What is an Allergy to Nickel?

Nickel is a common element found in our environment and in many everyday products—from jewellery and coins to keys, mobile phones, and even certain kitchen utensils. It’s frequently used as a base or coating in items made of stainless steel or metal alloys. While generally harmless to most people, a growing number of individuals may develop a sensitivity to nickel. This can lead to an immune reaction, known as nickel allergy or nickel allergic contact dermatitis (NACD), resulting in symptoms such as redness, itching, and rashes where the skin comes into contact with nickel-containing materials.

Interestingly, nickel allergy doesn't always stop at skin reactions. Some people may also experience more complex or internal symptoms that resemble food intolerances or systemic allergic responses. In such cases, it can be helpful to explore your triggers more thoroughly with a dedicated intolerance test, which may identify hidden dietary or environmental sensitivities—including potential reactions to nickel through ingestion rather than contact alone. It’s also worth noting that individuals who suffer from nickel allergies often have other sensitivities, such as hayfever or seasonal allergic rhinitis. These overlapping immune responses suggest a heightened reactivity to common allergens, which may complicate diagnosis and symptom management. For those experiencing persistent allergy-like symptoms, managing both environmental and dietary exposures becomes essential. If you suspect nickel is contributing to your symptoms, whether through contact or diet, it’s advisable to monitor your exposure closely. You can even take a nickel test to measure nickel levels in your blood and better understand how your body is reacting to this common element

Symptoms of a nickel allergy

Nickel allergy is a condition caused by an adverse skin reaction due to nickel exposure. It is one of the most widespread metal allergy variations and can affect both children and adults. This can be problematic as nickel can be found in everyday products such as belt buckles, eyeglass frames and coins.

The symptoms of a nickel allergy, or nickel sensitivity, can vary from person to person, but common symptoms include:

• Itching - Itching is often the first and most noticeable symptom of a nickel allergy.
  It typically begins shortly after the skin comes into contact with nickel. The sensation can range from mild to intense and may worsen with continued exposure. Scratching the itch may lead to skin damage or further irritation.
  Even after removing the nickel source, the itch may persist for several days.Applying a soothing treatment like E45 Itch Relief Cream can help calm the itch and reduce inflammation, offering relief while the skin recovers.
• Skin rash or bumps on the skin- A nickel allergy can cause raised, red bumps that look like a rash. These bumps may be grouped or scattered across the contact area. They can be itchy, inflamed, and sometimes painful to the touch.
  In chronic cases, the rash may reappear even without direct contact.
  This symptom is a clear sign of the body’s allergic response to nickel. For general skin irritation and minor allergic reactions, Sudocrem Antiseptic Cream may support healing thanks to its calming and protective properties.
• Redness- Redness occurs as the skin becomes inflamed due to the immune reaction. The affected area may feel warm and appear flushed or irritated.
  It usually surrounds the exact spot where the nickel touched the skin.
  Redness is often accompanied by other symptoms like itching or swelling.
  Persistent redness might indicate ongoing or repeated exposure. Using barrier-repair or anti-allergen topical treatments like Fusion Allergy Face Cream may help soothe irritation and support the skin’s natural barrier, especially for facial reactions
• Dry, scaly skin- Over time, allergic reactions can lead to dryness and flaking of the skin. The skin may look rough, cracked, or leathery in texture. This symptom is more common with prolonged or repeated nickel contact. Dryness can increase sensitivity and make the skin more prone to irritation. Moisturizing and avoiding nickel contact can help restore skin health.
• Blisters- Blisters may form in more severe or prolonged nickel allergies.
  These fluid-filled sacs can break open, causing oozing or crusting. They are often itchy and may be painful, especially if scratched. Blistering indicates a strong allergic reaction and should be monitored. If not treated, blisters may lead to infection or scarring.
• Swelling- Swelling occurs as part of the body’s natural inflammatory response. It may be localized to the area of nickel contact, such as the wrist or earlobe. The skin may feel tight, tender, or appear puffy. In some cases, swelling can spread slightly beyond the contact zone. Reducing exposure and using anti-inflammatory creams can help manage it.

 These symptoms typically appear in the area of the skin that has come into contact with the nickel. For example, suppose you are wearing earrings made of nickel and develop an allergy. In that case, the symptoms may appear on your earlobes.

How is nickel allergy diagnosed?

If you suspect that you have a nickel allergy, it is essential to see a dermatologist for a proper diagnosis. Your dermatologist will inquire about your past health conditions and medications and perform a physical examination to look for signs of a nickel allergy. They may also conduct a patch test. Patch allergy tests involve applying a small amount of nickel to a patch, which is then applied to a part of your skin. The patch is kept on for forty-eight hours and then removed. The dermatologist will then check the area for any reactions.

Causes of a nickel allergy

Dermatitis is commonly caused by wearing nickel jewellery or other accessories that contain this metal. Nickel allergies may also occur from coming into contact with clothing fasteners, belt buckles and other items such as hairpins, buttons (especially shirt studs), watchbands and shoe buckles.

A nickel allergy is caused by the body's immune response to nickel as if it were a harmful substance. When exposed to nickel, the body produces an antibody called immunoglobulin E (IgE). This antibody triggers the release of histamines, which can cause the symptoms of an allergic reaction.

Nickel allergy develops more commonly in women than in men, and it is estimated that around 10% of women and 1% of men have a nickel allergy. It is also more common in people who have a family history of atopic dermatitis (eczema) or other allergies and in those who live in areas with high air pollution levels.

Treatment of a nickel allergy

If you're allergic to nickel, the most crucial thing you can do is avoid contact with nickel as much as possible. This may involve avoiding certain jewellery types and opting for jewellery marked as "nickel-free", switching to stainless steel cookware, and wearing gloves when handling coins or other nickel-containing items.

Another option is surgical-grade stainless steel. It is most suitable for people with a nickel allergy since it is hypoallergenic and will not cause irritation to your skin. The only downside of surgical stainless steel is that it can be expensive, especially if you want something fancy, like a wedding band or engagement ring.

Another way to avoid contact with nickel is to follow a low-nickel diet, which involves limiting your intake of foods that contain high amounts of nickel. You should avoid eating nickel-containing foods, such as shellfish and soybeans, and drinking beverages that have them, such as grape juice. Other familiar sources of nickel in the diet include:

• Nuts, particularly almonds, hazelnuts, and peanuts

• Whole grains, including oats, wheat, and rye

• Chocolate and cocoa products

• Soy products, including tofu and soy milk

It is important to note that while these foods may contain small amounts of nickel, they are generally considered safe to eat and are not typically a concern for most people. However, if you are allergic to nickel, you may need to be more mindful of your intake of these foods.

Suppose you do come into contact with nickel and develop symptoms. In that case, over-the-counter antihistamines can help to alleviate the itching and swelling. Your dermatologist may also prescribe a more vital medication, such as topical corticosteroids, to help reduce inflammation.

Read more: How do allergy tablets work?

Systemic nickel allergy syndrome

Systemic nickel allergy syndrome (SNAS) is a rare condition when a person develops an allergic reaction to nickel after ingesting it rather than having skin contact with it. Its symptoms can include:

• Rash or hives - Rashes or hives caused by SNAS tend to appear after eating foods that contain nickel. These skin eruptions may show up suddenly and are often widespread across the body. Hives are typically raised, red, and very itchy, lasting for hours or even days. Unlike localized contact rashes, these reactions can occur on areas not directly exposed to nickel. Their presence suggests the immune system is reacting from within due to ingested nickel.

• Itching- Itching from SNAS can affect not only the skin but also internal areas such as the throat or mouth. It often begins soon after consuming nickel-rich foods like chocolate, nuts, or whole grains. The sensation can be persistent and irritating, even if there are no visible signs on the skin. In systemic cases, the itching tends to be more widespread compared to localized contact dermatitis. Managing this symptom requires dietary changes and, at times, antihistamines. Applying a natural barrier like HayMax Pure Organic Pollen Barrier Balm around the nostrils or lips may help reduce exposure to airborne allergens that often worsen symptoms in sensitive individuals.

• Swelling of the lips, tongue, and throat- This form of swelling is one of the more serious signs of systemic nickel allergy. It usually starts with a tingling or tight feeling around the mouth, progressing to noticeable puffiness. In severe cases, swelling may involve the throat, causing difficulty swallowing or breathing. This is a medical emergency and requires immediate attention to avoid airway compromise. It’s a clear distinction from regular contact allergies which don’t typically cause internal swelling.

• Difficulty breathing- Breathing issues linked to SNAS may feel like tightness in the chest, wheezing, or an inability to take a full breath. These symptoms often develop after ingestion and mimic those of a severe allergic reaction or anaphylaxis. The reaction may escalate quickly and should never be ignored. It reflects an overactive immune response inflaming the airways. Prompt use of emergency medications like epinephrine may be necessary. A product like Nasofed Relief Saline Nasal Spray may support easier breathing in milder cases of nasal or airway irritation, though medical care is essential in more serious reactions.

• Abdominal pain- Stomach pain in SNAS can present as cramping, bloating, or a sharp ache, usually shortly after eating nickel-containing foods. This symptom is due to irritation in the gastrointestinal tract triggered by nickel. It's often confused with conditions like IBS or food intolerance. If left unchecked, this discomfort can recur with each exposure. A nickel-restricted diet is the primary approach to alleviating this issue.

• Nausea and vomiting- Feeling nauseous or vomiting after eating may indicate your body is rejecting nickel internally. Nausea often occurs early, even before other allergic symptoms appear. Vomiting can range from mild to severe and might be accompanied by stomach cramps. This reaction is your digestive system’s way of trying to eliminate the allergen. Repeated episodes often prompt testing and diagnosis of SNAS.

SNAS is a potentially serious condition that can be life-threatening if left untreated. If you suspect you have SNAS, it is crucial to seek immediate medical attention.

It is important to note that while nickel allergy and SNAS are both caused by an allergic reaction to nickel, they are different conditions and require different treatment approaches.

Read more: What is a food sensitivity test?

The takeaway

A nickel allergy is an immune system reaction to the presence of nickel on the skin or in other products. It can cause symptoms such as itching, rash, and swelling. If you suspect a nickel allergy, it is important to see a dermatologist for proper diagnosis and treatment. Avoiding exposure to nickel is the most effective way to prevent a reaction.