Jewelry Causing Rash? You May Be Allergic
Nickel Most Common Type Of Allergic Contact Dermatitis
You may be one of the 1 million people who have allergic contact dermatitis. Look around you and at what you're wearing. You may find the cause of your discomfort: you may have a metal allergy.
"Allergic contact dermatitis accounts for a significant number of visits to a dermatologist's office and is usually caused by substances that come into contact with the skin," said Dr. Joseph Fowler, a dermatology professor at the University of Louisville in Kentucky. "Metal is one of the most common culprits of allergic contact dermatitis especially due to the popular trend of body piercing, which can lead to irritation and rashes in not only the earlobes, but upper portions of the ears, lips, nose, tongue, navel, breasts and genitalia as well."
Fowler presented the information Monday at a meeting of the American Academy of Dermatology in San Francisco.
After poison ivy, metal allergy is the most common form of allergic contact dermatitis. In the past, women have been more susceptible to metal allergy than men due to the amount of jewelry worn, but as the numbers of males wearing jewelry increases, so does the incidence of metal allergy among them.
Symptoms of metal allergy usually occur between six to 24 hours after exposure and will dissipate if the metal is removed from the skin. The affected skin may become red, swollen, and blisters often appear, which may break, leaving crusts and scales. Later the skin may darken and become leathery and cracked.
The rash is generally confined to the site of contact, although severe cases may extend outside the contact area, especially if the allergen is on your fingers and then transmitted to the face, eyelids or genitals.
"It's important to note that allergic contact dermatitis, such as metal allergy, can be difficult to distinguish from other rashes," Fowler said. "However, dermatologists can determine clues about the nature of a rash based on its location on the body and the patient's lifestyle and work habits."
Another way dermatologists can discover the source of an allergy is through patch testing. During patch testing, small amounts of possible allergens are applied to the skin on strips of tape and then removed after two days. An allergy shows up as a small red spot at the site of the patch and a dermatologist notes what the patient is most sensitive to.
Nickel
The most common of all metal allergens is nickel, which is found in costume jewelry, clothing ornamentation such as zippers, buttons and snaps, and virtually all common metal objects. About 16 percent of all people who are patch tested for allergies turn out to be allergic to nickel. Because sweat allows the metal ions to be better absorbed into the skin, areas on the body where nickel is present and where sweating may occur can see an increase in the severity of the dermatitis.
The most common location of nickel dermatitis is on the earlobes from earrings containing the metal. This reaction may start with the needle used to pierce the ears and continue as individuals begin to change their earrings daily. Dermatologists suggest that individuals with an allergy to nickel wear only nickel-free or plastic earrings.
Trace amounts of metal are found in food and people with sensitivity to metal can experience dermatitis. In particular, beans, lettuce and whole-grain foods are high in nickel, but most people do not ingest enough of them to develop a serious rash.
"While nickel dermatitis is associated most often with costume jewelry or watchbands, which have a high concentration of nickel, it can occur with finer jewelry, which is usually worn for prolonged periods -- for example a wedding ring," Fowler said. "If sentimental reasons prevent you from not wearing an item on a daily basis, the best way to prevent the reaction is to have it plated in a nonallergic metal, such as platinum."
Cobalt
Cobalt is also a common allergen that is found in many of the same items that contain nickel -- thereby making this allergen difficult to pinpoint. It is also found naturally in soil, dust and seawater. In the home, it is most often found in the blue pigments in porcelain, glass, pottery or ceramics, as well as blue and green water color paints and crayons. In the workplace, cobalt is found in cement, bricks and mortars.
"Combined allergic reactions are not uncommon and represent simultaneous specific sensations to each individual metals as opposed to being reactions to the combination," Fowler said. "Whenever possible, patients are encouraged to avoid the allergen, use plastic or wooden items, such as kitchen utensils or scissors, and wear protective clothing and a face mask at their workplace."
Chromate
Chromate is another dermatitis-causing metal, which is also found in cement, but more commonly used as a leather tanning agent. "Shoe dermatitis" may result from leather containing chromates and patients should change their shoes and socks throughout the day especially if they are allergic or if there is excess perspiration.
In addition, some matches contain chromates, and touching unlit matches can contaminate fingers. The fumes from a lit match and the charred match head also contain small amounts of chromate.
"When a metal allergy is suspected, it's important for people to seek the medical advice of a dermatologist, especially since nickel, cobalt and chromate can all be found in some common metal objects that people may touch every day," Fowler said. "If avoidance of an item isn't possible, your dermatologist can recommend some other treatment options and lifestyle changes that can help patients live and work without the itchy rash of allergic contact dermatitis."
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