What should you know about nickel skin rash?

Nickel sensitivity can cause allergic contact dermatitis after skin contact with jewellery, fasteners, tools, phones, or other metal objects. The reaction may be itchy and dry, or it may produce bumps, blisters, fluid, or crust. Its borders can reflect the shape of the object. Moisture, pressure, and repeated rubbing make contact more likely. A generalised rash, a rash without a clear exposure, or a pattern that does not improve after removal may have another explanation, including drug rash, psoriasis, atopic dermatitis, or heat rash.

Identify and stop contact with the suspected item. Clean the area gently, avoid hot water and fragranced products, and use a simple moisturiser to support the skin barrier. Do not peel blisters or share creams. A clinician can decide whether an anti-inflammatory treatment or patch testing is suitable. Once recovered, use verified nickel-free alternatives and keep a note of items that cause a reaction. Covering metal with a coating is not a dependable long-term solution because it can wear away with use.

Book an assessment if the rash is persistent, recurrent, extensive, or difficult to distinguish from another skin condition. Get prompt help for severe pain, warmth, pus, swelling, fever, or rapidly expanding redness. Emergency help is required for breathing problems, throat tightness, faintness, or sudden swelling of the lips or tongue.

Could nickel be responsible for this distribution? Should I have patch testing? What products should I avoid while the skin heals, and how can I recognise an infected rash?