Contact Allergy - Irritating fashion jewellery made of nickel

Itching, redness and rashes of the skin can be signs of contact allergy. Characteristic of a contact allergy is that the skin changes occur locally and only several hours after contact with the allergenic substance. A contact allergy is therefore also called a late-type allergy. In this blog article, our medical team explains exciting details about contact allergies.

Schmuck - Kontaktallergie Quelle: MikroKon/eigenart/ - Copyright: Scientific DX GmbH, 2020

What triggers contact allergies?

There are many different triggers for a contact allergy:

  • Nickel
  • Perfumes and preservatives in cosmetics
  • Disinfectants or medicines that are applied to the skin

The most common trigger of contact allergy worldwide is nickel. In most cases, even small amounts of nickel are sufficient to trigger allergic reactions. Fortunately, many patients only have a mild to moderate clinical picture - they experience moderate itching.

Nickel allergy

The symptoms of nickel allergy are limited to the area of skin that comes into direct contact with the allergen. The main areas affected are the fingers (when wearing rings), palms, navel, ears (for piercings and earrings) and wrists. However, skin changes can also be caused by cosmetics contaminated with nickel and can occur on the face.

Where can nickel be found everywhere?

Nickel is an extremely widespread metal that is industrially processed in large quantities. For example, it is found in various costume jewellery, spectacle frames, watches, pricings, hairpins and coins. Nickel can also be found in other everyday objects: tin cans, trouser buttons, cutlery, cooking pots, mobile phones or cosmetics. In addition to industrially manufactured items, nickel can even be found in some foods. The metal is infiltrated into plants via the earth during the growth process. People who are allergic to nickel should therefore also be careful when eating coffee, chocolate, potatoes or cereals. The EU has also reacted to the widespread use of nickel and the associated health risk of contact allergy. The EU Nickel Directive stipulates that products containing nickel may not release more than 0.5µg of nickel per square centimetre per week.

Who is affected?

It is noticeable that women suffer from a nickel allergy much more often than men. Studies by the Robert Koch Institute have shown that over 12% of all women and only about 3% of all men will be confronted with the diagnosis "contact allergy" during their lifetime. This suggests that frequent contact with nickel in costume jewellery and piercings is likely to lead to the development of a contact allergy.

Symptoms of nickel allergy

  • Excemption
  • Redness
  • Severe itching
  • Burning and pain of the skin
  • Swelling
  • Weeping bubbles
  • With frequent contact also dandruff or thickening of the skin

What happens in the body when you have a nickel allergy?

As with all allergies, the trigger of a nickel allergy is an overreaction of the body's own immune system. However, in contrast to most allergic diseases, it is not IgE antibodies but T lymphocytes that play the main role. T-lymphocytes, which are white blood cells, are an essential component of our immune system and normally protect us from pathogens. In the case of contact allergies, these cells falsely classify the harmless substance nickel as harmful. If the skin comes into contact with nickel, T lymphocytes migrate into the upper layer of the skin and trigger inflammatory reactions there. As this "migration" takes some time, the symptoms of contact allergy sufferers occur with a time delay. A nickel allergy can also be called a late type allergy or type 4 allergy.

Diagnosis of a nickel allergy

For the correct diagnosis of a nickel allergy, professional guidance is required. The first point of contact here is your dermatologist/dermatologist, who will give you an overview of the history of the disease, the skin changes and the timing of these changes. For the direct detection of a nickel allergy, the next step is a so-called epicutaneous test. Here, the allergenic substance (such as nickel) is applied to the skin with a plaster. This is removed again after 24 to 48 hours, after which the doctor takes a close look at the skin changes at the test site 🔎.

What can I do?

If the dermatologist diagnoses "nickel allergy", people affected should avoid the allergen as much as possible. For example, they should avoid costume jewellery containing nickel and everyday objects containing nickel. Protective measures, such as wearing gloves, can also be helpful. If avoiding allergens is not enough to combat the skin irritations, creams containing cortisone can also be used.

Note: Late type allergies (such as contact allergies) are triggered by allergen-specific T-lymphocytes. The IgE antibodies in the blood (which are detected in igevia) cannot be used for a diagnosis.


This article has been reviewed by unserem Medical-Team for accuracy of content.

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