Mystery Rash May Be Nickel Allergy
Special from Bottom Line's Daily Health News
An allergy to nickel can arise seemingly out of nowhere. In my neighbor's case, it was a watch she had loved and worn often for years. Her wrist and arm got red and itchy and started to blister. She thought it was poison ivy, which she was also allergic to, yet her conventional treatments didn't work. It wasn't until a friend mentioned nickel as a possible cause that she tried not wearing the watch -- and the mystery rash abated. She had to retire the watch to her jewelry box and is now careful to avoid all nickel-containing substances. Other people have far worse cases -- rashes that spread and take a longer time to subside. For details on nickel allergy -- why it has become so much more common and what can be done about it, I spoke with Audrey Kunin, MD, the founder and president of DERMAdoctor (www.dermadoctor.com) and coauthor of The DERMAdoctor Skinstruction Manual (Simon & Schuster).
WHY IS NICKEL ALLERGY GETTING MORE COMMON?
Nickel allergy is one of the 10 most common causes of "allergic contact dermatitis" (inflammation, redness and itching brought on by direct contact with an allergen) and more and more people are developing it. Costume jewelry is often made with nickel, but it can be found in pricy gold and silver as well, notes Dr. Kunin. It can be difficult to avoid nickel because you don't always know where it may be lurking -- I'll provide more information on that in a minute.
Nickel allergies vary widely from one person to the next. Reactions may develop after an initial exposure but more commonly (as for my neighbor) after prolonged or repeated exposure to nickel. Once the sensitivity has developed, people may experience tingling and itching within minutes of contact with nickel, followed by a rash in the area a day or two later. Bumps and blistering may also develop.
Dr. Kunin says the reason behind the dramatic increase in the number of people with nickel allergy is that piercing -- ears, noses, belly buttons and what-have-you -- has become so popular. In one study, only 1% of schoolgirls who had no piercings had nickel allergies... while 13% of those with piercings had developed a nickel allergy. It even arises among the very traditional women who just pierce their ears, one hole on each side, since the allergy is triggered by nickel in the piercing-post. Though the sensitivity can develop from other sources, nickel allergies more easily arise with a fresh piercing because the open wound allows the metal to leach directly into the bloodstream over the several days it takes to heal, says Dr. Kunin. Though nickel allergies affect more women (as many as 15% to 30%, by some estimates) than men, it's not just a girl thing -- men get it too. Plus, Dr. Kunin says, some people who are allergic to nickel will also react to chromium and cobalt dyes (green and blue dyes) commonly used in tattoo ink.
NOT SO EASY TO AVOID NICKEL
While there's no cure for nickel allergy, most cases are fairly mild and the best strategy is simply to avoid contact. Here is a list of items that commonly include nickel...
· Costume jewelry (rings, earrings, bracelets, necklaces, etc.)
· Belt buckles
· Zippers, snaps, clasps and other clothing fasteners
· Eyeglass frames
· Paper clips
· Certain eye creams
· Cigarette smoke
Orthodontia are not usually problematic, though in extremely rare cases sensitive people may react to nickel in stainless steel wires and brackets used in dentistry, says Dr. Kunin. She reassured me, though, that dental fillings, surgical staples, wires and orthopedic implants are not on the list of potential nickel allergy culprits. Since such allergies can worsen, sometimes (though only very rarely) leading to anaphylactoid reaction, people who are nickel-allergic should make sure their physician is aware of the problem prior to any treatment or procedure.
WHEN NICKEL ALLERGY IS SEVERE
A very small percentage of people who are nickel-allergic suffer from a severe form in which they may develop not only a local reaction, but a painful and itchy rash over most of the body. Some benefit from adhering to a nickel-free diet, says Dr. Kunin. Foods that contain nickel include....
· Nuts and legumes
· Canned fruits and vegetables
Tap water can also contain nickel, according to Dr. Kunin, but for the average individual who is allergic to nickel, this should not pose a problem. However since nickel levels are higher in hot water than in cold, terribly sensitive people should keep temperatures moderate for showering and bathing, she notes, because in theory they could react to it. Running the water for five minutes to flush out impurities (the source of the nickel comes from the plumbing) may also help.
MORE HELPFUL TIPS
Here are some other ideas that might be of use to people with nickel allergy...
· A helpful product to have on hand is Nickel Solution Detect & Protect ($25), which is a kit that includes both a product to detect nickel and a product that creates a barrier between jewelry and skin. DERMAdoctor carries it, as do some specialty drugstores. You can also search for allergy products on-line.
· Avoid nickel pierced jewelry! Use hypoallergenic, stainless steel, medical titanium or medical plastic backs. For posts, Blomdahl Medical carries titanium and medical plastic versions that are ideal for anyone with this concern.
· To salvage jewelry that is valuable to you, even if only because of a sentimental connection, consider having it professionally electroplated with gold. This will keep nickel particles from coming into direct contact with your skin. Electroplating deposits a very thin coating of a very pure form of gold to help provide a barrier against the nickel particles. Be aware, however, they remain present deeper in the jewelry... and the electroplating will eventually wear away and need to be redone.
· Keep cool and dry, especially those parts of your body that come into contact with metal. Perspiration can aggravate nickel contact dermatitis by leaching nickel particles from metal.
According to Daily Health News contributing editor Andrew L. Rubman, ND, it can be helpful to consult with an ND or other qualified professional who uses natural medicine to improve resistance to the challenge of certain metal exposures, including nickel. The sooner the better though, as the sensitivity increases and the reactions become more severe, the problem gets harder to treat. Typical strategies might include use of antioxidants (with vitamins A, C, E, Zinc, Selenium)... omega-3 supplementation... and avoiding fried foods and foods containing trans fats, all of which can reduce the intensity and frequency of reactions by increasing tissue concentration of natural anti-inflammatory substances.
As with all allergies, the best solution is to do all you can to avoid what brings on symptoms. For most people with nickel allergy, that's easy -- as much as you may like the jewelry, the rash that accompanies it is both ugly and uncomfortable. That's a higher price than anyone ought to pay for adornment.
First Printed: October 18, 2007
Reprinted with the permission of:
Bottom Line/Daily Health News
281 Tresser Blvd., 8th Floor
Stamford, CT 06901