Monday, July 6, 2015

How common are nickel allergies?

A recent case study in Pediatrics found a child had a red, itchy rash due to nickel in an iPad. Find out more about this type of allergy and what other products have nickel in them.

How common are nickel allergies?


Nickel allergy is one of the most common contact allergies next to poison ivy. There is a lot of nickel out there - in jewelry, belts, clothing, utensils, tools, keys, pots and pans, medical devices, topical products like eyeshadows and metallic powders, and even food. We often first notice a nickel allergy when a child gets a rash around the navel from a snap or zipper on his pants, or kids start wearing earrings or a watch with a metal band and develop a rash.

A recent case study in Pediatrics reported contact dermatitis, a red, itchy rash, in a child that was attributable to nickel in an iPad. Because nickel is so ubiquitous, it’s not surprising that it is found in iPads. We have been telling our patients about the possibility of exposure to nickel in smartphones, tablets and other devices.

Nickel is found in a large percentage of metal alloys because it imparts toughness to otherwise soft metals. The most widely used type of stainless steel contains about 8 percent nickel. Jewelry made of 14K gold contains nickel because it adds firmness to an otherwise malleable metal. You may have noticed that pure gold (24 Karat) is very pliable and moldable.  If you are allergic to nickel and are having hip surgery, be sure to ask what metals are contained in the hip implant!

Contact allergies generally occur as a delayed reaction. In other words, exposure doesn’t lead to a rash right away. A person may wear, touch or be exposed to nickel for a while before noticing a rash. Often, the greater the exposure, the more intense the reaction, sort of like the difference between poison ivy brushing the skin vs. rolling in it! Unlike food allergies, contact allergies will not cause anaphylaxis. Patients can, however, develop a stubborn, unpleasant rash and scratching can lead to infection.  The best treatment for nickel allergy is topical corticosteroids and/or oral corticosteroids, if needed.

We advise patients with a nickel allergy to look for nickel-free jewelry, tools with plastic or wooden handles, clothes with non-metallic zippers or fasteners, and to use cases that cover the back (metallic part) of the Ipad or other device.  When shopping, avoid products with “nickel sulfate” listed among ingredients.

Nickel allergies have been recognized for decades, though the iPad is a relatively new and uncommon source of contact dermatitis. Allergies in general have been on the rise during the past few decades, and many theories have been proposed to explain this phenomenon. Nickel allergy is likely to follow a similar trend.



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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
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