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I have an allergic reaction to most of my jewelry, including gold. Can I wear stainless steel?
Absolutely! Stainless steel is the most biocompatible (hypoallergenic) element known to man and will not irritate even the most sensitive skin. This is a blessing for pierced products. Unlike other jewelry materials, stainless steel does not need other alloys to harden the material. Many alloys create negative reactions with our body chemistry. Stainless steel can be safely and comfortably worn by everybody.

What is Stainless Steel?

Stainless steel contains chromium, and other alloying elements that keep them bright and rust resistant in spite of moisture or the action of corrosive acids and gases. Because of their shining surfaces, architects often use them for decorative purposes. Stainless steels are used for the pipes and tanks of petroleum refineries and chemical plants, for jet planes, and for space capsules. Surgical instruments and equipment are made from these steels, and they are also used to patch or replace broken bones because the steels can withstand the action of body fluids. In kitchens and in plants where food is prepared, handling equipment is often made of stainless steel because it does not taint the food and can be easily cleaned.

Nickel Exposure
Nickel is often mixed with other metals to produce an alloy. Gold jewelry of 14 karats or less may contain enough nickel to provoke a reaction. Even though pure sterling silver contains no nickel, it is often coated with it. White gold alloy often contains nickel.
Stainless steel contains nickel but its structure is such that the nickel is unable to escape or to be leached out by perspiration or moisture.

The word hypoallergenic may be misleading on some jewelry. The posts may not contain nickel but the jewelry might.

Besides jewelry, nickel may be found in belts, clothing hooks, eyeglasses, hairpins, metal buttons, watches, and zippers. Also consider cigarette lighters, cupboard handles, doorknobs, handbag catches, keys, key rings, kitchen utensils, lipstick holders, needles, paper clips, pins, pens, pocket knives, powder compacts, razors, scissors, silverware, thimbles, toaster, tools, and vacuum cleaners as potential sources of nickel.

Does It Contain Nickel?
There are kits available to test items for nickel content. The kit consists of two small bottles of clear fluid; one contains dimethylglyoxime and the other ammonium hydroxide. When mixed together in the presence of nickel, a pink color results. Ask your doctor or pharmacist where you can purchase one of these kits.

Contributing Factors
Factors that contribute to nickel contact dermatitis may include sweat, humidity, temperature, the general condition of the skin, and occlusion (e.g. by gloves).

Should Foods Containing Nickel Be Avoided?
There is disagreement within the medical community, whether a nickel-sensitive person should avoid dietary nickel. A nickel-restricted diet may be prescribed for highly nickel sensitive people for a few months to see if there is any improvement in symptoms.
In this instance, the foods to avoid include acid foods cooked in stainless steel utensils, baking powder, beans, buckwheat, canned fruits, canned vegetables, cacao & chocolate, dried fruit, figs, green beans, kale, leeks, legumes, lentils, lettuce, licorice, linseed, millet, nuts, oats, onions, oysters, peas, pineapple, prunes, raspberries, salmon, shellfish, soy powder, spinach, rhubarb, sprouts, sunflower seeds, tea, tomatoes, wheat bran products, and multigrain breads.

Treatment
There is no way to desensitize a person with nickel allergy with shots, pills, or any other method. Avoiding use of nickel containing products is the key in treatment. Often times a rash can be stopped by applying a cortisone cream or lotion.
For more information on nickel allergy, please refer to the collected Internet links.
Nickel salts may cause a primary irritant reaction of the skin, but the main effect of dermal exposure to nickel is allergic contact dermatitis. Contact dermatitis is the most common of the health effects associated with exposure to nickel, and it has been seen in both non-occupationally and occupationally exposed individuals.  

Contact allergy is never inborn, although there may be some genetic factors that play a role in the development of the allergy (Menné and Nieboer, 1989). An individual must first become sensitized. Sensitization and subsequent allergic reactions to nickel require direct and prolonged contact with nickel-containing solutions or items that are non-resistant to sweat corrosion. Nickel-containing alloys and materials that do not react to sweat will not cause contact dermatitis. There are many such alloys, the most important of which are various forms of stainless steels. Although it is possible for certain high-sulfur grades of stainless steel to undergo corrosion in sweat under adverse conditions, such circumstances are uncommon and most stainless steels are not of these grades (NiDI, 1992).  
Other factors related to nickel sensitivity include humidity, temperature, occlusion (e.g. by gloves), and the general condition of the skin (i.e. the susceptibility of the skin to permeation by irritants and/or sensitizers).  

Dermatitis may first appear as a papular erythema of the areas that have prolonged contact with nickel; lesions become eczematous in the chronic stage (Sunderman et al., 1986). The underlying immunological mechanism is one in which the nickel ion penetrates the skin and combines with a high molecular weight protein giving rise to an antigen. The antigen is transmitted through Langerhans cells to T-cells that then migrate to regional lymph nodes where they proliferate and differentiate into memory and effector cells that circulate to all tissues. Future recognition and response to the nickel antigen is thereby guaranteed (Menné and Nieboer, 1989).  

Nickel dermatitis may occur in sensitized individuals following contact with nickel-containing items such as jewelry (particularly pierced earrings), zippers, buttons, and other objects; by nickel leaching from implants and prostheses; and following occupational exposures. Hypersensitivity to nickel is more prevalent in women than in men. This prevalence is probably due, in large part, to the continuous exposure that women receive upon first piercing their ears and inserting sweat-corrosive, nickel-containing posts into the open wound. It is estimated that 8 to 15 percent of the female population is nickel sensitized; estimates for men range from 0.2 to 2 percent (Sunderman et al., 1986; Menné and Nieboer, 1989).  

Although most nickel sensitization results from non-occupational exposures, nickel dermatitis has been observed in the workplace. Historically, in workplaces where continuous contact with soluble nickel was high, risks for nickel dermatitis were likewise high. For example, nickel dermatitis was common in the past among nickel platers. Due to improved industrial and personal hygiene practices, however, reports over the past several decades of nickel sensitivity in workplaces, such as the electroplating industry, have been sparse (Fischer, 1989). Further, evidence suggests that dry, clean operations with moderate or even intense contact with nickel objects will seldom, alone, provoke dermatitis (Fischer, 1989).  

While reports of nickel dermatitis are now rare in most workplaces, there are occupations for which hand eczema has been reported in higher proportion than the general populace. These include cleaning (where wet work is involved), hairdressing, and hospital wet work (Fischer, 1989). In such circumstances, the eczema may be aggravated by contact with nickel. Wet working, particularly hairdressing or where detergents are used, may cause deterioration of the skin, allowing penetration by irritants or sensitizers, including nickel.  

Experimental challenge via oral exposure to nickel has been shown to trigger dermatitic flares in nickel sensitized individuals. However, the clinical significance of this is somewhat controversial (Veien et al., 1990). Review of the literature on this topic reveals that a single dose of < 1.0 mg soluble nickel sulfate produces few flares of dermatitis, whereas 2.5 mg causes reactions in 50 percent of the patients tested and 5.0 mg nickel causes reactions in 75 percent of those tested. Some investigators have also seen reactivation of nickel patch test sites following oral challenges with doses of 2.5 to 5.0 mg nickel. As these doses are considerably higher than the average daily intake of nickel from food (0.15 mg) and have been administered as single doses of nickel salt, the significance of these findings for nickel sensitive individuals is questionable. Other studies have found no reaction in nickel-allergic patients exposed to doses ranging from 2.5 to 4.0 mg nickel (Burrows et al., 1981; Gawkrodger et al., 1986).  
The difficulty in evaluating the role of oral challenge in nickel sensitive individuals is due to the confounding factors that can influence the amount of nickel that actually reaches the target cells, including the type and amount of food present in the gut at the time of nickel ingestion, the patient's degree of nickel sensitivity, and the bioavailability of the nickel compound. Thus, within the medical community, there is disagreement as to the value of restricting dietary nickel intake in nickel-sensitive persons. 

Q: Why am I allergic to some gold jewellery?
Every year we get a few customers who believe that they cannot wear gold jewellery because they get an allergic reaction to it. Some believe that they are allergic to gold. We have never yet known anybody who was allergic to pure gold.
The most common cause of allergic reactions to jewellery is nickel contained in the alloy. Nickel is, or was, frequently used in white gold alloys because it is inexpensive, hard, and has a strong whitening effect. Better quality white gold alloys use palladium, which has excellent properties but is more expensive.

An EC directive is due to come into force soon which will regulate the use of nickel in any articles including jewellery, and restrict its use to very low proportions.
The directive has two components:-
Content
To be considered nickel-directive compliant, an article must contain no more than 500 parts per million of nickel. This applies to articles which may be in contact with broken skin, such as ear-rings.
Release
This applies to all articles which may be in close and prolonged contact with skin. The release rate calculation is not simple, but items must not exceed 0.5 micrograms nickel per square centimetre of surface per week. The rate applies to all new articles, and they must remain compliant for at least two years in testing.

Commonest Causes
The next commonest cause of allergies for jewellery wearers appears to be detergent or other chemicals which lodge between the jewellery, usually rings, and the skin. Hairdressers are often affected. Rinsing well can help, but it is probably best to remove rings before using any troublesome chemicals, and use a barrier cream.

Other Causes
A few jewellery wearers still seem to be slightly allergic to yellow golds, nickel cannot be the cause because it is not used in yellow gold alloys. In most cases sufferers only experience problems with low gold content alloys such as nine carat, so upgrading to a better alloy such as eighteen carat usually solves all problems.

Higher Carat Gold
The other common components of nine carat gold alloys are copper, silver and zinc. Zinc is usually very well tolerated, it is used in many medical preparations. Silver and copper do not usually cause allergic reactions, but both will form compounds with atmospheric pollutants which may be the cause of some reported problems. When copper and silver are present in high carat alloy such as eighteen or twenty two carat, they are more resistant to attack by chemicals, because they are bound more closely with the gold content, and this will explain why high carat alloys cause fewer problems.
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That itchy rash you get when you wear earrings might not be because you bought them from the sales rack; and the redness on your finger when you wear your wedding ring is not a "sign" that your marriage is in trouble. You may be one of the million of individuals who have allergic contact dermatitis. Look around you and at what you’re wearing. You may find the cause of your discomfort: you may have a metal allergy.
Speaking at the American Academy of Dermatology’s 2003 Annual Meeting in San Francisco, dermatologist Joseph F. Fowler, Jr., MD, spoke about allergic contact dermatitis and the various metals that can trigger it.
"Allergic contact dermatitis accounts for a significant number of visits to a dermatologist's office and is usually caused by substances that come into contact with the skin," said Dr. Fowler. "Metal is one of the most common culprits of allergic contact dermatitis especially due to the popular trend of body piercing which can lead to irritation and rashes in not only the earlobes, but upper portions of the ears, lips, nose, tongue, navel, breasts and genitalia as well."

After poison ivy, metal allergy is the most common form of allergic contact dermatitis. In the past, women have been more susceptible to metal allergy than men due to the amount of jewelry worn, but the numbers of males wearing jewelry is increasing and so is the incidence of metal allergy in this population.

Symptoms of metal allergy usually occur between six to 24 hours following exposure and will dissipate if exposure to the allergen is eliminated. The affected skin may become red, swollen, and blisters often appear, which may break, leaving crusts and scales. Later the skin may darken and become leathery and cracked. The rash is generally confined to the site of contact, although severe cases may extend outside the contact area, especially if the allergen is on your fingers and then transmitted to the face, eyelids or genitals.

"It’s important to note that allergic contact dermatitis, such as metal allergy, can be difficult to distinguish from other rashes," stated Dr. Fowler. "However, dermatologists can determine clues about the nature of a rash based on its location on the body and the patient's lifestyle and work habits."
Another way dermatologists can discover the source of an allergy is through patch testing. During patch testing, small amounts of possible allergens are applied to the skin on strips of tape and then removed after two days. An allergy shows up as a small red spot at the site of the patch and a dermatologist notes what the patient is most sensitive to.

Nickel
The most common of all metal allergens is nickel, which is found in costume jewelry, clothing ornamentation, such as zippers, buttons and snaps, and virtually all common metal objects. Approximately 16 percent of all individuals who are patch tested for allergies turn out to be allergic to nickel. Because sweat allows the metal ions to be better absorbed into the skin, areas on the body where nickel is present and where sweating may occur can see an increase in the severity of the dermatitis.

The most common location of nickel dermatitis is on the earlobes from earrings containing the metal. This reaction may start with the needle used to pierce the ears and continue as individuals begin to change their earrings daily. Dermatologists suggest that individuals with an allergy to nickel wear only nickel-free or plastic earrings.
Trace amounts of metal are found in food and people with sensitivity to metal can experience dermatitis.

In particular, beans, lettuce and whole-grain foods are high in nickel, but most people do not ingest enough of them to develop a serious rash.
"While nickel dermatitis is associated most often with costume jewelry or watchbands, which have a high concentration of nickel, it can occur with finer jewelry which is usually worn for prolonged periods, for example a wedding ring," said Dr. Fowler. "If sentimental reasons prevent you from not wearing an item on a daily basis, the best way to prevent the reaction is to have it plated in a non-allergic metal, such as platinum."

Cobalt
Cobalt is also a common allergen that is found in many of the same items that contain nickel, thereby making this allergen difficult to pinpoint. It is also found naturally in soil, dust and seawater. In the home, it is most often found in the blue pigments in porcelain, glass, pottery or ceramics, as well as blue and green water color paints and crayons. In the workplace, cobalt is found in cement, bricks and mortars.
"Combined allergic reactions are not uncommon and represent simultaneous specific sensations to each individual metals as opposed to being reactions to the combination," stated Dr. Fowler. "Whenever possible, patients are encouraged to avoid the allergen, use plastic or wooden items, such as kitchen utensils or scissors, and wear protective clothing and a face mask at their workplace."

Chromate
Chromate is another dermatitis-causing metal, which is also found in cement, but more commonly used as a leather tanning agent. "Shoe dermatitis" may result from leather containing chromates and patients should change their shoes and socks throughout the day especially if they are allergic or if there is excess perspiration.

In addition, some matches contain chromates and touching unlit matches can contaminate fingers. The fumes from a lit match and the charred match head also contain small amounts of chromate.

"When a metal allergy is suspected, it's important for people to seek the medical advice of a dermatologist especially since nickel, cobalt and chromate can all be found in some common metal objects that people may touch every day," said Dr. Fowler. "If avoidance of an item isn't possible, your dermatologist can recommend some other treatment options and lifestyle changes that can help patients live and work without the itchy rash of allergic contact dermatitis."