Metal in Everyday Items Can Trigger Reactions

By Melissa Cassutt, The Gazette, Colorado Springs, Colo.

Mar. 10–Breanna Johnson started breaking out with tummy rashes when she was 4 years old.

Her mom tried to soothe her skin with cortisone cream, and when that didn’t work she tried covering the area with a Band-Aid. The rashes got worse as Breanna got older. Necklaces caused tiny bumps on her neck, and earrings irritated her lobes.

Suspecting a skin allergy, her mom, Debbie, took Breanna to the Colorado Springs Allergy & Asthma Clinic for patch testing.

A series of stickers steeped in common allergens were placed on Breanna’s back to sit for 48 hours. Positive reactions vary from a mild rash to a blister.

After two days, Breanna was itchy in one spot — a sign of a moderately severe reaction to nickel.

Though skin allergies, also known as contact dermatitis, aren’t as common as “true allergies” (reactions to allergens such as cat dander or peanuts, which can escalate to anaphylactic shock), the rashes can be prolonged and severe. Local allergists say patients can spend years with intensifying rashes before discovering the problem.

And unlike true allergies, shots and pills do not help the body adjust its reaction.

“The No. 1 therapy is avoidance,” says Dr. Daniel Soteres, allergist at Asthma & Allergy Associates in Colorado Springs.

After Breanna, now 8, tested positive for a nickel allergy, Johnson honed in on metal of any kind — buttons, jewelry, even the metal edging of her daughter’s desk that caused Breanna’s elbows to break out in a rash.

“We just count everything as being nickel,” says Johnson, 28.

Nickel is a common component of buttons, belts and zippers, but can also be found in unforeseen places such as umbrellas, razors, eyelash curlers and bike handlebars. Jewelry is often made partly of nickel — even pieces that appear to be gold.

“The most common thing that we test for that we get positive for is nickel,” says Dr. Cory Dunnick, assistant professor of dermatology at the University of Colorado at Denver School of Medicine.

Most metal and metal plated items contain some nickel and cobalt, including silver and 14-karat gold alloys, according to a handout provided by the University of Colorado Hospital. Cobalt ranks 10th on the list of common skin allergies, according to a 2001-02 study by the North American Contact Dermatitis Group.

Allergists aren’t sure why some people are allergic to cat dander and others break out in rash from nickel contact. But allergies, in general, are reported to be on the rise. More than half the people in the United States have at least one allergy, some studies indicate. There may be a few reasons for this:

– Genetics. A child has a 50 percent chance of developing an allergy if a parent has allergies; the percentage increases to 75 percent to 80 percent if both parents have allergies. The strange thing: Children aren’t necessarily more likely to develop allergies to the same things as their parents, Soteres says.

– A cleaner environment. “Nowadays if the cookie hits the floor, it goes in the trash,” says Dr. Eric Caplan, allergist at the Colorado Springs Allergy & Asthma Clinic. “We think that the body’s immune system gets bored easily.”

What docs know for sure is: “No one is born into this world allergic, so you have to encounter the thing for some degree of time,” Caplan says. “There’s really not a lot of predicting who can tolerate what.”

But singling out the offending skin allergens in clothing and cosmetics can be difficult. Few products list all ingredients, and even items labeled “hypoallergenic” aren’t necessarily safe because there are no regulations on products that carry that tag.

If ingredients aren’t listed, Soteres suggests a short trial — place the cosmetic or product on the forearm and cover for at least 48 hours.

Easy-to-use kits can test for metals. Allerderm’s nickel allergy test, for example, combines a drop of Solution A (dimethylglyoxime) with a drop of Solution B (ammonium hydroxide) on a cotton swab for a mixture that will turn red after 15 seconds of rubbing on metal that contains nickel.

Johnson hasn’t tried the nickel test yet — but she scrutinizes all metals that touch her daughter. Buttons are covered with patches, and only nickel-free jewelry is purchased.

“She knows what bugs her and what not to wear,” Johnson says. “She knows if she gets jewelry for Christmas, she’s got to try it on before she can really depend on it. She knows when it starts itching, to get it off of her.”

CONTACT THE WRITER: 636-0152 or melissa.cassutt@gazette.com

TOP 10 SKIN ALLERGIES

1. Nickel ………………………………16.7 percent

2. Neomycin …………………………11.6 percent

3. Balsam of Peru ………………….11.6 percent

4. Fragrance …………………………10.4 percent

5. Thimerosal ……………………….10.2 percent

6. Gold ……………………………….10.2 percent

7. Quaternium-15 …………………….9.3 percent

8. Formaldehyde …………………….8.4 percent

9. Bacitracin …………………………..7.9 percent

10. Cobalt ………………………………7.4 percent

SOURCE: North American Contact Dermatitis Group. The 2001-02 study tested 65 allergens on a pool of 4,913 patients. Results are Not indicative of general population incidence.

—–

To see more of The Gazette, or to subscribe to the newspaper, go to http://www.gazette.com.

Copyright (c) 2008, The Gazette, Colorado Springs, Colo.

Distributed by McClatchy-Tribune Information Services.

For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.