Chromium (or chrome) allergy

Chromium is a metal. It is found in many alloys, for example, stainless steel. Chromium is also found in the raw materials used in cement production and it is used in tanning leather.

What causes chrome allergy?

In Denmark, leather goods–shoes, gloves, belts, straps–are the most frequent cause of chrome allergy, because they give off, or release, chrome. Chrome is used in the tanning process and it can be given off by the finished product.

Chrome eczema was widespread among bricklayers and others in the building trade before legislation in 1981 to restrict the use of chrome. Since then there have been few cases of chrome allergy in Denmark.

In countries where there is no legislation to restrict the use of chrome, chrome allergy among those working in the building trade is still widespread. In 2003, the EU, as Denmark had done earlier, legislated against the use of large amounts of allergy-provoking chrome in cement produced and used in EU countries.

Chromium is bound in metal alloys used, for example, in production of stainless steel. Chrome allergy that results from contact with metal alloys is mostly restricted to industrial workers, such as those working in the steel industry. Chrome-tanned leather work gloves are also a cause of occupation-related chrome allergy. There are also a number of other occupations where the workers are exposed to chrome, for example, the graphics industry.

Chrome allergy not related to the work area usually comes from contact with leather goods, particularly shoes, gloves and belts. Chrome is given off from these products when they are being worn.

Finding the precise cause of a chrome allergy is not always possible. Many consumer products, such as cosmetics and cleaning agents, have been tested for chrome. In general, the amount of chrome is low in products on the European market; however, it is not known if these products in themselves can cause chrome allergy. In a recent study, chrome was found in some eye shadows, but it is uncertain if this plays a role in provoking eczema.

Chrome allergy as a result of wearing leather shoes.

 Chrome allergy as a result of wearing a leather watchstrap.

How widespread is chrome allergy?

Nowadays, chrome allergy occurs to the same extent in both sexes. The number of men with chrome allergy has dropped significantly since the 1981legislation against chrome in cement. Chrome allergy is seen in 2%–3% of people with eczema who have been allergy tested.

Diagnosis and treatment

Eczema on the hands and feet may be a symptom of chrome allergy. Eczema on the feet can be both on top of the foot and on the foot sole. An allergy test, a patch test, done by a dermatologist is needed for a precise diagnosis. The patch test will often include samples from the patient’s leather shoes and gloves. The treatment for chrome allergy is similar to that for others types of eczema.

What can you do yourself? If your chrome allergy comes from wearing leather shoes, it is very important that you stop wearing these shoes and instead use chrome-free footwear, otherwise the eczema will not heal. Chrome allergy on the feet can be difficult to manage and may lead to long-term sick leave from work. You are legally entitled to apply for chrome-free footwear through your doctor. To prevent flare-ups of the eczema is important never to wear any leather products that are in close contact with the skin, for example, shoes, gloves, belts and watchstraps.

Scientific publications

Hansen Barré M et al. Quantitative aspects of contact allergy to chromium and exposure to chrome-tanned leather. Contact Dermatitis 2002:47:127-134

Johansen JD et al. Changes in the pattern of sensitization to common contact allergens in Denmark between 1985-86 and 1997-98, with a special view to the effect of prevention. British Journal of Dermatology 2000:142:490-495.

Avnstorp C. Cement eczema:an epidemiological intervention study. Acta Derm Venereol 1992:179:1-22.

Basketter D et al. Nickel, cobalt and chromium in consumer products:

a role in allergic contact dermatitis ? Contact Dermatitis 1993:28:15-25

Geier J et al. Contact allergy to dichromate in women. Dermatol Beruf Umwelt 2000:48:4-10

Sainio EL et al. Metals and arsenic in eye shadows. Contact Dermatitis 2000; 42:5-10.

Zachariae CO et al. Chromium allergy in consecutive patients in a country where ferrous sulfate has been added to cement since 1981 Contact Dermatitis 1996:35:83-85.