Nickel Allergy

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Nickel allergy
Last updated: Wednesday, August 17, 2011

BACKGROUND

Nickel abhorrence occurs if the body’s allowed arrangement overreacts to substances in nickel. Nickel is a hard, bright, silver-white metal that is begin in soil. This metal is a accepted basic of argent coins, belt buckles, jewelry, and abounding added accustomed items.

Patients with nickel abhorrence about advance a derma adventurous alleged acquaintance dermatitis afterwards acknowledgment to the metal. Acquaintance dermatitis causes the derma to become red, itchy, and swollen.

According to the Centers for Ache Ascendancy (CDC), the added acknowledgment an alone has to nickel-containing products, the added acceptable the accommodating will become allergic to nickel. Patients can become allergic to nickel at any age.

There is currently no accessible abstracts on the accident ante of nickel allergy. Historically, nickel abhorrence has afflicted added women than men. Advisers accept that this is because women are added acceptable to get their aerial pierced. Nickel is present in earrings unless the adornment is hypoallergenic, stainless steel, solid gold, or admirable silver. However, as physique acute continues to accretion popularity, an accretion amount of males are appear to accept nickel allergies.

Although there is no cure for allergies, antihistamines, corticosteroid creams and ointments, air-conditioned compresses, hydrocortisone creams, and moisturizing creams may advice abate abhorrence symptoms. In general, affection may endure anywhere from a few hours to days.

The best way to anticipate affection from alternating is to abstain acknowledgment to nickel. Whenever possible, patients should acquirement nickel-free items. Patients can acquirement a nickel-testing kit at their bounded pharmacies to advice them analyze articles that accommodate nickel.

CAUSES

General: Typically, an allergic acknowledgment to nickel is not triggered the aboriginal time the physique is apparent to it. The first, or several times afterwards the physique is apparent to nickel, the allowed arrangement becomes sensitized. During this process, the body’s white claret beef advance immunoglobulin E (IgE) antibodies to the nickel. Once sensitized, the antibodies are able to apprenticed ascertain and bind to the nickel allergens if they access the body. These antibodies aswell activate the absolution of chemicals (such as histamine) that could could cause allergic symptoms, such as red, itchy, and bloated skin.

Triggers: Abounding accustomed articles are fabricated with nickel. Products, such as argent coins, keys, adornment (necklaces, earrings, bracelets, rings, and watchbands), belt buckles, zippers, buttons, bra hooks, suspender clips, pens, hair clasps, electrical shavers, paperclips, and ability accoutrement may accommodate nickel.

Some advisers accept appropriate that bubbler baptize and bistro aliment that accommodate top amounts of nickel (such as salmon, chocolate, nuts, grains, and canned fruits and vegetables) may advance to nickel abhorrence in acutely acute patients. However, these claims accept not yet been accepted by authentic evidence. Further analysis is bare afore a close cessation can be reached.

HOW TO IDENTIFY NICKEL PRODUCTS

If a accommodating is borderline whether a artefact contains metal, they may alarm the manufacturer.

Patients can acquirement a nickel testing kit (such as Spot Analysis for Nickel Kit?) at bounded pharmacies. The kit contains two bottles of bright fluid:

dimethylglyoxime and ammonium hydroxide. The accommodating applies one bead of anniversary band-aid to the article in question. Again a affection brawl or Q-tip is rubbed on the object. If the affection brawl or Q-tip turns pink, the article contains nickel.

RISK FACTORS

Gender: Historically, nickel abhorrence has afflicted added women than men. Advisers accept that this added accident may be because women are added acceptable to accept their aerial broken than men. However, as physique acute continues to accretion popularity, there accept been an accretion amount of letters of men with nickel allergies. If the aerial or added physique allotment is pierced, the physique is apparent to nickel in the adornment for several canicule until the derma heals. An allergic acknowledgment can be prevented if the patient’s derma is broken with adornment that is hypoallergenic, stainless steel, solid gold, or admirable silver.

Repeated exposure: Patients who are apparent to nickel on a approved base accept an added accident of developing nickel allergies. For instance, cashiers who handle bill for continued periods of time may accept an added accident of developing the allergy.

SYMPTOMS

Symptoms about advance aural 20 account of acknowledgment to nickel. Affection may endure anywhere from a few hours to days. Patients who are allergic to nickel advance acquaintance dermatitis, which causes the derma to become red, itchy, and swollen. The severity of this derma adventurous varies a allotment of individuals. Some patients may advance fluid-filled blisters. In a lot of cases, the afflicted derma is apprenticed to the breadth that was apparent to the metal. However, it is accessible for the adventurous to advance to added areas of the body.

DIAGNOSIS

Skin test: A derma test, alleged an epicutaneous (patch) test, is acclimated to actuate whether a accommodating is allergic to nickel. During the procedure, the nickel allergen is activated to a patch, which is again placed on the skin. The appliance is beat on the arm or aback for 48 hours. While the appliance is on, the accommodating should not bathe, and he/she should try not to diaphoresis heavily. The healthcare provider will abolish the appliance afterwards 48 hours and beam the analysis website for allergic derma reactions. If the derma is red, itchy, and swollen, a absolute analysis is made. A derma analysis is about conducted in a healthcare provider’s office. Derma tests could could cause minimal, if any, discomfort.

Allergen-specific immunoglobulin (IgE) test: An allergen-specific immunoglobulin E (IgE) test, frequently referred to as radioallergosorbent analysis (RAST©), may aswell be acclimated to actuate whether the accommodating is allergic to nickel. However, this analysis is beneath authentic than a derma test. It is usually performed in patients who accept circumstantial astringent derma diseases (like eczema or psoriasis) that accomplish it difficult to adapt a derma test.

During the procedure, a sample of claret is taken from the accommodating and beatific to a class that performs specific IgE claret tests. The nickel allergen is apprenticed to a cardboard disc alleged an allergosorbent. Again the patient’s claret is added. If the claret contains immunoglobulin antibodies that ascertain and bind to the nickel, the claret will bind to the allergen on the disc. A radio labeled ANTI-IgE antibiotic is again added to the disc to admeasurement the akin of immunoglobulin E present in the blood. The college the radioactivity, the college the akin of IgE in the claret and the added astringent the allergy.

A able healthcare provider will adapt the after-effects of the test. In general, the acuteness of these tests ambit from 50-90%, with the boilerplate getting about 70-75%. The accommodating will accept analysis after-effects in about seven to 14 days.

TREATMENT

General: Although there is no cure for allergies, antihistamines, corticosteroid creams, air-conditioned compresses, hydrocortisone creams, and moisturizing creams may advice abate abhorrence symptoms. The best way to anticipate affection from alternating is to abstain acknowledgment to nickel.

Antihistamines: Antihistamines may be acclimated to allay abhorrence symptoms, including red, acquisitive skin. Accepted nonprescription antihistamines cover diphenhydramine (Benadryl©), chlorpheniramine (Chlor-Trimeton©), clemastine (Tavist©), and loratadine (Alavert© or Claritin©). Frequently acclimated decree medications cover desloratadine (Clarinex©), fexofenadine (Allegra©), cetirizine (Zyrtec©), and hydroxyzine (Atarax© or Vistaril©).

Cool compress: Applying a air-conditioned abbreviate to afflicted areas of the derma may advice abate itching, swelling, and redness.

Hydrocortisone: Hydrocortisone chrism has been activated to the afflicted breadth to briefly abate itching. Hydrocortisone 1% cream, which is accessible over-the-counter, has anti-inflammatory furnishings and relieves abscess and bloom in accession to itching. Decree hydrocortisone has been acclimated to abate itching, redness, dryness, crusting, scaling, inflammation, and ache associated with the allergic reaction.

Moisturizing creams: Moisturizing creams and lotions like Gold Bond Medicated Moisturizing Physique Lotion© may advice abate dry, acquisitive skin. Moisturizing creams should not be activated to accessible cuts, blisters, or sores on the skin.

Topical corticosteroids: Contemporary corticosteroid creams like clobetasol chrism and balm (Embeline© and Temovate©) accept been activated to the afflicted skin. The cream, which is accessible by prescription, helps abate redness, itching, and inflammation. Analysis with contemporary corticosteroids should not endure best than two weeks.

INTEGRATIVE THERAPIES

Unclear or adverse authentic evidence

:

Acupuncture

: Acupuncture is frequently acclimated throughout the world. According to Chinese anesthetic theory, the beastly physique contains a arrangement of action pathways through which basic energy, alleged “chi,” circulates. These pathways accommodate specific credibility that action like gates, acceptance chi to breeze through the body. Needles are amid into these credibility to adapt the breeze of chi. Acupuncture additional point-injection has been begin amiable for the analysis of hives, although added analysis is bare to affirm these findings.

Needles accept to be antiseptic in adjustment to abstain ache transmission. Abstain with affection valve disease, infections, bleeding disorders, medical altitude of alien origin, or acoustic disorders. Abstain if demography drugs that access the accident of bleeding. Abstain on areas that accept accustomed radiation therapy. Use carefully with pulmonary ache (such as asthma or emphysema). Use carefully in aged or medically compromised patients, diabetics, or with history of seizures. Abstain electroacupuncture with arrhythmia (irregular heartbeat) or in patients with pacemakers. Abstain if pregnant.

Bromelain

: Bromelain has been apparent to abatement inflammation, adapt the allowed system, and accept antiviral furnishings and may advice amusement derma rash.

Avoid if allergic to bromelain, pineapple, honeybee, venom, latex, besom pollen, carrots, celery, fennel, cypress pollen, grass pollen, papain, rye flour, aureate flour, or associates of the Bromeliaceae

family. Use carefully with a history of bleeding disorders, abdomen ulcers, or heart, liver, or branch disease. Use attention afore dental or surgical procedures or while active or operating machinery. Abstain if abundant or breastfeeding.

Butterbur

: Preliminary analysis suggests that butterbur may not abolish allergic derma ache reactions if compared to the decree biologic fexofenadine (Allegra©), which does abolish these reactions. Additional abstraction is needed. Use attention if allergic or acute to Petasites hybridus or added plants from the Asteraceae/Compositae ancestors (like ragweed, marigolds, daisies and chrysanthemums). Raw, chapped butterbur bulb should not be eaten due to the accident of alarmist or branch accident or cancer. Abstain if abundant or breastfeeding.

Calendula

: Apprenticed aboriginal analysis suggests that calendula extracts may abate derma inflammation. Beastly studies are defective in this area.

Avoid if allergic to plants in the Aster/Compositae ancestors such as ragweed, chrysanthemums, marigolds, and daisies. Use carefully in patients demography sedatives, claret burden medications, cholesterol medications, claret sugar-altering agents, and immunomodulators. Use carefully with diabetes and in children. Abstain if abundant or breastfeeding.

Jewelweed

: Jewelweed has been acclimated frequently as a analysis for assorted types of acquaintance dermatitis, including adulteration ivy/oak rashes and allergic dermatitis, however, beastly abstraction indicates that it may not be able for this use. Abstain if allergic or acute to jewelweed (Impatiens biflora), its constituents, or associates of the Balsaminaceae family. Use carefully if demography calcium supplements and with branch rock disorders. Abstain arresting balance amounts of jewelweed due to letters of top mineral content, decidedly calcium oxalate. Abstain if abundant or breastfeeding.

Marshmallow

:

Marshmallow extracts accept frequently been acclimated to amusement anarchic derma conditions. Several class experiments, mostly in the 1960s, appear acquiescent to accept anti-inflammatory action but apprenticed beastly abstraction is available. Safety, dosing, and capability compared to added anti-inflammatory agents accept not been examined.

Historically, acquiescent is about admired as getting safe in advantageous individuals. However, back studies accept not evaluated the assurance of marshmallow, able doses and continuance in bodies are not known. Allergic reactions may occur. There is not abundant authentic affirmation to abutment the safe use of acquiescent during abundance or breastfeeding.

Onion

: Aboriginal analysis shows that contemporary appliance of an alcoholic onion abstract decidedly bargain responses to allergies, such as hives and flares. Added analysis is needed.

Avoid if allergic or acute to onion (Allium cepa), its constituents, or associates of the Lilaceae family. Use carefully with hematologic (blood) disorders, diabetes, hypoglycemia (low claret sugar), and hypotension (low claret pressure). Use carefully if demography anticoagulants or antiplatelets (blood thinners). Abstain alleviative doses if abundant or breastfeeding.

Para-aminobenzoic acid

: Para-aminomethylbenzoic acerbic (PABA) may be advantageous in the analysis of lichen slerosus, a benign, accelerating dermatologic action characterized by inflammation, pruritus (itching), and pain, abnormally in the anogenital arena (involving the anus and genitals). Additional investigations are bare apropos the use of PABA for anarchic derma disorders.

Avoid with accepted hypersensitivity to PABA or its derivatives. Discontinue use if rash, nausea, or anorexia occurs. Abstain articulate use in accouchement and abundant or nursing women. Use carefully in patients with renal or alarmist disease. PABA should not be accustomed accordingly with sulfonamides. Use carefully in patients with bleeding disorders or demography anticoagulants. Use carefully in patients with diabetes or hypoglycemia.

Peony

: Peony basis may accept amiable furnishings on allowed function. These furnishings may advice abatement deepening associated with allergic derma reactions such as allergic dermatitis. There is currently not abundant affirmation to acclaim for or adjoin the use of peony in allergic derma conditions.

Avoid if allergic or acute to peony. Abstain with bleeding disorders or if demography drugs, herbs, or supplements that access bleeding risk. Use carefully with estrogen-sensitive cancers or if demography drugs, herbs, or supplements with hormonal activity. Abstain if abundant or breastfeeding.

Tea timberline oil

: Baby studies appearance that tea timberline oil activated to the derma may abate allergic derma reactions acquired by histamine-induced inflammation. Further analysis is bare to affirm these results.

Avoid allergic or acute to tea timberline oil (Melaleuca alternifolia), any of its constituents, analgesic of Peru, benzoin, colophony (rosin) tinctures, eucalyptol, or associates of the Myrtle (Myrtaceae) family. Abstain demography tea timberline oil by mouth. Abstain if demography antineoplastic agents. Use tea timberline oil activated to the derma carefully in patients with antecedent tea timberline oil use. Abstain if abundant or breastfeeding.

Thyme

: Historically, thyme has been acclimated topically for a amount of anarchic derma disorders. After-effects are mixed. Additional abstraction is bare in this area.

Avoid with accepted allergy/hypersensitivity to associates of the Lamiaceae (mint) ancestors or to any basic of thyme, or to rosemary (Rosmarinus officinalis). Abstain articulate assimilation or non-diluted contemporary appliance of thyme oil due to abeyant toxicity. Abstain contemporary affairs in areas of derma breakdown or injury, or in atopic patients, due to assorted letters of acquaintance dermatitis. Use carefully in patients with gastrointestinal affliction or comestible abscess ache due to anecdotal letters of gastrointestinal irritation. Use carefully in patients with thyroid disorders due to empiric anti-thyrotropic furnishings in beastly analysis of the accompanying breed Thymus serpyllum. Abstain if abundant or breastfeeding.

Traditional or abstract uses defective acceptable evidence

:

Burdock

: Burdock is a bulb that is built-in to Europe and arctic Asia. The basis is a lot of about acclimated in herbal preparations. Traditionally, burdock has been acclimated to amusement hives. However, there is currently no beastly affirmation on its assurance and capability for this use.

Avoid if allergic to burdock or added plants of the Asteraceae/Compositae ancestors (such as ragweed, chrysanthemums, marigolds, or daisies). Abstain with a history of dehydration, diabetes, affection disease, cancer, top claret pressure, or HIV. Stop use afore and anon afterwards surgeries or dental or analytic procedures with bleeding risks. Abstain if abundant or breastfeeding.

Chamomile

: Although chamomile has frequently been acclimated to amusement hives, authentic affirmation is lacking.

Avoid if allergic to chamomile or any accompanying plants, such as aster, chrysanthemum, mugwort, ragweed, or ragwort. Stop use two weeks afore and anon afterwards surgery/dental/diagnostic procedures with bleeding risks. Use carefully if active or operating machinery. Abstain if abundant or breastfeeding.

Detoxification analysis (cleansing)

: Detoxification is a ample abstraction that encompasses abounding altered modalities and substances acclimated in cleansing the body’s systems and organs. Detoxification has been appropriate as a accessible analysis for hives. However, there is currently no authentic affirmation of its assurance or capability for this use.

In cases of illness, the assorted forms of detoxification should be acclimated beneath able guidance. See specific monographs for precautions and warnings associated with modalities of detoxification.

Ephedra

: Ephedra is a accustomed stimulant. Traditionally, ephedra has been acclimated to amusement hives. However, there is currently no affirmation on the assurance and capability of ephedra for this use.

Even admitting this assemble has been appropriate as a abeyant analysis for hives, it is alarming for humans. Austere reactions, including affection attack, stroke, seizure, and afterlife accept occurred. The U.S. Aliment and Biologic Administration (FDA) has banned sales of ephedra comestible supplements. The FDA has calm added than 800 letters of austere toxicity, including added than 22 deaths. Abstain use in individuals adolescent than 18 years old. Abstain use for abiding periods (longer than seven days) due to accident of corruption or toxicity. Discontinue use at atomic one anniversary above-mentioned to aloft anaplasty or analytic procedures. Use carefully with cardiovascular disease, including structural affection disease, arrhythmia, coronary avenue disease, top claret pressure, cerebrovascular disease, and a history of achievement or brief ischemic attack. Use carefully with depression, all-overs disorders, anorexia/bulimia, a history of baleful ideation, insomnia, tremors, urinary retention, continued prostate, diabetes, branch disease, glaucoma, thyroid disease, and comestible abscess disease. Use carefully with monoamine oxidase inhibitor (MAOI) or analeptic use. Abstain if abundant or breastfeeding.

Kudzu

: Kudzu is an assemble that has been acclimated in Chinese anesthetic for abounding years. Traditionally, kudzu has been acclimated to amusement hives. However, there is currently no authentic affirmation on the assurance and ability for this use.

No well-designed studies on the abiding furnishings of kudzu are available. Abstain if allergic or acute to Pueraria lobata or associates of the Fabaceae/Leguminosae family. Use carefully with claret thinners and claret pressure-lowering agents, hormones, antiarrhythmics, benzodiazepines, bisphosphonates, diabetes medications, drugs that are metabolized by the liver’s cytochrome P450 enzymes, mecamylamine, neurologic agents, and methotrexate. Abstain if abundant or breastfeeding.

Moxibustion

: Moxibustion is a ameliorative adjustment in acceptable Chinese medicine, classical (five element) acupuncture, and Japanese acupuncture. During the therapy, an assemble (usually mugwort) is austere aloft the derma or on the acupuncture credibility in adjustment to acquaint calefaction into an acupuncture point and allay symptoms. There is apprenticed affirmation suggesting that moxibustion may advice amusement hives. Additional analysis is bare to appraise the assurance and ability of moxibustion for this use.

Use carefully over ample claret argosy and attenuate or anemic skin. Abstain with aneurysms, any affectionate of “heat syndrome,” affection disease, convulsions, cramps, diabetic neuropathy, acute fatigue and/or anemia, fever, or anarchic conditions. Abstain use over allergic derma conditions, abscessed sores, derma adhesions, or affronted areas or organs. Do not use on contraindicated acupuncture points, the face, genitals, head, or nipples. Use carefully in patients who accept just accomplished appliance or demography a hot ablution or shower. Use carefully in aged bodies with ample vessels. Not appropriate to ablution or battery for up to 24 hours afterwards a moxibustion treatment. Abstain if abundant or breastfeeding.

Peppermint oil

: Peppermint is a beginning bulb that grows throughout Europe and North America. Peppermint is usually developed for its ambrosial oil. Historically, peppermint has been acclimated to amusement hives. Further analysis is bare to actuate whether peppermint is safe and able for this use.

Avoid if allergic or acute to peppermint or menthol. Peppermint is about advised safe in non-allergic adults if taken in baby doses. Use carefully with G6PD absence or gallbladder disease. Menthol, which makes up allotment of peppermint oil, is about advised safe in non-allergic adults. However, doses of menthol greater than 1 gram per kilogram of physique weight may be baleful in humans. Abstain if abundant or breastfeeding.

Probiotics

: Probiotics are amiable bacilli that are sometimes alleged affable germs. They advice advance a advantageous civil and advice the physique abstract foods. They aswell advice accumulate adverse bacilli and yeasts in the gut beneath control. A lot of probiotics appear from aliment sources, abnormally able milk products. Although probiotics accept been appropriate as a accessible analysis for hives, there is bereft authentic affirmation on its assurance and ability for this use.

Probiotics are about advised safe and able-bodied tolerated. Abstain if allergic or acute to probiotics. Use carefully if lactose intolerant.

PREVENTION

Avoid articles that accommodate nickel: The alone way to anticipate abhorrence affection from alternating is to abstain nickel. The metal is present in abounding articles that are frequently used. Patients should abstain or abbreviate acquaintance with argent coins, keys, adornment (necklaces, earrings, bracelets, rings, and watchbands), belt buckles, zippers, buttons, bra hooks, suspender clips, pens, hair clasps, electrical shavers, paperclips, and ability accoutrement that accommodate nickel.

Patients can acquirement another articles that are not fabricated from nickel. For instance, patients can cautiously use black cardboard clips that are coated with plastic. Patients can abrasion hypoallergenic, stainless steel, solid gold, admirable silver, or artificial jewelry. Patients should attending for accouterment with plastic-coated or corrective metal zippers, buttons, or clasps.

Avoiding foods that accommodate nickel: Some healthcare providers may acclaim that patients abstain bistro aliment that contains top amounts of nickel (such as salmon, chocolate, nuts, grains, or canned fruits and nuts). However, it charcoal cryptic whether these foods can activate an allergic reaction. Further analysis is bare afore a close cessation can be reached.

Creating a barrier: If acquaintance with nickel is unavoidable, patients can abrasion artificial gloves. For instance, patients who are cashiers and handle argent bill consistently may account from gloves. Also, if a accommodating is borderline whether a section of jewelry, hair clasp, zipper, or added agnate artefact contains nickel, bright attach brightness can be activated to the item. This creates a barrier amid the patient’s derma and the product. Patients can aswell acquirement artificial covers for earrings that accommodate nickel. These covers, accessible at adornment stores, anticipate the nickel from affecting the derma and causing an allergic reaction.

AUTHOR INFORMATION

This advice has been edited and peer-reviewed by contributors to the Accustomed Standard Analysis Collaboration (www.naturalstandard.com).

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  • Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com. Copyright © 2009. Accessed May 25, 2009.
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Copyright © 2011 Accustomed Standard (www.naturalstandard.com)

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