Metal allergy

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Metal allergy
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Dermatitis, itching, rash, swelling
Complications	Chronic dermatitis, infection
Onset	Varies, often after repeated exposure
Duration	Chronic or recurrent
Types	N/A
Causes	Hypersensitivity to metals such as nickel, cobalt, chromium
Risks	Jewelry, piercings, dental work, orthopedic implants
Diagnosis	Patch test
Differential diagnosis	Contact dermatitis, atopic dermatitis, psoriasis
Prevention	Avoidance of known allergens
Treatment	Topical corticosteroids, antihistamines, emollients
Medication	N/A
Prognosis	N/A
Frequency	Common, especially in women
Deaths	N/A

Metals implicated in allergies

Georgia May gets her ears pierced

Metal Allergy is a type of allergic reaction that occurs in response to exposure to certain metals. This condition is also known as metal hypersensitivity and can affect various parts of the body, leading to a range of symptoms from skin irritations to more severe systemic reactions. The most common metals that cause allergies include nickel, cobalt, and chromium, though individuals can also be allergic to gold, silver, and mercury, among others.

Causes and Mechanisms

Metal allergy is primarily caused by the immune system's overreaction to the presence of specific metal ions in the body. When these ions come into contact with the skin or are implanted in the body, they can bind to proteins, forming a complex that is recognized as foreign by the immune system. This recognition triggers an immune response, leading to an allergic reaction. The exact mechanism can vary between individuals, with some reactions being immediate (Type I hypersensitivity) and others delayed (Type IV hypersensitivity).

Symptoms

Symptoms of metal allergy can range from mild to severe and may include:

• Dermatitis: Red, itchy, and swollen skin at the site of contact with the metal.
• Blisters and lesions: In severe cases, prolonged exposure can lead to blistering and lesions.
• Systemic reactions: Rarely, individuals may experience systemic symptoms such as joint pain, fatigue, and in very rare cases, organ dysfunction.

Diagnosis

Diagnosis of metal allergy typically involves a detailed medical history and physical examination, followed by patch testing. Patch testing is the gold standard for diagnosing contact allergies to metals. During this test, small amounts of various metals are applied to the skin, usually on the back, and covered with patches for 48 hours. The skin is then examined for any allergic reactions.

Treatment

The primary treatment for metal allergy is avoidance of the offending metal. For skin reactions, topical corticosteroids may be prescribed to reduce inflammation and itching. In cases where metal implants are the cause of the allergy, removal of the implant may be considered, though this is a last resort due to the complexity of such procedures.

Prevention

Preventing metal allergy involves avoiding direct contact with known allergenic metals. This can include choosing jewelry made from hypoallergenic materials, using protective barriers such as clothing or gloves, and being aware of the metal content in personal care products.

Images

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  Epikutanni test

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  2+ reaction

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  Wrists adorned with beads

See Also

• Allergic reaction
• Dermatitis
• Patch testing
• Hypersensitivity

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