Nickel Contact Allergy

Also known as: Nickel dermatitis, Metal allergy

Nickel is the most common cause of allergic contact dermatitis worldwide. The reaction occurs when nickel-containing metal contacts skin over time, causing an itchy, red, blistering rash at the point of contact.

Category

Contact Allergens

Severity

Mild to Moderate

Prevalence

Affects 10–15% of women and 1–2% of men; particularly common from jewellery exposure.

Symptoms

Skin

  • Itchy, red rash at contact site
  • Dry, scaly patches
  • Blisters and fluid-filled bumps
  • Skin darkening at chronic contact sites

How It's Diagnosed

  • Patch testing — the gold standard for contact allergy diagnosis
  • A nickel-containing disc is applied under occlusion to the skin for 48 hours; read at 48 and 96 hours
  • Differentiate from irritant contact dermatitis (no immune component, more immediate)

Avoidance Strategies

  • Choose jewellery labelled '24-carat gold', 'surgical steel', or 'nickel-free'
  • White gold often contains nickel — check the formulation
  • Belt buckles, watch clasps, jeans studs, spectacle frames, and bra clips are common nickel sources
  • Coat metal items with clear nail polish as a short-term barrier
  • Avoid prolonged skin contact with coins, keys, or metal tools

Nickel in food: systemic contact dermatitis

A small subset of severely nickel-sensitised patients develop systemic contact dermatitis — widespread eczema triggered by dietary nickel. High-nickel foods include wholegrains, legumes, chocolate, nuts, and seeds.

A low-nickel diet is rarely necessary and should only be pursued under specialist guidance after patch-test confirmation of severe sensitivity.

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Medical disclaimer

This page is for educational purposes only. Allergy diagnosis and management must be carried out by a qualified allergist. Do not attempt to test yourself with suspected allergens. Always carry prescribed emergency medications and follow your written action plan.

Reviewed 2026-06-01 · Looms Medical Team