It is impossible to completely avoid nickel because it is found in so many foods. However, patients can avoid allergy-related symptoms by avoiding direct, prolonged contact with nickel or nickel-plated products.

Because nickel is present in so many everyday items, those with an allergy must constantly watch for its presence. Dimethylglyoxime spot test kits are available to test suspect items for nickel content.

These kits contain two bottles: one containing dimethylglyoxime, and the other containing ammonium hydroxide. When an item containing nickel is used to mix the chemicals together, a pink color will result. Patients should ask their physician or pharmacist about where to purchase these kits.

Those with nickel allergy must avoid skin contact with nickel. This is especially true of skin that is broken, cracked or damaged from frequently being wet.

Tips to avoid contact with nickel include:

• Ear piercing and other forms of body piercing should only be done with stainless-steel needles. Make sure to use earrings with sterling silver, 18-karat gold or stainless-steel studs in pierced ears. This is especially crucial before the holes heal, because open skin allows nickel to easily pass into a person’s bloodstream.
  
  
• Purchase jewelry carefully, keeping the following in mind:
  
• • Beware of the term “hypoallergenic.” It is used for some jewelry where nickel is not present in the posts, but is present in the earrings themselves.
    
    
  • Gold with 14 karats or less may contain enough nickel to provoke a reaction. Most jewelry is made of 9-karat gold, which may contain nickel. Gold-plated and rolled-gold jewelry should also be avoided because the plating can wear off, exposing the skin to nickel.
    
    
  • Pure sterling silver contains no nickel, but is often coated with it.
    
    
  • White gold alloy often contains nickel.
    
    
• Stainless steel can be an excellent choice of metal for those with nickel allergy. Although nickel may be present, the structure of stainless steel of high quality is such that the nickel will not be leached out by contact with perspiration or moisture.
  
  
• Try to use substitutes for metal, such as items made of wood, plastic, glass, paper or fabric.
  
  
• Items made of nickel do not usually cause a reaction if they are covered with paint, nail polish, lacquer, varnish or masking tape. This prevents the nickel from coming into contact with the skin. However, if the coating chips or flakes off, it is possible for the nickel to contact the skin again.
  
  
• Keep money in a bag, purse or wallet rather than in a pocket that is next to the skin.
  
  
• Wear cotton gloves when touching things containing nickel.

Since many types of medical implants and prostheses also contain nickel, it is important for individuals with nickel allergy to inform their physicians about the allergy, particularly before a surgical procedure. Patients should also carry a card that identifies their allergies in their wallet.