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Nickel allergy: triggers, symptoms, diagnosis

by Josephine Andrews
Published: Last Updated on 395 views

Nickel allergy is the most common form of contact allergy. Contact with nickel causes a rash in those affected. By avoiding objects containing nickel, the eczema heals again. In severe cases, a low-nickel diet may help. Read everything you need to know about nickel allergy here.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

L23

quick overview

  • Symptoms: skin rash about one to three days after contact with nickel, sometimes digestive problems with a nickel-rich diet
  • Diagnostics: patch test for allergic reactions
  • Causes and Risk Factors: Contact with nickel is the cause; Risk factors are, for example, activities in which those affected come into frequent contact with nickel or water
  • Therapy: Relief of symptoms with skin care, sometimes cortisone ointments or UV therapy
  • Course and prognosis: Complaints usually disappear if contact with nickel is avoided
  • Prevention: Avoiding contact with nickel, which is found in jewelry or food, for example, abstaining from smoking

What is a nickel allergy?

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

What are the symptoms?

In patients with a nickel allergy, so-called contact eczema develops as a result of skin contact with nickel in the affected areas. The following symptoms appear:

  • skin redness (erythema)
  • swelling (angioedema)
  • Formation of weeping blisters and hives
  • crusting or flaking
  • itching or burning

If skin contact is prolonged, chronic contact eczema develops. The skin thickens and becomes calloused, the skin patches become coarser (lichenification). However, contact eczema is not limited to the area of ​​skin that came into contact with the metal, but in some cases spreads to cover the entire skin.

In principle, it is possible for a nickel allergy to show up on all areas of the skin, including the face, the ears through Jewellery or the eyes, for example through glasses containing nickel.

How is a nickel allergy diagnosed?

Anyone suffering from an unexplained rash and suspecting a nickel allergy should consult a dermatologist. This first asks the patient in detail about the medical history (anamnesis), asking the following questions, for example:

  • When did the symptoms first appear?
  • Are the symptoms limited to one skin area?
  • Is there anything that relieves the discomfort, such as avoiding certain items of clothing or jewelry?
  • Do you suffer from any allergies or neurodermatitis?

The doctor then examines the affected area of ​​skin. He pays attention to possible changes such as redness, pustules or weeping spots.

Nickel allergy: patch test

If the suspicion of a contact allergy is confirmed, the doctor will carry out a so-called patch test. In this allergy skin test, samples of nickel and other common allergens are applied to the patient’s back and covered with bandages. After a day or two, the doctor removes the plaster and examines the skin. If reddening of the skin or wheals have formed where the nickel was applied, this indicates a nickel allergy.

What causes a nickel allergy?

In the case of an allergy, the body’s own defense system is directed against substances that are actually harmless. These substances are called allergens. In some cases, these are metals, as in the case of nickel allergy.

The first contact with nickel does not lead to an allergic reaction. Rather, the body is sensitized at first contact. This happens particularly often when ear piercing or piercing, when jewelry containing nickel is then worn. Certain cells of the defense system, so-called T-cells, absorb the nickel ions and transform themselves into memory cells – the body “remembers” the supposed enemy.

If 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 change in the skin. This usually occurs 24 hours to three days after contact with nickel. That is why doctors speak of a late-type allergy.

Nickel allergy: risk factors

In principle, it is possible for everyone to develop a nickel allergy. However, various risk factors favor the development of such a contact allergy. These include:

  • Predisposition to atopic diseases such as neurodermatitis or other existing allergies
  • Moist skin from sweat or exposure to water at work: Moisture causes cracks in the skin that allow more nickel ions to penetrate the skin.

How is a nickel allergy treated?

The cause of a nickel allergy cannot be cured. The sensitivity to the substance usually lasts a lifetime. However, the symptoms can be relieved.

Moisturizing and care products help the skin to rebuild. Moisturizing creams, oils or baths are recommended.

In the case of strong allergic reactions, an ointment containing cortisone provides relief: cortisone inhibits the excessive immune response and thus reduces the inflammatory reaction of the skin. To avoid side effects, it is recommended to only use cortisone for a short time and only on small areas of the skin.

If the skin areas affected by the nickel allergy do not heal sufficiently after the ointment treatment, the doctor will prescribe tablets containing cortisone in some cases. The same applies here: only use for a short time and under medical supervision, as there is a risk of significant side effects.

UV light therapy

In the case of chronic eczema – especially chronic hand eczema – UV therapy helps to alleviate the symptoms in many cases. UVB rays or PUVA (psoralen plus UVA rays) are used.

skincare

Good skin care with hydrating basic therapeutics accelerates skin regeneration. Consult a doctor or pharmacist when choosing the 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 substances that are harmful to the skin.

Nickel allergy: Avoid these foods

If patients suffer from a very severe nickel allergy, it is possible to try a low-nickel diet. It is best to discuss this with a doctor or nutritionist in advance.

The diet consists of limiting the consumption of foods with a high nickel content. These foods include, for example:

  • nuts
  • chocolate
  • legumes
  • liver
  • mushrooms
  • asparagus
  • spinach
  • broccoli
  • cauliflower
  • tomato
  • onions
  • potato
  • whole grains
  • Black tea

When preparing acidic dishes such as salads with vinegar or fruit, it is important to avoid using kitchen appliances containing chromium-nickel. Because there is a risk that the acid will dissolve nickel. Better alternatives are kitchen utensils made of ceramic, porcelain, glass or plastic.

It is advisable to stick to the diet for two to three months before you see any success. Whether it is really helpful is controversial among medical professionals.

What is a nickel allergy?

A nickel allergy usually lasts a lifetime from the moment of sensitization. However, if those affected avoid objects containing nickel, it is possible in most cases to live a symptom-free life. Symptoms usually go away on their own within two to three weeks.

If nickel allergy symptoms persist for a long time, the affected skin areas are more susceptible to fungal or bacterial attack. The skin then becomes warm, very red or swollen and painful. Depending on the pathogen, an infection is treated with antimycotics or antibiotics.

In some cases, patients with a nickel allergy experience rejection reactions when foreign material is used. This happens, for example, when treating broken bones with screws or nails.

The nickel allergy becomes problematic at work, for example when the skin often comes into contact with water, as is the case with hairdressers, or is exposed to an increased risk, as is the case in some professions in the healthcare sector. Then there is a risk that the nickel allergy will spread, the skin changes will become chronic and further contact allergies will develop ( cross-allergy ).

A nickel allergy is also found internally in some of those affected – for example in the intestines. People with a nickel allergy occasionally suffer from digestive problems if they eat too many foods containing nickel.

How can a nickel allergy be prevented?

It is not possible to prevent a nickel allergy from developing. However, those affected can take various measures to prevent the allergy from blooming and prevent symptoms such as a skin rash. The most important thing is to avoid contact with nickel.

Among other things, nickel is contained in:

  • costume jewellery
  • bra clasps
  • denim buttons
  • eyeglass temples

Gold jewelry often contains a small amount of nickel. However, many people allergic to nickel have no problem wearing it.

Nickel is also a component of tobacco smoke. Therefore, do not smoke if you suffer from a nickel allergy. It is possible for tobacco smoke to cause or worsen symptoms. Passive smoking should also be avoided.

If it is not possible to avoid nickel at work, doctors recommend that those affected wear protective clothing such as protective gloves.

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