OSD is irritation of the skin from contact with substances at work. Strong irritants (such as acids, alkalis or solvents) cause skin inflammation after a short period of skin contact. Weak irritants (such as water, detergents, coolants) cause inflammation after repeated exposures over a longer time.
Allergy
Another important cause of OSD is allergy to substances handled at work. Examples of substances which can cause skin allergies are cement, metals and resins. Rubber gloves and boots worn for protection may sometimes paradoxically cause allergy.
How can OSD be recognised?
OSD usually occurs on the parts of the body which come into contact with work substances. OSDs occur most frequently on the hands and forearms.
Early signs of OSD include dryness, redness and itch of the skin. If severe, the skin may become swollen and vesicles may develop. The skin may eventually become cracked, scaly and thickened.
These skin changes often improve when the worker is away from work, such as during weekends and holidays. Fellow workers who do the same job may also have similar skin problems.
Can I stop my child becoming allergic to nickel?
There isn’t much you can do to stop anyone becoming allergic to nickel, because everyone comes into contact with it every day. But, ear piercing often starts off a nickel allergy, so if anyone decides to have their ears pierced, make sure the studs that are put in as the ears are pierced are either sterling silver, 18-carat gold or good quality stainless steel. When the holes have healed wear good quality gold earrings.
Can a special diet help my nickel allergy?
Studies abroad have found that some people with severe hand eczema, thought to be due to nickel allergy, have improved following a nickel-free diet. Nickel can be released into food if anything acidic (rhubarb, apples, citrus fruit) is cooked in a stainless steel saucepan. Canned foods also contain nickel. Many foods, such as leafy green vegetables, naturally contain nickel, which makes this diet a difficult one to follow. More research needs to be done on this subject before we can be sure whether hand eczema really is helped by this diet. If you are considering modifying your diet to try to improve your skin, always consult your doctor first.
Will I always be allergic to nickel?
Once you become sensitive to nickel you are likely to remain so for life. But not everything containing nickel will necessarily bring out a rash every time. If your skin is raw or broken, nickel can easily pass through the surface, and you are more likely to get a rash – the same is true if your skin is damaged by being wet a lot. If you are sweaty and come into contact with nickel, you are more likely to get a rash – for example a red itchy patch may come up underneath your watch when you're hot, but not when you're cold. If something containing nickel is pressed very close to your skin, or rubbed against it, you are also more likely to develop a rash – metal studs often found on the tops of jeans and canvas trousers are more likely to cause a reddened patch if the trousers are tight fitting. Some women find they are more sensitive to nickel on certain days of their menstrual cycle, but this is not always the case.
There aren't any medicines you can take to stop you being allergic to nickel. The main way to prevent a rash starting once you're sensitive to nickel is to avoid coming into prolonged contact with anything made of it. This is very hard when so many things have nickel in them, but you must aim for this.
Look closely at everything at home and at work and decide whether it is likely to be made of nickel. Anything made of wood, plastic, glass, paper, or fabric is safe, but check there isn't a metal trim on these things.
For anything made of metal, try to find out whether it contains nickel – if you can't then assume it contains nickel, and avoid touching it.
If something made of nickel is coated with paint, nail polish, lacquer or varnish, this will prevent your skin coming into direct contact with the metal. Although everything can't be painted in this way, it can sometimes be useful. For example a bra fastener or press stud can easily be painted to protect your skin. But remember, this only works as long as the coating is complete – if it chips or flakes off, nickel will touch your skin. Some metal objects can also be covered with masking tape.
Some metal items can be backed with material so that they can be worn. Some people wear a sweat band under their watch if it's made of metal. Tucking a shirt into jeans so the metal stud doesn't touch your skin is often sufficient, but if you find a rash appearing whenever you're hot and sweaty then coat the stud with lacquer or cover it with material as well.
Keep money in a bag, purse or wallet, rather than loose in your trouser pocket.
Jewellery can be covered with clear nail varnish to protect your skin but this is difficult to do and may spoil it – plastic jewellery won't cause you any problems. Watches made only from plastic, or with plastic material watch straps, are available, or else wear a fob watch instead.
Wear cotton gloves if you need to handle anything made of nickel at home or work and rubber or PVC gloves with cotton liners for any wet work.
If your skin becomes damaged after being in contact with nickel, look after it carefully until it is fully healed. Use a moisturiser frequently to stop the skin becoming dry and cracked, and watch out for signs of infection.
A mild steroid cream or ointment, such as 1% hydrocortisone cream, may be prescribed by your doctor to clear up the rash and reduce itching. But only use a steroid cream or ointment for a few days until the rash clears.
Remember – even when the rash goes away you are still allergic to nickel, so all contact with it still needs to be avoided.
I'm allergic to Nickel – can I wear gold jewellery?
If you are allergic to nickel you are unlikely to be allergic to gold too. But, pure gold is not used to make gold jewellery because it's not hard enough, so other metals have to be mixed with gold to make it stronger and more easily worked. 18– and 24- carat gold doesn't contain nickel, so you can safely wear jewellery made from either. 9– carat gold can contain nickel so this should be avoided. Unfortunately, most jewellery is made of 9-carat gold, so be careful. Gold-plated jewellery and rolled gold should not be worn either. Gold plating is usually thin and wears off quickly, and nickel then comes to the surface. Foreign gold is made up of a different mixture of metals and so this type of gold should also be avoided. White gold can also contain nickel. Sterling silver doesn't contain nickel so jewellery made from these metals can be safely worn. Stainless steel does contain nickel, but if it's good quality it can be worn as the nickel is tightly bound to other metals and won't be released.
