With an increase in hand-washing and the use of hand sanitiser during the past year, many people are noticing that their skin is a little more sensitive than usual. As a jeweller, this is something that I am perhaps more aware of than others as the pieces I make are in direct contact with my customers' skin. But what exactly is a jewellery allergy, how can you tell it apart from other skin reactions, and what can you do about it?
Firstly, a disclaimer: this article is written for general interest and is not meant to replace medical advice. If you are worried or experiencing ongoing symptoms, please get in touch with a pharmacist or doctor.
What is a jewellery allergy?
Jewellery allergies can occur when jewellery containing an allergen is in regular or constant contact with the skin. The allergen causes the skin to become red, itchy and/or hot; it may blister, weep a clear, sticky fluid or crust over; the skin may become dry, thickened and cracked - this is called "contact dermatitis". These allergies typically occur with earrings (in pierced ears), rings and metal watch straps or buckles.
People tend to develop a sensitivity to the allergen over a period of time and will notice a reaction starting sooner the more they are exposed to the allergen. Not everyone will develop an allergy and they tend to be more common in women than in men. If soreness, itchiness or reddening is happening in an area that is larger than or not directly next to the jewellery, it is more likely to be due to something else.
What is it not?
A jewellery allergy is NOT the skin turning black or green with no irritation. That is just the oxides that form on the surface of the metal being transferred to the skin, which is harmless. It tends to happen with copper, brass, bronze and to some extent, sterling silver.
Jewellery is also not known to trigger anaphylaxis, which is a severe allergic reaction and a medical emergency. It should be noted that any allergen has the potential to cause anaphylaxis, but it is most likely to occur from insect stings, certain foods and medicines. If you suspect you or a someone you are with is suffering from this, seek medical help immediately.
What can cause a jewellery allergy?
Many jewellery allergies are caused by the metal that the piece is made from. The most common culprit is nickel which has commonly been used as a base metal in costume jewellery before being plated in silver or gold. Nickel is a good alloying agent (metal that is mixed with other metals) as it improves properties such as corrosion resistance, especially in stainless steel. This makes it excellent for door handles as skin is not in contact with them for long periods of time. But for jewellery, not so much! Even plated items can cause problems as the plate wears off over time, leaving the base metal exposed. In the UK, there is a limit on how much nickel is allowed to "leach out" from jewellery into the surrounding skin (technically the nickel content itself isn't limited), but in practise, it is better to avoid using nickel in jewellery altogether.
Two alternative metals that are used in costume jewellery are cobalt and chromium. Whilst both these metals can cause allergies, they both have a lower prevalence than nickel. One issue with cobalt, however, is that it tends to be contaminated with nickel which can make it difficult to distinguish between a nickel allergy and a cobalt allergy.
A relative newcomer to the jewellery scene, palladium is growing in popularity as an alternative precious metal. Because it is relatively new, we only have limited data showing it causing jewellery allergies, and from the data we have, its prevalence is considerably less than that of nickel. However, there is some evidence of a link between nickel sensitivity and palladium sensitivity: people who are already sensitised to nickel are more likely to develop a sensitivity to palladium than those who aren't.
From a newcomer to one of the oldest metals known to humans, copper is considered to be a very weak "sensitiser" compared with other metals such as nickel. It is used in medical applications such as the intra-uterine device (IUD, also known as "the coil") where it will sit inside the body for many years, so we have plenty of evidence showing that reactions to this metal are very rare and most people will have no problems wearing it as jewellery.
The common alloys of copper, brass (copper and zinc) and bronze (copper and mostly tin), have also been used in jewellery-making since ancient times. Although they might leave a greenish tinge to the skin, they do not commonly cause an allergic reaction when worn.
The three white metals that are most commonly used in the jewellery industry, silver, platinum and titanium, have a few isolated reports of being associated with allergies, but are not generally known to be sensitising metals. Like copper, titanium is used in medical devices such as replacement hips, where it needs to be strong, lightweight and inert in the body. Along with medical grade stainless steel, titanium is usually recommended for body piercing jewellery. The majority of reports of silver reactions are most likely due to the metal not actually being silver, or having a relatively high nickel to silver ratio.
Finally, allergic reactions to gold, whilst very rare, are not unheard of. It is more likely to occur in lower carat golds, especially white gold as the pure metal is alloyed with other white metals to achieve the white hue. It probably won't come as any surprise that one of the white metals that has historically been used in white gold is... nickel. Most modern white golds produced in the UK and Europe no longer contain nickel, but antique pieces may. It is still worth noting that gold itself is recognised as an allergen.
It is also quite common for a reaction to occur due to a build-up of dirt, grease or sweat under a piece of jewellery or a watch strap. This certainly accounts for most reports of reactions to hypoallergenic silicone watch straps that populate the fitness device industry at present, especially when there is no metal present.
Jewellery allergies don't commonly occur with gemstones, pearls or amber, partly because they are less likely to be in direct contact with the skin.
What can I do about jewellery allergies?
Firstly, if you start to experience any of the symptoms in the skin right next to a piece of jewellery, take it off immediately. Give your jewellery or watch strap a good wash (soap and hot-to-the-touch water should be fine for most pieces), and gently rinse the affected area with lukewarm water. Allow the skin to settle for a few days before trying again. If you repeatedly get a reaction to a certain piece of jewellery, you may have to stop wearing it altogether. If the reaction doesn't settle even after removing the jewellery, speak to a pharmacist or doctor.
If you are thinking of buying a special piece of jewellery such as a wedding ring and suspect that you have a gold allergy, consider alternative precious metals such as platinum, titanium or silver. You could consider getting a patch test if you have your heart set on gold.
Avoid wearing cheap costume jewellery regularly or for long periods of time. Try to buy silver jewellery that bears a hallmark (note: a 925 stamp on its own is not a hallmark - look for a maker's mark, fineness mark and assay office mark. You can find out more about hallmarks here). When buying gold, opt for a higher carat if you can, especially if you're buying white gold. You could also ask your jeweller for more information on their gold - most metal refiners in the UK have stopped using nickel entirely in their gold and silver.
If you are looking for a special piece of jewellery but are worried about allergies, you can get in touch with me to discuss various options. For example, I am in regular contact with my metal refiners and can easily find out the composition of most of the silver and gold that I use in my pieces.
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Take care! Until next time,