Jewelry, jeans and skin allergy testing– Musings of an NYC Dermatologist

blue jeans

Most little girls of West Indian descent of my generation had their ears pierced during infancy.  My mother waited until I was older to pierce mine.  It was because I was a twin.  She was concerned that my brother would see my bright shiny earrings and pull on them.  As I waited years to be allowed to wear earrings, like all the other little girls, it was impressed on me that it was important to take care of my ears should I get them pierced.  I was warned that poor care could result in infection—and that my holes would close up.

I finally had my ears pierced when I was seven years old.  My mother, a physician, did it in the living room with a surgical needle and a potato.  I had suture in my ear for at least a month.  Then I graduated to getting real earrings.  The starter earrings were gold.  Then I expanded to other fun earrings.  I took care of my piercings, cleaning them regularly with alcohol, but I always had problems.  My ears would get itchy and red.  They would crust.  I’d put antibiotic ointment on them—it didn’t help.  Eventually I had to take the earrings out.  My ears would close up and I’d feel ashamed that I wasn’t mature enough to take care of earring piercings.  By the time I was in high school I had had my ears pierced three times.  It was years before I figured out that my problem was not poor habits resulting in an infection.

Eventually I realized that the problem wasn’t me but the earrings I was wearing.  I would get a reaction to some earrings and not others.  I was relieved to finally figure out that I was allergic to nickel in some earrings.  Avoiding this metal allowed me to enjoy wearing earrings without a reaction.  There were even “fun” earring made with surgical steel for nickel allergic people like me.

Now, nickel allergy in jewelry is a well-known cause of contact dermatitis—particularly in North American women.  Some causes of nickel allergy, however, are not as well known.  Now that I am a dermatologist, I more commonly see people coming in with a recurrent itchy, rash on the abdomen that they cannot explain.  This, too, is a nickel allergy—usually to a belt buckle or the metal studs on the buttons of jeans.

Sometimes it’s obvious that someone likely has a nickel allergy, but types of skin allergy testing, called patch testing can help more directly identify what may be causing a recurrent rash.  Patch testing usually requires 3 visits in 1 week.  The first is to place the test patches and the 2nd and 3rd are to read the results.  If you think that you might be having a reaction to something your skin is coming into contact with, make an appointment to be considered for patch testing today.

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