Author: Hadia Zainab
Skin disorders are the most common diseases health professionals encounter. According to the CDC, one type of eczema, also known as contact dermatitis, accounts for 90–95% of work-related skin disease cases in the U.S. It causes itchy, flaky, and inflamed skin that can lead to discomfort and distress. People with eczema have different triggers, and nickel could be one of them.
According to the journal of Contact Dermatitis, nickel is one of the most frequent causes of contact dermatitis, often resulting in a nickel allergy rash. Here, we present ways to minimize the risk of eczema flare-ups caused by jewelry. Keep reading to learn more.
Disclaimer
We strive to use gender-inclusive language to promote equality and avoid discrimination. However, we may use specific terms such as 'man' or 'woman' to accurately reflect the terminology used in referenced sources. In these cases, 'woman' refers to individuals assigned female at birth (AFAB) and 'man' refers to those assigned male at birth (AMAB). Our goal is to be inclusive while maintaining accuracy and improving searchability.
Understanding eczema: a common skin condition
Eczema is a skin condition characterized by dry and itchy skin caused by a weakened skin barrier. This impairment makes it difficult for the skin to keep moisture and protect against outside environmental factors.
Eczema is characterized by:
- Severe itching
- Redness
- Scaling
Eczema is non-contagious, meaning it cannot spread from person to person. However, eczema symptoms can flare up when you touch something that irritates your skin or causes an allergic reaction. According to the National Eczema Association, over 31 million Americans of all ages have some type of eczema.
There are seven main types of eczema:
1. Atopic dermatitis
Atopic dermatitis (AD) is the most common type of eczema. It affects about 9.6 million children and 16.5 million adults in the U.S. Atopic dermatitis is believed to have a complicated cause that involves both genetic and environmental factors. These factors result in problems with the skin and immune system.
- It can appear anywhere on your body.
- Common symptoms include intense itching followed by pain, rashes, and sometimes trouble sleeping due to itching.
- AD can weaken your immune system by damaging your skin's protective barrier.
Atopic dermatitis (AD) is often linked with other allergies like hay fever, asthma, and food allergies. AD can significantly affect a person's health, and its occurrence seems to have been rising in recent decades.
The main parts of treatment include avoiding triggers like certain soaps, detergents, or extreme weather. You should also take care of your skin daily using anti-inflammatory therapies and other supportive methods.
2. Contact dermatitis
Contact dermatitis is an inflammatory skin condition that causes inflammation and eczema. It happens when chemicals or metals irritate the skin without triggering an immune response (contact irritants) or when small reactive chemicals change proteins and cause the immune system to react (contact allergens).
It was once thought that allergic contact dermatitis was rare, but recent data shows that it is prevalent, affecting nearly 20% of children. The positive side is that most cases improve independently and can be managed with basic treatments. However, for some people, it is a long-lasting condition that can significantly impact their quality of life.
Contact dermatitis can occur either due to an allergic reaction (allergic contact dermatitis) or direct irritation (irritant contact dermatitis).
- Allergic contact dermatitis occurs when the skin comes in contact with an allergen, which triggers an immune response.
- Irritant contact dermatitis occurs when the skin comes in contact with a substance that physically irritates it, such as harsh chemicals, detergents, or prolonged exposure to water. This is not an allergic reaction but rather a direct irritation to the skin.
- Symptoms include redness, dryness, or itching.
Avoiding irritants or allergens can help treat contact dermatitis. If that's not possible, use moisturizers and steroid creams. In rare cases, a doctor might prescribe oral steroids for severe outbreaks.
3. Dyshidrotic eczema
Dyshidrotic eczema (pompholyx) is a type of eczema that primarily affects the hands and feet. It isn't common, and the exact number of people it affects is still unknown.
- It is more common in men than women.
- Symptoms include tiny, itchy blisters on the hands, feet, and the edges of the fingers and toes.
- The blisters can cause discomfort and may crack or peel.
Soaking with potassium permanganate can help during the initial stage of dyshidrotic eczema. Other treatments include ointments like steroids, tacrolimus, or pimecrolimus on the affected area.
4. Neurodermatitis
Neurodermatitis is eczema that affects approximately 12% of the total population and is often associated with stress, anxiety, or other psychological factors. Other possible causes include insect bites, dry skin, and tight clothing. It is common in people with different types of eczema or psoriasis.
- It causes intense itching.
- Visible changes include skin lines, scales, and discoloration from scratching.
- This condition appears in areas like the feet, hands, wrists, elbows, shoulders, neck, and scalp.
Using corticosteroids, antihistamines, antibiotics, and capsaicin creams can help manage symptoms and pain.
5. Nummular eczema
Nummular eczema is also called discoid eczema. It is often associated with dry skin, especially in winter and is more common in middle-aged men.
- It appears as round patches resembling coins on the skin.
- These patches are often dry, itchy, and may occasionally ooze.
- Their circular shape makes them distinct from other types of skin conditions.
- Possible triggers include dry skin, insect bites, and certain medications (that cause dry skin).
Keeping the skin moisturized, using topical corticosteroids or antihistamines for itching can help relieve the symptoms.
6. Seborrheic dermatitis
Seborrheic dermatitis typically affects the scalp. It is more common in infants (called cradle cap) and adults, especially between ages 30–60.
- It causes itchy, red, and scaly patches.
- It is more common in men and people with oily skin.
- A yeast called Malassezia on the skin is believed to be the main cause.
Using antifungal shampoos, topical corticosteroids, and medicated creams can help treat seborrheic dermatitis.
7. Stasis dermatitis
Stasis dermatitis is caused due to poor blood flow in the legs. It occurs in older adults and people with varicose veins or other circulation issues.
- It makes your skin itchy, especially your legs.
- Prolonged standing or sitting can make it worse.
- If you have lighter skin, it might look red.
- For darker skin tones, it can appear brown, purple, gray, or ashen.
Improving circulation with compression stockings, leg elevation, and exercise can help treat this type of eczema. Topical steroids or moisturizers can also be effective.
Eczema triggers: what irritates your skin?
The exact cause of eczema isn't fully understood, but it's believed to involve genetic factors, environmental triggers, and abnormalities in the immune system. However, whatever the cause, various factors can trigger eczema. Some of them are:
- Allergens. Contact with allergens, such as certain metals, fragrances, chemicals, and some foods, can result in eczema.
- Irritants. Harsh soaps, detergents, fragrances, rough fabrics, and excessive sweating can also aggravate eczema.
- Dry skin. Cold weather, low humidity, or hot showers more often can lead to itching and irritation.
- Stress. Emotional stress can also worsen eczema symptoms.
Jewelry and eczema: the nickel connection
Nickel is often found in many types of jewelry, especially budget ones. It is a popular choice for manufacturers because of its durability and shiny appearance. However, this widespread use has a downside: exposure to nickel frequently causes eczema flare-ups, known as allergic contact dermatitis.
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The American Academy of Dermatology reports that one in five people in North America has a nickel allergy, affecting at least 11 million children. When people with a nickel allergy come into contact with items containing nickel, their immune system reacts, leading to an allergic response. This response can manifest as redness, itching, and bumps around the area where the jewelry or other nickel-containing item touches the skin.
A systematic review and meta-analysis found that about 20% of the general population have contact allergies, with nickel being the most common allergen (11.4%). The same study indicated that women are more likely to get contact allergies than men. This is probably due to more contact with allergens through cosmetics, jewelry, and personal care products, which often contain substances like nickel and fragrances.
Symptoms of a nickel allergy can include:
- Redness
- Itching
- Rashes
- Swelling
- Bumps or blisters around the area of contact
The skin may become dry, thickened, and pigmented in more severe cases. These symptoms are not life-threatening but can be uncomfortable and irritating if you’re frequently exposed to nickel.
Other potential jewelry-related eczema triggers
While nickel is the most common metal allergen in jewelry, it's not the only potential trigger for eczema flare-ups. Other metals and materials used in jewelry can cause skin reactions in sensitive individuals.
Cobalt and chromium are often used in jewelry-making alloys. About 1–4% of the general population has an allergy to cobalt, and among people with eczema, this percentage increases to 4–11%. A recent study published in the British Journal of Dermatology found that cobalt nanoparticles (CoNPs) caused eczema in the tested area of patients’ skin.
Additionally, platinum and palladium (white gold alloys) can trigger contact dermatitis. Acrylates and rubber accelerators used in costume jewelry can cause allergic reactions. Some other metals and minerals that might cause allergy include copper and gemstones.
Minimizing eczema risks when wearing jewelry
Dr. Camila Azzini, a Dermatologist at Messina Clinic in London, United Kingdom, spoke to Healthnews about minimizing the symptoms of eczema and the risk of developing a rash when wearing jewelry. Here’s what she advised.
"Eczema is a chronic condition, which means there is no cure. But effective care involves maintaining good skin care practices and using medications to control itching and rashes.
When it comes to wearing jewelry, select hypoallergenic metals, which means they have low chances of irritating the skin. Look for items made from materials such as pure platinum, sterling silver, surgical stainless steel, or high-karat gold (18K or 24K). These metals are less likely to trigger allergies, which can help you with managing eczema.
Remove rings and other jewelry before washing your hands, and dry your skin well before putting them back on. This helps reduce the irritation and discomfort. Also, make sure to clean your jewelry regularly to remove any eczema irritants like soap, sweat, or dirt that can cause skin reactions altogether."
Consulting a dermatologist for eczema and jewelry
If your jewelry seems to be causing skin problems even after taking proper care, it's essential to see a dermatologist. A consultation with a doctor and testing may help identify environmental triggers or may help identify your eczema type. Getting the correct diagnosis can help treat eczema symptoms more effectively.
Dermatologists may also offer recommendations and treatments, such as creams or medications, to manage the symptoms. Their expertise guarantees you the best care for your skin problem.
Final word
In summary, jewelry doesn't cause eczema, but certain metals, such as nickel, can trigger allergic reactions. This can result in a nickel allergy rash and worsening symptoms. To reduce these risks, choose jewelry made from hypoallergenic materials, test new pieces cautiously, keep your jewelry clean, and seek guidance from a dermatologist if needed. This is how you can wear jewelry safely and comfortably without concerns about worsening your eczema or developing a rash.
