Nickel allergy

Nickel is a metal. It is used in the production of polished metal items, such as jewellery, buttons, zippers, buckles, hooks, and spectacle frames. Nickel is also used in tools both for industrial and home use.

What causes nickel allergy?

Nickel allergy is most often caused by wearing inexpensive metal jewellery and by fastenings. On close contact with the skin over a prolonged period, these items give off nickel. Nickel allergy is seen as eczema–redness, blisters and cracking of the skin. The symptoms can last from days up to weeks. If close skin contact with the item causing the allergy continues, the eczema may spread to other parts of the body.

Nickel allergy as a result of wearing earrings containing nickel.

Nickel allergy as a result of using tools containing nickel.

People who come into contact with nickel in large amounts or those who are exposed to nickel on their hands may develop hand eczema. The hand eczema appears as small blisters on the palms and on the sides of the fingers. Nickel eczema on the hands can be chronic.

Nickel eczema, particularly on the hands, may be occupation-related and should be reported to the National Board of Industrial Injuries in Denmark. Occupation-related nickel eczema is seen in nickel-plating industries; in industries where there is repeated work with nickel items, for example, mounting nickel-plated elements; and with prolonged or frequent use of tools that release nickel. In rare cases, occupation-related nickel allergy can arise from frequent contact with coins.

Nickel found in food can cause nickel eczema on the hands in people who are sensitive to nickel. Any special diets to treat nickel allergy should be planned under medical supervision.

How widespread is nickel allergy?

Nickel allergy is frequent, especially among girls and women. The main cause is wearing inexpensive metal jewellery containing nickel. A population study has shown that 15% of women and a few per cent of men are sensitive to nickel. The allergy often begins when the person is young, especially in connection with ear-piercing and wearing metal jewellery containing nickel. In 1991, Denmark introduced legislation to restrict the amount of nickel in fastening, clips and jewellery, also piercing jewellery. Since then, it has been documented that nickel allergy was far more widespread among teenage girls who had their ears pierced before rather than after the legislation. It is also significant that there were no cases of nickel allergy among the younger girls who had not had their ears pierced. Nickel allergy is expected to be less widespread in the future, after the Danish legislation, and legislation by the EU in 2000.

Proportion of Danish schoolgirls with nickel allergy

Pierced before 1992  Pierced after 1992  Not pierced Secondary school (10–14 years)  15.4 % 4.4 % 0 % High school (17–22 years)  26.9 % 12.4 % 5.3 %

Reference: Jensen CS, Lisby S, Baadsgaard O, Volund A, Menné T. Decrease in nickel sensitization in a Danish schoolgirl population with ears pierced after implementation of a nickel-exposure regulation. British Journal of Dermatology 2002 Apr; 146(4):636-42

What can you do yourself?

With the current legislation leading to lower amounts of nickel in various items, the number of people developing nickel allergy from skin contact with fastening, clips or jewellery should be vastly reduced. Nevertheless, if you should have an allergic reaction to, for example, a hair slide, a watch or a fastening on jeans, it is important that you stop wearing that item. A prolonged exposure to nickel, even on a small area from something such as a button or a piece of jewellery, can eventually lead to an increased risk of developing severe eczema. Jewellery, hair slides, clips, fastenings, buttons and watches that give allergic reactions in people sensitive to nickel are likely not to be in line with the new regulations to reduce the nickel content. You should therefore contact the place where you bought the item and ask for a replacement.

The Danish Environmental Protection Agency has a chemical inspection service, which checks that products conform to the various legislations. Fact sheets on the work of the Environmental Protection Agency to ban the import and sale of certain products containing nickel can be found on
 

www.mst.dk (Danish)

How can you test if a polished metal item gives off nickel?

You can buy a nickel testing set at a chemist, a dimethylglyoxime test. The test set has two bottles each containing a different chemical; apply one drop from each bottle on a piece of cotton wool; then rub the cotton wool against the metal.   If the cotton wool turns a pink colour within a few seconds, it means that the item gives off nickel in a sufficient amount to cause an allergic reaction.

The dimethylglyoxime test. The pink-red colour shows that the item gives off nickel in a sufficient amount to cause an allergic reaction.

 

Treatment of nickel allergy

Nickel allergy is treated with a hormone cream that can be prescribed by your own doctor or a specialist dermatologist. Nickel allergy can be chronic, especially if it is on the hands. It is very important to avoid all contact with nickel, whether it comes from clothes fastenings or jewellery or whether it comes from something at your workplace. Use the nickel test described above to find out if you are exposed to nickel in your daily life.

Legislation

In 1991 in Denmark and in 2000 in the rest of the EU countries, legislation was made to restrict the release of nickel from products designed to be in prolonged contact with the skin, for example, clothes fastenings, such as bra hooks; jewellery; watches etc. Occupation-related nickel contact and contact with nickel-containing items not designed to be in close or prolonged contact with the skin are not cover by the legislation.

 

For further information visit:

www.mst.dk  (Danish)