What should you know about nickel allergy nose piercing?

Nickel allergy is a delayed immune reaction to contact with nickel. A nose piercing may expose the inside and outside of the nose to jewellery, especially while heat, sweat, friction or moisture keep the metal against the skin. Contact dermatitis can cause itching, redness, scaling, tenderness or small blisters. Irritation from a fresh piercing and infection can look similar, so the timing, distribution and type of discharge matter. Nickel allergy is not the only possible explanation for a sore piercing.

Do not keep touching, twisting or covering the jewellery with cosmetics. Wash hands before any care and follow the piercer's cleaning instructions without using harsh alcohol or household products. Contact a qualified clinician and an experienced piercer before removing jewellery from a fresh piercing, because the channel may narrow and trap infection. Future jewellery should be selected with professional guidance and made from a material suitable for people with nickel sensitivity. A dermatologist can use patch testing when the diagnosis is uncertain. A topical corticosteroid may be prescribed for surrounding dermatitis, but it should not be placed inside a piercing channel unless directed.

Get prompt medical advice for increasing pain, warmth, swelling, pus, bad smell, fever or redness spreading across the nose or face. Seek urgent help if swelling affects breathing or swallowing, or if you develop widespread hives or facial swelling. A persistent lump, bleeding or recurrent rash also deserves an examination rather than repeated self-treatment.

Does this look more like nickel allergy, irritation or infection? Should the jewellery stay in place while it is assessed? Would patch testing help, and which material is appropriate for a replacement?