The Seven Day Itch: A Tale of Allergy Testing

I recently had some allergy testing done, in order to get to the bottom of a mysterious rash on my hand and on my eyelids that has been coming and going for several years. When I told my dermatologist my symptoms and she took a look, she had a pretty immediate suspicion about what I was reacting to; but she recommended that we do an allergy patch test to confirm. So thus began my week of washing my hair under the faucet so as not to get my back wet. Big pain.

The test that the dermatologist used was called Thin-layer Rapid Use Epicutaneous Patch Test, or T.R.U.E. Test. The test consists of three large pieces of adhesive, like large rectangular stickers, each with 12 little squares of common allergens.  The 36 allergens that the T.R.U.E. Test tests for includes things like fragrance, dyes, chemicals, rubbers, and metals, all of which are among the most common causes of dermatitis, or itching and rashes.

So the doc slaps the three stickers on my back, where I can’t really reach them, and tells me to come back in two days. She told me I might itch a bit, and it could either be from an allergic reaction to one of the allergens, or just an irritation from the adhesive stickers. By that afternoon I was pretty itchy, particularly in two spots. Obviously, I couldn’t tell what allergens corresponded to those spots because they were covered by the stickers, and I couldn’t really effectively itch. Suffice it to say, I was cranky.

Two days later I went back to get the stickers removed so the doc could see what, if anything I was reacting to. The T.R.U.E Test classifies allergic reactions at five levels: doubtful, irritant, weak positive, strong positive, and extreme positive. I was beyond extreme positive for two allergens: gold, and nickel. The doc didn’t put the stickers back on, but I was still instructed to not get my back wet and to come back at the end of the week to see if any delayed reactions showed up. Nothing did, but I sure itched like crazy for the rest of the week, and two weeks later I’ve still got the remnants of red welts on my back in the spots where those two allergens were.

So, wait. Gold and nickel?! Who on earth is allergic to gold and nickel? Well, as it turns out, it’s not all that uncommon. Something like 15% of the population, mostly women, have some degree of nickel allergy;  but the gold allergy is less common. For me, this new information actually explains a lot: the red itchy, swollen, ears whenever I would wear earrings; the itchy back when I would wear dresses with back zippers (I always blamed the material or my detergent);  and the constant neck scratching when I would wear necklaces, like I’ve got human fleas.  I guess I thought everyone was just as itchy as me. Kind of like, before I got glasses in 4th grade I thought everyone just saw trees as big green blurs with no individual leaves. Turns out, thats not normal.

So what does this all mean? Well, no more wearing cheap jewelry for one. And no gold, not even white gold.  No silver or platinum either, unless its confirmed nickel free. There is a test kit you can buy to test jewelry for nickel content, but I haven’t purchased that yet, I’m just laying off the jewelry for now.  Also, I’m now hyperaware of just how much nickel there is EVERYWHERE. Keys, coins, doorknobs, handles, faucets, electronics, and a ton of other stuff you can’t really avoid. So now I’ve been instructed to cut the nickel where I can avoid it, so that includes things like flatware, cooking utensils, clothing, and food with a high nickel content.

So, you might be wondering, what kind of food has nickel? What does the nickel allergic person need to avoid? Well, only the foods that I tend to eat EVERY DAY, OF COURSE! Oats (my every morning breakfast), nuts (my every day snack), soybeans and soy products (my preferred meat alternative), chocolate (my too often treat), figs, dates, pineapple, raspberries, peas, legumes, lettuce, spinach, and shellfish, among other things. You can get a comprehensive list of high and low nickel content foods here.

Even food that normally doesn’t have high nickel content isn’t ok if it’s been cooked in cookware that contains nickel, like stainless steel. This is particularly true for acidic foods, like tomatoes, which cause nickel to leach out of stainless steel. I should note that eating food with high nickel content or cooking food in stainless steel is not a big deal for non-nickel allergic people, as their bodies will just process and excrete excess nickel.

So it looks like my diet will be changing a bit, at least for several months. Supposedly, a cheat is allowed occasionally once a strict nickel free diet is followed for a good length of time to clear up the symptoms. We’ll see how it goes. It won’t be easy, to know me is to know that I love chocolate, and being promptly tempted by chocolate goodness at Outside Lands last weekend was no fun, no fun at all.

Look how sad I am. An entire area devoted to chocolate and I can’t have any!

Thankfully, there are no limits on cheese!

Cheese tower at the San Francisco Ferry Building. Yum.

Additional Info:

Ingredients to avoid if you have a nickel allergy:
Nickel sulfate (NiSO4) or nickel soluble salts
nickel (Ni)
carbonyl nickel powder
nickel alloys
elemental nickel
nickel catalyst
Chrome (or chromate)

Ingredients to avoid if you have a gold allergy:
Gold or gold-plating
Gold sodium thiomalate
Gold sodium thiosulfate
Gold Stannate
Gold Trichloride
Natrium-bis (thiosulfato) aurat (I)
Potassium bromoaurate
Potassium dicyanoaurate
Sodium aurothiomalate
Sodium chloroaurate
Sodium aurothiosulphate

Interesting Reading:

T.R.U.E. Test website

The MELISA Medica Foundation Nickel Allergy Information

Low-Nickel Diet Information

An article about the nickel allergy and diet

An article about how healthier eating has resulted in an increase of diagnosed nickel allergies


About PGMG

Mama. Bookworm. Hiker. Music lover. Retro enthusiast. Eater of nachos.
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7 Responses to The Seven Day Itch: A Tale of Allergy Testing

  1. Bianca says:

    Very interesting! Thanks for sharing. I had a mysterious rash a few months ago, mostly on my face, under my eyes. The doctors I saw couldn’t figure it out. I am pretty sure that it was caused by my nickel shower caddy. Around the time the rash started I had switched from liquid soap to bar soap and had started leaving the bar soap in the nickel shower caddy. I have bee allergic to cheap jewelry for as long as I can remember, but just recently was told that that meant I had a nickel allergy. Let me know how the nickel-free diet goes. Good luck giving up chocolate, but like you said at least there’s no nickel in cheese! 🙂

    • PGMG says:

      My rash started on my eyelids and under my eyes too. Very weird. Other possible eye culprits: eye glasses or sunglasses. Also, touching things that are nickel (knobs, handrails, keys, etc) and then touching your face. You touch your face more often than you realize. Pay attention and you’ll be surprised. The allergy testing was pretty interesting, if your dermatologist can get it covered by your insurance I highly recommend it.

      • Bianca says:

        That’s weird that yours was around your eyes too. Hmm. I actually went to an allergist and he tested my blood for a bunch of things, but not metals. They weren’t able to do a skin test because apparently my skin was reacting to everything. The allergist demonstrated this by lightly scratching my name on the inside of arm… it immediately swelled up and he said that meant that any allergy skin tests would be inconclusive. I’ve been super sensitive to everything since I had my son 2.5 years ago, it’s bizarre.

      • PGMG says:

        I had a bunch of blood tests too, all negative. I had two dermatologists tell me I probably wouldn’t learn anything from the patch test and convinced me not to do it. I think sometimes they just like to keep you coming back. One of the doctors saw me every couple of weeks for 6 months or so. She had me try all kinds of things, no fragrance, no para end, no plant based cosmetics.. it was a frustrating guessing game. I’m really glad I finally have something conclusive to work with.

      • Bianca says:

        Oops, I came back here to ask a question and just now saw your reply. Yes, it seems like I keep getting bounced from doctor to specialist and back. They really do like to keep you coming back. I’m thinking about getting rid of my stainless steel cookware. Did you find a good replacement for yours? I’m reading about ceramic cookware, but it’s pretty mind-boggling.

  2. nickelfree says:

    I tested positive for a nickel allergy about 6 months ago too…. I feel your pain!! I also have a dairy allergy, which constricts my diet further. Total nightmare, haha. I cook in glass stovetop pots, which seems to work… My rashes on my face and arms have slowly started disappearing, but I still get itchy from time to time. I think that by changing our lifestyles our bodies will eventually regulate back out, the waiting just really, really sucks……

  3. Emily says:

    So three years later, how are you coping? Just last week I was diagnosed with a gold allergy. I have been wearing the same 14k gold ring for over a decade and just in the last six months my eyelids sporadically started itching and turning red. With each episode, the rash got worse.. eventually spreading to under my eyes. I looked like a wicked raccoon! Then I figured out it was the gold allergy, which was fired up when gold came in contact with titanium dioxide (in everything – make up, shaving cream, lotion, shampoo, etc). So now I’ve stopped wearing my ring, but not my cheap jewelry. I’ve been make up free all summer (hate it!) but found some titanium dioxide hippie dippie stuff online and hope to be able to wear it without issue. What a crazy world! And side note, I also got glasses in 4th grade and the trees were AMAZING!!!!!!! Leaves!!!! Who knew?!?!?!

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