What are the symptoms of nickel exposure?

From the Guidelines

Nickel exposure can cause allergic contact dermatitis, presenting as a red, itchy rash with small blisters at the site of contact, as well as other skin and respiratory symptoms, and should be treated by removing the source of exposure and using topical corticosteroids for skin reactions. The symptoms of nickel exposure can vary, but the most common reaction is allergic contact dermatitis, which appears as a red, itchy rash with small blisters at the site of contact, as seen in individuals with ear piercings who develop an allergic reaction to nickel-containing earrings 1. Some key points to consider when dealing with nickel exposure include:

• Allergic contact dermatitis typically develops 12-48 hours after exposure and may spread beyond the contact area
• Other skin symptoms include dryness, cracking, and a burning sensation
• Respiratory symptoms can occur from inhaling nickel compounds, including coughing, wheezing, shortness of breath, and reduced lung function
• Ingesting nickel can cause nausea, vomiting, diarrhea, and abdominal pain
• Chronic exposure has been linked to more serious conditions including lung fibrosis, nasal septum perforation, and increased cancer risk
• Treatment typically involves removing the source of exposure, using topical corticosteroids for skin reactions, and taking oral antihistamines for itching, as well as avoiding the metals that trigger a reaction, as described in the context of ear piercings and contact dermatitis resulting from nickel exposure 1.

From the Research

Symptoms of Nickel Exposure

• Nickel is a contact allergen that can cause Type I and Type IV hypersensitivity, leading to cutaneous eruptions following dermal or systemic exposure 2
• The symptoms of nickel exposure can include itch, discomfort, and skin eruptions, and can range from localized to widespread dermatitis 3, 4
• Nickel allergic contact dermatitis (Ni-ACD) is the most common cutaneous delayed-type hypersensitivity reaction worldwide, and can cause severe disabling hand eczema in adulthood 4
• Nickel exposure has also been linked to other health effects, including cardiovascular and kidney diseases, lung fibrosis, lung and nasal cancer, and neurotoxicity 5, 6
• The mechanisms of nickel-induced toxicity are not yet fully understood, but are thought to involve mitochondrial dysfunctions and oxidative stress, as well as epigenetic alterations induced by nickel exposure 5, 6

Health Effects of Nickel Exposure

• Nickel exposure can cause a range of health effects, including:
  • Allergy and immunotoxicity 2, 3
  • Cardiovascular and kidney diseases 5
  • Lung fibrosis and lung and nasal cancer 5
  • Neurotoxicity and reproductive toxicity 6
  • Hepatotoxicity and nephrotoxicity 6
• The health effects of nickel exposure can be caused by acute, subchronic, or chronic exposure to nickel, and can affect various metabolically active tissues in the body 6

Prevention and Treatment of Nickel Exposure

• Prevention of nickel exposure is key to reducing the risk of nickel-induced health effects, and can involve avoiding contact with nickel-releasing items such as jewelry and metal in clothing 3, 4
• Treatment of nickel allergic contact dermatitis (Ni-ACD) can involve topical and systemic therapy, as well as avoidance of nickel exposure 2, 3
• Legislation and regulation of nickel use can also help to reduce the incidence of Ni-ACD and other nickel-induced health effects 4