Beneath the Surface

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A reaction to your jewelry? It’s more common than you think.

It starts with an itch – around your neck, finger, wrist, or on your ears. The skin feels warm, tender. It starts to swell and turn red. If things get really bad, blisters and dry patches form, it may look like you’ve been burnt.

If you’ve been wearing jewelry, it’s likely you’re having an allergic reaction to metal – most likely Nickel. In spite of being one of the most common skin allergies, nickel is frequently used in accessories, and is often part of alloys that make up stainless steel, silver, and white gold jewelry. Not only are nickel allergies incredibly common, they can also appear out of nowhere. You can wear a necklace for years only to develop symptoms suddenly and without warning. Once a metal allergy appears, it is typically with you for life. While there is no way to predict who will experience allergic contact dermatitis, it is more common among people who had asthma or hay fever as a kid.

What can you do?

Confirm that the allergy is to nickel.

Your dermatologist can perform a patch test by placing nickel and other suspected allergens onto patches. These remain on your upper back for 48 hours. If nickel is the culprit, you’ll develop a controlled reaction within that amount of time, confirming your suspicions.


Avoid your allergen.

Ok, this sounds pretty obvious, but avoiding nickel can be difficult. Boxing up the offending jewelry isn’t enough. You’ll need to check your eyeglasses, zippers, and belt buckles to prevent further direct-contact exposure. You’ll also need to be cautious with cell phones, coins, and keys, as these items also commonly contain nickel.

When it comes to other jewelry, purity is important. Ordinary stainless steel is out since it can contain trace amounts of nickel, but surgical grade is okay. Silver should be marked as Sterling 925, meaning it’s over 90% pure. When choosing gold, go for 14K or higher. Avoid white gold, as nickel is commonly mixed into the alloy to bring out the “whiteness” of the metal.


Find some relief.

Typically, a hydrocortisone cream will eliminate the itch and give your skin time to heal. An over-the-counter antihistamine can also cut back on symptoms. If your reaction is severe, your dermatologist may prescribe steroids (oral or topical) and possibly a prescription strength antihistamine.

If your skin is broken, cracked, or bleeding in any way, remove any metal jewelry seek help from a board-certified dermatologist immediately. Open reactions are a breeding ground for infection.


Not sure if you’re experiencing an allergic reaction? Avoid a long wait to see the doctor and heavy traffic by visiting a dermatologist online through DermatologistOnCall.com. Within 24 hours, you’ll have a diagnosis, treatment plan, and prescriptions if necessary.

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