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Is jewelry causing that skin rash?
 It’s the end of the day. You take off your go-to pair of earrings that you wear all the time and notice your ear lobes are covered with itchy red bumps. That rash may be the sign of a nickel allergy.Allergies are the 6th leading cause of chronic illness in the U.S. and more than 50 million Americans experience various types of allergies each year. Nickel isn’t one of the more common allergens. Here are answers to five common questions about nickel allergy: What is nickel allergy? Nickel is found in costume jewelry, watchbands, belts and eyeglass frames. Nickel allergy is different from your typical environmental, animal or food allergy. With those allergies, people usually experience an immediate reaction. If it’s environmental, you usually get sinus symptoms such as itchy eyes, runny nose and congestion. With animal allergy, you have the same sinus symptoms and may have difficulty breathing and hives. Food allergy symptoms include hives, swelling, shortness of breath, chest tightness or vomiting shortly after the exposure. With nickel allergy, it takes a while for the immune cells to become sensitized. It could be months or years before you develop the contact dermatitis the allergy causes. The itchy red and sometimes blistering rash develops over time and it can take a long time to go away if left untreated. What causes nickel allergy? The cause of nickel allergy is unknown and there aren’t any risk factors for nickel allergy, unlike with the typical environmental, animal or food allergies. If you have a strong family history of environmental, animal or food allergies, you have a higher risk of developing an allergy. With allergies that cause contact dermatitis, it’s really hard to predict who will get it and when. There are people who may have used a product or been exposed to something their entire lives and, all of sudden, they start reacting to it because their immune cells have become overstimulated. How is nickel allergy diagnosed and treated? When I see a patient who thinks they have a nickel allergy, I take a good clinical history based on the location of the rash. I may also recommend patch testing. Patch testing is a little different from our typical allergy testing, where we’re doing a scratch test to look for immediate allergens. Patch testing involves taping allergen chambers to the back and leaving them on for 48 hours. One to two days after the patch is removed, the area of the back is examined and graded by a doctor. Sometimes people have a little redness all the way up to full on blisters. Then we know what degree of allergy they have. How is nickel allergy treated? Nickel allergy is usually treated with a topical steroid. You might be able to get away with an over-the-counter ointment but, if it’s a little more extensive, I’ll prescribe a prescription-strength topical steroid cream or ointment. If it’s really severe, you may need oral steroids to get the reaction to calm down. How do you prevent nickel allergy rashes? We really focus on prevention to keep nickel allergy rashes at bay. Wear gold, platinum, stainless steel or nickel-free jewelry. Silver jewelry is often a mixture of metals, so you need to make sure the silver doesn’t contain nickel. Use cloth, leather or plastic watchbands. If you have issues with belt buckles, wear an undershirt that tucks into your pants or skirt so there’s nothing rubbing against your skin. People have tried painting the item with clear nail polish, but there’s no scientific evidence it works. Usually, we just try to eliminate nickel or put a barrier between the skin and the allergen. Princess Ogbogu is director of Allergy and Immunology at The Ohio State University Wexner Medical Center.
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 Makeup products, including mascara and eyeliner, are an important part of many people’s beauty regimens. However, bad habits and poor makeup hygiene can lead to problems involving your eyes and eyelids. Additionally, if you have sensitive skin, you may be more prone to allergy and irritation resulting from cosmetics. Put simply, by applying makeup correctly and practicing good hygiene techniques, you can avoid many unwanted eye problems. 1. Avoid applying eyeliner to your eyelid marginsThe edges of your eyelids (the eyelid margins, near where your eyelashes grow) contain important oil glands called the meibomian glands. These oil glands provide the oily component of the tear film that lubricates your eyes.  Makeup can block these oil glands, causing an unstable tear film that evaporates too quickly. This can lead to issues with dry eye and irritation. Applying eye makeup at the “waterline” – behind the lash line, where your eyelid meets your eye – is more likely to block the meibomian oil glands. Additionally, applying eye makeup to the waterline may increase the amount of cosmetic that enters your tear film and therefore contacts the surface of your eyes. Products such as glitter may be more likely to do this. This is not only irritating, but may also potentially expose your eyes to harmful bacteria. If you want to apply eyeliner, make sure you do so on the side of your eyelashes that is farther from your eye. 2. Remove makeup before bedTaking makeup off before bed allows your eyes and eyelids to take a break from any potential inflammatory and irritating makeup particles. Remove your makeup every evening with a gentle makeup remover. Be sure to remove your contact lenses first! Some people with sensitive skin or a history of allergies may benefit from a hypoallergenic makeup remover. .  Health tip: A gentle alternative to clean your eyelashes and remove makeup is baby shampoo. 3. Throw away old makeupEye makeup, especially mascara, provides a moist environment that can act as the perfect breeding ground for bacteria. This puts you at risk for conjunctivitis, or pink eye. For this reason, it’s a good idea to dispose of any liquid or creamy eye makeup, including mascara and eyeliner, after three months. If your makeup becomes contaminated (for example, by touching something other than your eyelids), or if you develop pink eye, you should dispose of your eye makeup immediately 4. Don’t share makeup brushesSharing makeup and cosmetic tools, such as makeup brushes, can facilitate the spread of bacteria. This increases the risk of infection of the eyelids and even of the eye itself. It may be wise to avoid samples at makeup stores for this reason. 5. Contact lens wearers may be at higher riskWearing contact lenses can increase the risk of eye problems such as irritation and infection, particularly with poor contact lens hygiene. If your makeup hygiene is subpar, these risks are even higher. However, with the appropriate contact lens hygiene and makeup hygiene, most people can safely incorporate both contact lenses and makeup into their daily routines.  If you develop eye problems with your makeup, such as redness, pain, irritation, or vision changes, you should discontinue the use of all cosmetic products and see your eye care provider as soon as possible. Originally published August 30, 2018 by
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