Dermatologists offer tips to avoid nickel-induced dermatitis

    SCHAUMBURG, Ill., May 12 /PRNewswire/ -- For the estimated 82 percent
of women with pierced ears, earrings are an important fashion accessory
that many women wear, and change, daily. However, a new study suggests that
women may be getting more than they bargained for when purchasing
inexpensive earrings. Nickel exposure from these earrings is a common cause
of dermatitis on the earlobes and repeated exposure can make treatment
difficult.

    In the report entitled, "Nickel release from earrings purchased in the
United States: The San Francisco earring study," published online in the
Journal of the American Academy of Dermatology, dermatologist Howard I.
Maibach, MD, FAAD, professor of dermatology at the University of
California, San Francisco, presented evidence that nickel exposure from
inexpensive earrings purchased from various stores and vendors is frequent
in the United States and does not correlate with the price of the earrings
within the "inexpensive" price range.

    "Sensitization to nickel is quite common in the United States, with
studies estimating that 5.8 percent of American adults tested positive to
nickel allergy through a routine skin test," said Dr. Maibach. "In the
early 1990s, the European Union Nickel Directive was passed in an effort to
decrease the prevalence of nickel sensitization in consumer and
occupational products in Europe, with results indicating the directive is
working. However, no such regulations exist in the United States to limit
nickel exposure -- leaving millions of people at risk for dermatitis from
common goods, such as earrings."

    For the study, Dr. Maibach and his collaborator, Jacob Pontoppidan
Thyssen, MD, purchased inexpensive earrings from 34 different stores and
artists in San Francisco in October 2007. Inexpensive earrings were
classified as those under $50; in contrast, expensive earrings were
classified as those made of gold or platinum available from fine jewelry
stores. A total of 277 earrings were purchased from four different
categories of vendors -- a downtown market with licensed local artists
producing custom-made jewelry; jewelry stores in China Town targeting
mainly tourists; national and international clothing and accessory chain
stores targeting mainly girls and women under age 40; and similar stores
targeting mainly women over age 40.

    All earrings purchased were examined with the dimethylglyoxime (DMG)
test -- a routine spot test using solutions to detect the presence of
nickel and other alloys. Of the 277 earrings that were tested, 85 (or 30.7
percent) demonstrated at least one spot that tested DMG-positive for
nickel. Dr. Maibach noted that the highest proportion of DMG-positive
earrings was purchased from local artists, with 69 percent of these
earrings testing positive for nickel. A large portion (42.9 percent) of
earrings purchased from stores in China Town also tested positive for
nickel.

    When the number of DMG-positive earrings was examined from accessory
and clothing stores targeting younger women under age 40 and those stores
targeting women over age 40, Dr. Maibach found a large discrepancy.
Specifically, 24.1 percent of the earrings purchased at the stores
targeting younger women tested positive for nickel; whereas only 1.7
percent of earrings from stores targeting women over 40 tested DMG
positive.

    "Except for one store targeting girls and young women where a
significant number of DMG-positive earrings were found, the proportion of
earrings that tested positive for nickel was generally higher among
individual China Town stores and local artists than in individual national
and international chain stores," said Dr. Maibach. "We also found no
correlation between the country where the earrings were manufactured and
the frequency of DMG-positive reactions or whether the price of the
inexpensive earrings correlated with testing positive for nickel exposure."

    Dr. Maibach added that in one accessory store, none of the 44 earrings
priced between $5 and $8 were DMG positive, whereas numerous earrings
priced between $15 and $25 in another accessory store were DMG positive.

    "From our findings, we could not establish a 'safe-limit price' as a
guide for consumers who want to avoid excessive nickel exposure when
purchasing inexpensive earrings," said Dr. Maibach. "But it's safe to say
that young customers purchasing earrings at a considerable price range in
U.S. chain stores are potentially at risk of nickel exposure and
sensitization."

    Studies show that nickel sensitization increases the risk of hand
eczema, but Dr. Maibach argued that avoiding nickel -- which is found
almost everywhere -- can be difficult. He acknowledged that there are some
patients with nickel dermatitis who refuse to give up their jewelry, even
when they know it is the cause of their condition. Since the best way to
avoid nickel sensitization and subsequent dermatitis is to prevent nickel
exposure, Dr. Maibach suggested the following tips:


    -- Look for jewelry and clothing labeled "nickel-free" or "hypoallergenic"
    -- Wear only stainless steel, platinum or gold jewelry if you know you are
       allergic to nickel
    -- Discontinue wearing jewelry that causes any noticeable skin irritation,
       such as redness or itching
    -- Use 1% hydrocortisone cream or ointment, which can be purchased
       over-the-counter, to treat nickel-induced dermatitis
    -- See your dermatologist if symptoms worsen or do not improve within
       three to five days of not wearing jewelry

    Headquartered in Schaumburg, Ill., the American Academy of Dermatology
(Academy), founded in 1938, is the largest, most influential, and most
representative of all dermatologic associations. With a membership of more
than 15,000 physicians worldwide, the Academy is committed to: advancing
the diagnosis and medical, surgical and cosmetic treatment of the skin,
hair and nails; advocating high standards in clinical practice, education,
and research in dermatology; and supporting and enhancing patient care for
a lifetime of healthier skin, hair and nails. For more information, contact
the Academy at 1-888-462-DERM (3376) or http://www.aad.org.

SOURCE American Academy of Dermatology