What are the other Names for this Condition? (Also known as/Synonyms)

• Allergy to Jewelry
• Jewellery Allergy

What is Jewelry Allergy? (Definition/Background Information)

• Jewelry Allergy is an allergic condition that manifests as an abnormal immune reaction/response of the skin to certain metals found in jewelry. It is described as a form of allergic contact dermatitis that is manifested as skin rashes and lesions on the jewelry contact areas such as the neck, ears, and fingers
• Most jewelry is made of inexpensive metals, most of which includes nickel. Nickel is a very common allergen causing allergic contact dermatitis. Some jewelry is simply electroplated (coated) with a thin layer of one or more precious metals, such as gold or silver. This coating can wear off, exposing skin to the more allergenic metals
• Expensive jewelry is made of solid precious metals such as gold, silver, and platinum. However, nickel is used in trace quantities in many alloys, especially white gold. It is reported that most individuals who develop Jewelry Allergy are allergic to the metal nickel. However, gold itself can be the causative allergen, though to a lesser extent

Who gets Jewelry Allergy? (Age and Sex Distribution)

• Jewelry Allergy may be observed in any individual, whether a child or an adult
• Both males and females are affected. However, since girls and women more frequently wear jewelry, they are at a much higher risk for allergic skin reactions
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Jewelry Allergy? (Predisposing Factors)

The risk factors for Jewelry Allergy include:

• Wearing any form of jewelry or metal ornaments, such as necklaces, bracelets, earrings, nose rings, bangles, and anklets, including metal watch straps
• Handling or using coins made of precious metals
• Some ornaments are made with gold or silver coating on a base metal; when the coating wears off, contact with the base metal may result in an allergy
• Any family history of skin allergies may put one at a higher risk for the same
• Having one form of allergy may place one at risk for other allergy forms
• Individuals with sensitive skins are also at risk for the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Jewelry Allergy? (Etiology)

An allergic reaction occurs in an individual with Jewelry Allergy because the immune system recognizes certain ornamental metals, such as nickel, gold, or silver, as being dangerous and harmful to the body.

Jewelry Allergy is a type of allergic contact dermatitis caused from factors including:

• Metals present in the jewelry (frequently nickel)
• Individuals with sensitive skin (exposure to some precious metals) are more susceptible to the condition

It is important to note that ornaments made from pure forms of precious metals, such as gold, silver, or platinum, are less prone to skin allergies. However, 24-carat (pure) gold is very soft and prone to bend or scratch. Gold is most frequently alloyed with nickel, copper, silver, or nickel. It is observed that gold alloyed with only copper is least likely to cause allergic reactions.

Nevertheless, not all cases of adverse skin reactions to jewelry may be considered as Jewelry Allergy:

• In some cases, bacterial infections may arise at the site of metal piercings such as on the nose, ear lobes, or belly button
• Minor trauma caused by wearing jewelry may be a site for other skin conditions such as psoriasis or vitiligo
• Friction caused between the skin and ornaments (rough edges/sides or dirt) may result in irritant-induced contact dermatitis
• Water and soap film, or moisturizer components trapped under a ring can lead to irritant dermatitis, allergic contact dermatitis, or yeast infection

What are the Signs and Symptoms of Jewelry Allergy?

The signs and symptoms of Jewelry Allergy may vary from one individual to another. In some it may be mild, and in others, severe. The presentations may include:

• Presence of skin rashes (of reddish discoloration) on the areas of contact with the metal jewelry
• The condition may be acute or chronic
• Acute cases may show reddish discoloration with blister formation; these may be severely pruritic (itchy)
• Chronic conditions may manifest as dry skin that is thickened and discolored (usually darkly pigmented)
• Constantly touching or feeling the metal ornaments may also result in hand dermatitis
• The common areas presenting skin lesions include the ears, nose, neck, chest, wrists, fingers, and toes

How is Jewelry Allergy Diagnosed?

A diagnosis of Jewelry Allergy may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation, including use of sunscreens and other cosmetics
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin patch test
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Jewelry Allergy?

The possible complications due to Jewelry Allergy include:

• Emotional stress due to cosmetic issues
• Superimposed bacterial and fungal skin infections
• Recurrence of the condition

How is Jewelry Allergy Treated?

The treatment measures available for Jewelry Allergy include:

• Immediately removing the precious metal ornament(s) causing the condition
• Use of moisturizing creams
• Use of topical steroidal creams
• Anti-allergic medications, as necessary
• Administration of antibiotics or antifungals for secondary infections, as needed

How can Jewelry Allergy be Prevented?

Jewelry Allergy may be prevented by considering the following steps:

• Avoid contact with the offending metal that is causing the allergy; use suitable alternatives made of other elements
• Ensure to use pure gold or silver ornaments; some reports inform that stainless steel or plastic piercings are less prone to causing skin reactions at the contact site
• Where possible, encase the jewelry contact surface in plastic, to avoid direct skin exposure to the offending metal alloy
• Drying skin thoroughly before putting on jewelry
• Buy jewelry from authorized or well-established dealers

What is the Prognosis of Jewelry Allergy? (Outcomes/Resolutions)

The prognosis of Jewelry Allergy is generally good with appropriate treatment, including removal of the offending jewel/ornament.

Additional and Relevant Useful Information for Jewelry Allergy:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/