Allergy to nickel is widespread and well documented. It is particularly associated with causing contact dermatitis – sometimes at sites remote from the spot where nickel has touched the skin. This can complicate diagnosis, but as nickel allergy is reliably detected by patch testing, it can be quickly identified as a cause of remote reactions.

It is hard to avoid nickel in daily life. It is found in metal coins, jewellery, wristwatches, spectacles, fastenings on garments, pins and metal buttons, metal handles, wire supports in bras and other support garments. It is also found in some medical uses such as the needles of hypodermic syringes, orthopaedic implants, some prostheses, heart valves, electrodes, and in some kinds of contraceptive intra-uterine device (coil).

Tapwater can also contain nickel, leaching from pipes and boilers. Filtering water will remove this. Stainless steel contains nickel, but it is only released when in contact with water or a liquid that is acid. Cooking acid foodstuffs, such as apples or rhubarb, in stainless steel utensils can cause nickel to be released. Some detergents, and sweat, also have the capacity to release nickel from stainless steel. For these reasons, although stainless steel is usually free of problems, it is probably best avoided for cooking utensils. Ceramic utensils are a good alternative. For avoidance of nickel in daily life, it is best to try and avoid wearing metal jewellery, watches, fastenings, buttons or anything else next to the skin, or even where sweat may carry it through a garment.

Some jewellery is labelled hypoallergenic (low-allergen) but other jewellery may contain nickel (for instance, some gold jewellery). Often jewellers will not know if a certain type of gold contains nickel or not. Wearing earrings particularly pre-disposes to nickel allergy and people sensitive to nickel should only wear stainless-steel earrings (which do not release their nickel) or more costly gold earrings free of nickel. Having the ears pierced only with stainless steel needles, and wearing stainless steel earrings for at least three weeks after piercing can help protect against nickel sensitivity developing, as can avoiding piercing ears in early childhood.

Chromates

Chromates are compounds of the metal chromium. They can cause allergy through contact in industrial and occupational exposure, and in daily life where chromates are used in tanned leather, in various toiletries and cleaning products, as a mordant in fixing dye to some fabrics, and a number of other uses, including in some match heads.

Chromates are a significant problem in allergic reactions resulting from exposure at work. One of the most common causes is cement in the construction industry. Other occupations that are vulnerable include printing, dyeing, photography, rust-proofing, enamelling, tanning, and handling wood treated with chromates. There may be no way to avoid these problems at work, although wearing face masks and gloves can help.

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