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The Skin Allergy Section

Nickel’s Nasty Prickle

Sometimes there will be a more general eczema reaction that spreads to other parts of the body, even where there was no direct nickel contact. But that’s not common.

If you have either the rash or the eczema symptoms, but your doctor isn’t sure whether the reaction is to nickel or some other substance, you may be referred to a dermatologist for patch testing.

In this process, explains Dr. Charles Morton, a Vancouver dermatologist, “we take low concentrations of metals, chemicals, rubbers or whatever we think the irritant might be, put that under special tape, apply it to the patient’s back and leave it for 48 hours.”

If there’s a raised, itchy rash on the patient’s back, they can identify the allergen.

The good news for those who aren’t yet allergic to nickel is that it can be prevented.  Research shows that, while there is some evidence of genetic predisposition, the most important factor by far in nickel sensitization is direct and prolonged exposure to high concentrations of nickel.

To curb nickel allergy, people should avoid buying products that will release high amounts of nickel (for example, nickel-plated jewelry).

Or, if you already have nickel-plated consumer items that you wish to continue to use, avoid prolonged skin contact with them. Fleeting contact with nickel is less worrisome.

In Canada all the silver coins are nickel-plated steel, not a problem if your contact with them is brief. Same goes for casual contact with faucets, house keys and doorknobs. American coins, while more likely to release nickel, are still unlikely to cause problems if your contact with them is short-lived.

Because of the prevalence of nickel allergy, more than a decade ago the European Union adopted rules limiting nickel-release levels on the surface of consumer products intended for direct and prolonged contact with the skin. Unfortunately, there isn’t similar protection in North America.

Bruce McKean, the director of stewardship and sustainable development at the Nickel Institute in Toronto, explains this is because “we are so far removed from the nearly all offshore manufacturers who may be using nickel inappropriately.”

However, the Nickel Institute, whose role is to provide research on the effective use of nickel in manufacturing and production, “does try to educate manufacturers, branders and retailers, and work with dermatological societies and sponsor research to raise the profile of nickel allergy,” he says.

Heightened awareness and promising research proves that lowering everyday exposure to nickel can reduce sensitization rates. Perhaps, if manufacturers use appropriate alloys in all our fasteners, non-corrosive instruments are used in body piercing and our children avoid prolonged contact with nickel-releasing jewelry and fasteners, the next generation may be protected.

But for the sensitized, it seems, nickel will continue to surprise us. Remember that trumpet mouth piece that Kathy Weber gave to her non-allergic husband?

Well, within a week, Weber had the same itchy, burning lips that had plagued her daughter. “Being the ‘kissing couple’ that we are, I suddenly realized that my husband’s playing and subsequent kisses were causing a reaction,” she says.

The nickel had leached from the mouthpiece, to her husband’s lips, to Weber’s. “We quickly bought a replacement mouthpiece!” Weber says with a laugh.

There are no scientific studies that back up exquisitely sensitive anecdotes like these, but like with any long-time allergy-sufferer, Weber’s hunch is probably right. Dare we sound a hypoallergenic-trumpet? Avoid nickel now.

From Allergic Living magazine.
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