After receiving a body piercing, did your skin break out into a rash? When this happens, your skin probably isn’t reacting to the piercing itself but rather to the nickel in your jewelry. Unfortunately, body piercings offer a direct route for metal exposure, so the more piercings people get, the more likely it is that they’ll develop a sensitivity.
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A metal found in many everyday items (including inexpensive jewelry), nickel is a common rash-producing culprit. And, it’s difficult to avoid it, says dermatologist Alok Vij, MD.
“Nickel is everywhere around us. It’s in coins, car and house keys, belt buckles, clothing buttons, home fixtures, and cheap or costume jewelry,” he says. “We’re exposed to it all the time.”
Does this mean you have to abandon your piercings? Dr. Vij answers common questions.
Q: What does a nickel reaction look like?
A: Unlike poison ivy, which quickly causes a reaction, a nickel response happens slowly with repeated or prolonged exposure. In most people, it causes excessive itchiness and a dry, scaly red rash — also known as allergic contact dermatitis. It can also cause dark skin splotches in some cases.
But, because it’s a skin sensitivity, your body’s reaction likely isn’t as severe as a full-blown allergic response. Nickel exposure doesn’t cause the same swelling and breathing difficulties that a bee sting might, for instance.
Q: How does nickel sensitivity develop?
A: The cause is unknown, Dr. Vij says.
“There’s some thought that a little bit of nickel may allow your body’s immune system to see it and develop a tolerance,” he says. “Just touching your skin or mouth creates tolerance, but if you have something that breaches the skin or is internal — such as a piercing or a hip or knee replacement — there’s a greater nickel concentration and your body’s immune system will react more strongly.”
Several studies confirm this. One study found that nearly 30% of those with ear piercings had a nickel sensitivity, while only about 3% of those without ear piercings had one.
Another study found that those who had braces and ear piercings had a high nickel sensitivity rate, but those who got braces first had a lower rate. Having braces alone did not create a nickel sensitivity, the study found.
Q: Will more piercings make the reaction worse?
A: Yes, if your jewelry contains nickel. The more nickel that breaches your skin, the higher your rash risk, Dr. Vij says. Your immune system is conditioned to react each time you’re exposed, so you could develop worsening eczema if you continue to wear jewelry that contains nickel.
“With one-time exposure, such as having your ears pierced, you might not develop a reaction,” he says. “But, after more exposures — six to eight or more — your body will have a greater likelihood of a response.”
Q: Are there pre-existing risk factors for developing nickel sensitivity?
A: There is some indication that those with atopic dermatitis, asthma or infant eczema are at greater nickel sensitivity risk, Dr. Vij says. There aren’t other identified risk factors.
Q: How can you manage or treat a nickel sensitivity?
A: If you develop a rash, your doctor can provide topical steroids — or oral steroids for more serious cases — to help get your reaction under control.
But you won’t have to abandon your piercings. The easiest thing to do is avoid nickel, Dr. Vij says. Make sure all your jewelry is either 18-karat gold, sterling silver or hypoallergenic surgical steel.
“The reaction will continue as long as you continue exposure,” Dr. Vij says. “With nickel, this is one of those things in dermatology that we can find a cure for. Just avoid it.”
