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Contact Dermatitis And Its Diagnosis

By on October 19, 2012

Does your skin get irritated and itchy every time you wear jewelry that is not made of gold or silver? If zippers and metal buttons cause your skin to become red and inflamed, then you probably have an allergic reaction to metals.

What causes contact dermatitis?

Allergic reaction to jewelry, also known as contact dermatitis is most often caused by the presence of nickel in necklaces, watches or even eyeglass frames. There are other metals such as cobalt, chromium or iron that can also cause such reactions. Silver and gold themselves don’t cause allergies, but due to the fact that they have to be combined with some alloys, in order to make them less malleable for jewelry making, it becomes possible for them to also cause allergies.

Who is prone to metal induced allergies?

Contact Dermatitis And Its Diagnosis

By: Yasser

Approximately 11% of the population is allergic to metals, most often nickel. There is a higher risk for women to develop such allergies because they come in contact more often with jewelry that can contain such metals. They can also affect men, although the percentage is much lower. Contact dermatitis can happen at any age, but nowadays it occurs more frequently among teenagers.

Once the allergic reaction has produced, it will reappear every time the skin gets in contact with the allergen. If left untreated it will probably persist throughout many years, and may even last for your entire lifetime.

Its severity can also vary; some people may get the first symptoms after short contacts with the allergen, meanwhile it can take years for other people. It is possible for you to wear a piece of jewelry for a long time without any problems and then suddenly get an allergic reaction to it. From that moment your skin will react this way every time you wear that piece of jewelry. Usually reactions appear in areas that have most often been exposed to metals, like wrists, fingers, ears.

What are the symptoms that can occur?

Sensitized individuals may develop an allergic reaction within 12 to 48 hours from being exposed to the metal. The symptoms can persist for many days, up to four weeks. Even though the initial allergic reaction occurs in some parts of the body, after the reaction has fully developed, it can transpire in any part that is exposed.

Contact dermatitis can have the following signs or symptoms:

  • Itching (also referred to as pruritus) – is the most common sign of an allergic reaction, and can sometimes be very severe causing the patient to scratch and produce skin lesions.
  • redness – can appear as spots, usually on the skin part that was exposed to the allergen, but it is possible for it to appear on other parts of the body. It can sometimes resemble a fingerprint.
  • Dry skin that may be followed by desquamation.  This can give the skin an aspect similar to a burn lesion.
  • Blisters – often appear if the allergy is more severe.
  • lumps on certain areas
  • bleeding
  • In severe allergies there can be transparent or yellow fluids that appear on the affected area.
  • These symptoms most commonly occur on the following areas:
  • Earlobes – due to metal earrings,
  • Temples – from glasses frames,
  • Hands and wrists – from rings and bracelets and
  • Lower abdomen- from metallic buttons on jeans, zippers, belt buckles.

How can you be diagnosed?

Allergies to nickel or other metals can only be diagnosed by a doctor after he performs an allergy or a blood test.  For the skin allergy test, your doctor will have two options:  the prick/scratch test or the patch test.  For the first one, he will scratch or prick the skin on your forearm with a small needle that contains a solution of the allergen that is being tested.

The patch test involves placing a small patch containing the allergen on the skin.

In both cases your doctor will watch for any abnormal response that may consist in redness or itching. The test will be positive if any specific allergy symptoms will appear on your skin. This test can be performed by a dermatologist or an allergist.

Is there any type of treatment?

Unfortunately, there is no treatment that can eliminate this type of allergic reaction forever. To prevent contact dermatitis from developing, if you are known to be allergic to any metal, you need to avoid any contact with your allergen. Symptoms will often subside on their own if you avoid exposure to such metals. Although, there is medication that can be used to treat some of the symptoms, but that will not eliminate the cause and it is only a temporary solution.

Symptomatic treatment includes antihistaminic medication like loratadine, desloratadine or ketotifen. Topical cortisone creams can also be helpful with relieving the unpleasant symptoms.

If the reaction is severe, it can turn into a real wound that can easily get infected. This would require antibiotic treatment along with antihistaminic medication. If the symptoms do not subside under medication, you need to consult with your doctor.

How to avoid getting contact dermatitis from jewelry

Being allergic to metals does not necessarily mean you won’t be able to wear any jewelry. Even though it’s more expensive, you can always choose gold or silver jewelry. Sterling silver contains 92.5% pure silver, the rest of 7.5% usually being copper, which is not known to cause allergies. You can recognize sterling silver by the 925 mark on jewelry items. Also you should keep in mind to avoid other types of silver like German silver or silver that is combined with nickel, lead or zinc.

Other metals that are known to be non-allergenic include steel, copper, platinum and titanium.

If you still want to use jewelry made from allergenic metals you should know that perspiration can induce or worsen the symptoms that may occur, because it can form metal salts that are very irritating. Detergents or soaps that come in contact with this type of jewelry can break the skin’s protective barrier and cause rashes. In order to avoid this, you can improvise by applying a coat of clear nail polish on top of your jewelry items. Applying some talc powder on these items before wearing them can also be very helpful.

Even if you can protect you skin this way, it is still inadvisable to wear jewelry that contains nickel for a long time, if you are allergic to it. If you see any sign of redness or itching, you should immediately take off the pieces of jewelry and wash the area with cold water. You should always have a topical antihistaminic cream with you when you decide to wear allergenic jewelry, so you can apply it if any symptoms occur.