TABLE 2

Handout for Patients

Nickel is a metal that is added to many metal objects to harden them. Nickel can be found in almost all costume jewelry (including earrings, necklaces, watch backs, rings, and bracelets), some belt buckles, and such jewelry as ball and chain necklaces, dog tags, metal tabs, grommets, and button flies.
When you sweat, the nickel is released from the metal, even if it is only a small amount or percentage of the metal. Stainless steel is a stronger white metal and does not release nickel as easily.
If you are allergic to nickel, your rash will keep returning until you avoid nickel completely. There are many steps required to avoid nickel completely. It is not easy, but it is necessary to make you feel better.
 1. Remove all nonessential metal from your clothing; replace button flies with plastic buttons and wear a belt that ties or has a plastic buckle.
 2. For metal that you cannot remove, such as grommets on the side pockets of your jeans or the back of your watch, coat with 2 coats of clear nail polish every week or after washings.
 3. Avoid sitting in shorts on metal chairs or plastic chairs with metal tabs.
 4. Do not cook acidic foods in stainless steel cookware. Avoid stainless steel cookware if you can.
 5. Tucking in your shirt does not prevent you from reacting to the nickel in your belt buckle or button fly.
 6. Avoid ear piercing, especially if dental work, such as braces, is expected.
 7. Sources of nickel in jewelry include costume jewelry, including earring posts that are not stainless steel, white gold, and all low-karat gold jewelry. Sterling silver and high-karat yellow gold jewelry are expected to have a low content of nickel but are not generally nickel free.
 8. Tests to look for nickel released from household metals can be found at the following Web sites: https://nonickel.com/collections/nickel-test-kit-for-jewelry-and-meteorites and https://www.delasco.com/spot-test-for-nickel/. More information can be found at https://athenaallergy.com/pages/how-to-test-for-nickel-using-nickel-alert-dimethylglyoxime-test.