Nickel is a metal that is commonly used in jewelry, buttons and belt buckles, because it’s inexpensive and can be used as an alloy to harden other more expensive metals, like gold. Nickel is the No. 1 confirmed contact allergen nationwide in all age groups. The number of children who have tested positive for nickel has quadrupled over the past three decades, and research estimates that over 1.1 million children are sensitized to it. A new American Academy of Pediatrics policy statement, “Nickel-Allergic Contact Dermatitis: Identification, Treatment, and Prevention,” reported in the May 2020 Pediatrics journal (published online April 27), calls on the U.S. government to enforce protective regulations regarding nickel used in clothing and jewelry to reduce allergic risk potential. Nickel allergy causes an itchy, inflamed, red rash, sometimes days later. It can evolve to a point that it causes school absence, reduces quality of life, and sleep disturbances. In adulthood it has been linked to disabling hand eczema. Nickel can be hard to avoid for those who have developed this condition, as it is in common items like rivets, buttons and zippers on clothing; metal posts on earrings, laptops and phones; cell phone case; watches; cookware; and silverware. AAP offers parents and pediatricians guidance, such as advising that parents wait to get a teenager’s ears pierced until after they’ve had braces or use plastic earring posts while the skin heals after piercing, to avoid compounding the exposure to nickel. Denmark and the European Union issued a health directive to reduce nickel in items like earrings and clothing over 20 years ago. Since these were implemented, there has been a global reduction in incidence of nickel reactions in adults, children and young adults, as well as a significant decrease in morbidity and cost savings to the global health care system. The AAP policy recommends the U.S. adopt similar regulation. Furthermore, the policy recommends more research be conducted to better understand the relationship between nickel exposure and health.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.