As guests watched, the goldsmith pierced baby Anusha's ears and pushed in the studs. The procedure was smooth; the pain would subside in a few minutes. But the baby didn't stop howling. Her ears went red and she frantically tried to scratch them. Quickly Anusha's mother asked the goldsmith to remove the jewellery. Later, a dermatologist told her the baby was allergic to something in the studs.
Jewellery allergy is a common cause of “allergic contact dermatitis” that occurs when our immune system develops intolerance to a particular element/chemical and reacts against it, explains consultant dermatologist Dr. Anand. “It should not be confused with irritant dermatitis in which there is a reaction to contact with irritants such as water, alkaline soap, solvents, acids, detergents and friction,” he says. “Typically allergy occurs within a few hours to days after contact with an allergen. Itching, redness and oozing at the site of contact are signs of allergy. The commonest are watch-strap, jewellery and rubber glove allergy.”
Nickel, the culprit
If jewellery causes itching, the main culprit is nickel, says Dr. V. R. Janaki, senior consultant dermatologist. (As little as 4-6 parts per million (ppm) of nickel or chromium can cause allergy.) If, because of sweat, it leaches into the skin in the form of nickel salts, chances of allergy are more, she adds. Lakhs of people wear jewellery, but 1-6 per cent may have allergic diathesis (predisposition). People say they have gold allergy, but that is very rare, she says. You may instead be allergic to soap, buttons or dirt attached to gold jewellery. Reaction could be immediate or delayed. It goes away when removed, but may cause redness and itching when worn again even after months, making the tendency near-permanent. Watch out if you have a sensitive skin! There is a lot of cheap jewellery around, doctors warn, and we don't know what goes into them. Nickel is added to the base metal to whiten and/or strengthen the piece which is then plated with gold or silver. You'll see allergic rash on earlobes (from earrings), fingers (from rings) and neck (from necklaces). They get uncontrollably itchy, red, blistered (acute dermatitis) or dry, thickened and pigmented (chronic dermatitis). You may also detect a pungent smell. Pompholyx, a blistering type of hand dermatitis, could occur from contact with nickel in coins, keys, zips and spectacle frames.
How will I know if my jewellery hides nickel? You won't be looking at the pretty piece you're set on buying. But if you're prone to metal allergy, assume all metal jewellery has some bit of Ni, except when it is made of surgical stainless steel, 14-24 carat gold, sterling silver or pure platinum. If that puts you in the will-accept-only-expensive-gifts category, enjoy your status! Spread the word among friends and family who are likely to gift you a piece.
Rhodium, a silvery white metal, is often used to plate yellow gold to convert it into white. The initial plating protects you against any nickel in the gold, but eventually wears off leaving white gold (+nickel) in contact with your skin. Similarly, silver-plated jewellery may contain nickel, plated with a fine layer of silver alloy. Gold alloys that contain palladium, silver and other white metals are safe. So, use hypo-allergenic metals or polycarbonate plastic. Do your must-wear ear studs contain nickel? Add plastic covers made especially for ear studs.
Remove the ring/bangle/chain at the first sign of itching. Sorry, you can't wear them again. Ask a dermatologist to do a simple skin patch test. Once your nickel (or titanium) allergy is confirmed, take extra care when you buy jewellery. Corrosion-doctors.org warns of “increasing susceptibility to nickel allergy” from body piercing. Have it done with a stainless steel needle. Ensure that nickel is not part of your dental filling/cap.
Insights into allergy
- Copper jewellery is considered pure.
- Eight earring sellers from >Etsy.com who hand-make jewellery say they have never had an allergy complaint.
- Wear jewellery for short periods of time. Keep the area which touches the jewellery clean and dry.
- Coat jewellery with clear nail polish, apply frequently.
- Have jewellery lacquered, plated or coated with palladium.
- If sensitivity to Ni is extreme you may need to avoid nickel-rich foods like fish and chocolate.
Some solutions
- Consult a dermatologist for relief.
- You may be prescribed cortisone, or a cream containing antihistamine or some antibiotic cream.
- Home remedies include application of weak tea, a paste of baking soda and water, or vitamin E oil.
- Apply a drop each of dimethylglyoxime and ammonium hydroxide to the metal item.
- Rub gently with a cotton bud. If it is clear, the item has no free nickel.
- If it turns pink, be warned. The chemicals, however, will not harm jewellery.
