Study Finds Nearly One-Third of All Inexpensive Earrings Examined Tested Positive for Nickel

Dermatologists offer tips to avoid nickel-induced dermatitis



12 May, 2008, 01:00 ET from American Academy of Dermatology

    SCHAUMBURG, Ill., May 12 /PRNewswire/ -- For the estimated 82 percent
 of women with pierced ears, earrings are an important fashion accessory
 that many women wear, and change, daily. However, a new study suggests that
 women may be getting more than they bargained for when purchasing
 inexpensive earrings. Nickel exposure from these earrings is a common cause
 of dermatitis on the earlobes and repeated exposure can make treatment
 difficult.
 
     In the report entitled, "Nickel release from earrings purchased in the
 United States: The San Francisco earring study," published online in the
 Journal of the American Academy of Dermatology, dermatologist Howard I.
 Maibach, MD, FAAD, professor of dermatology at the University of
 California, San Francisco, presented evidence that nickel exposure from
 inexpensive earrings purchased from various stores and vendors is frequent
 in the United States and does not correlate with the price of the earrings
 within the "inexpensive" price range.
 
     "Sensitization to nickel is quite common in the United States, with
 studies estimating that 5.8 percent of American adults tested positive to
 nickel allergy through a routine skin test," said Dr. Maibach. "In the
 early 1990s, the European Union Nickel Directive was passed in an effort to
 decrease the prevalence of nickel sensitization in consumer and
 occupational products in Europe, with results indicating the directive is
 working. However, no such regulations exist in the United States to limit
 nickel exposure -- leaving millions of people at risk for dermatitis from
 common goods, such as earrings."
 
     For the study, Dr. Maibach and his collaborator, Jacob Pontoppidan
 Thyssen, MD, purchased inexpensive earrings from 34 different stores and
 artists in San Francisco in October 2007. Inexpensive earrings were
 classified as those under $50; in contrast, expensive earrings were
 classified as those made of gold or platinum available from fine jewelry
 stores. A total of 277 earrings were purchased from four different
 categories of vendors -- a downtown market with licensed local artists
 producing custom-made jewelry; jewelry stores in China Town targeting
 mainly tourists; national and international clothing and accessory chain
 stores targeting mainly girls and women under age 40; and similar stores
 targeting mainly women over age 40.
 
     All earrings purchased were examined with the dimethylglyoxime (DMG)
 test -- a routine spot test using solutions to detect the presence of
 nickel and other alloys. Of the 277 earrings that were tested, 85 (or 30.7
 percent) demonstrated at least one spot that tested DMG-positive for
 nickel. Dr. Maibach noted that the highest proportion of DMG-positive
 earrings was purchased from local artists, with 69 percent of these
 earrings testing positive for nickel. A large portion (42.9 percent) of
 earrings purchased from stores in China Town also tested positive for
 nickel.
 
     When the number of DMG-positive earrings was examined from accessory
 and clothing stores targeting younger women under age 40 and those stores
 targeting women over age 40, Dr. Maibach found a large discrepancy.
 Specifically, 24.1 percent of the earrings purchased at the stores
 targeting younger women tested positive for nickel; whereas only 1.7
 percent of earrings from stores targeting women over 40 tested DMG
 positive.
 
     "Except for one store targeting girls and young women where a
 significant number of DMG-positive earrings were found, the proportion of
 earrings that tested positive for nickel was generally higher among
 individual China Town stores and local artists than in individual national
 and international chain stores," said Dr. Maibach. "We also found no
 correlation between the country where the earrings were manufactured and
 the frequency of DMG-positive reactions or whether the price of the
 inexpensive earrings correlated with testing positive for nickel exposure."
 
     Dr. Maibach added that in one accessory store, none of the 44 earrings
 priced between $5 and $8 were DMG positive, whereas numerous earrings
 priced between $15 and $25 in another accessory store were DMG positive.
 
     "From our findings, we could not establish a 'safe-limit price' as a
 guide for consumers who want to avoid excessive nickel exposure when
 purchasing inexpensive earrings," said Dr. Maibach. "But it's safe to say
 that young customers purchasing earrings at a considerable price range in
 U.S. chain stores are potentially at risk of nickel exposure and
 sensitization."
 
     Studies show that nickel sensitization increases the risk of hand
 eczema, but Dr. Maibach argued that avoiding nickel -- which is found
 almost everywhere -- can be difficult. He acknowledged that there are some
 patients with nickel dermatitis who refuse to give up their jewelry, even
 when they know it is the cause of their condition. Since the best way to
 avoid nickel sensitization and subsequent dermatitis is to prevent nickel
 exposure, Dr. Maibach suggested the following tips:
 
 
-- Look for jewelry and clothing labeled "nickel-free" or "hypoallergenic" -- Wear only stainless steel, platinum or gold jewelry if you know you are allergic to nickel -- Discontinue wearing jewelry that causes any noticeable skin irritation, such as redness or itching -- Use 1% hydrocortisone cream or ointment, which can be purchased over-the-counter, to treat nickel-induced dermatitis -- See your dermatologist if symptoms worsen or do not improve within three to five days of not wearing jewelry Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or http://www.aad.org.

SOURCE American Academy of Dermatology
    SCHAUMBURG, Ill., May 12 /PRNewswire/ -- For the estimated 82 percent
 of women with pierced ears, earrings are an important fashion accessory
 that many women wear, and change, daily. However, a new study suggests that
 women may be getting more than they bargained for when purchasing
 inexpensive earrings. Nickel exposure from these earrings is a common cause
 of dermatitis on the earlobes and repeated exposure can make treatment
 difficult.
 
     In the report entitled, "Nickel release from earrings purchased in the
 United States: The San Francisco earring study," published online in the
 Journal of the American Academy of Dermatology, dermatologist Howard I.
 Maibach, MD, FAAD, professor of dermatology at the University of
 California, San Francisco, presented evidence that nickel exposure from
 inexpensive earrings purchased from various stores and vendors is frequent
 in the United States and does not correlate with the price of the earrings
 within the "inexpensive" price range.
 
     "Sensitization to nickel is quite common in the United States, with
 studies estimating that 5.8 percent of American adults tested positive to
 nickel allergy through a routine skin test," said Dr. Maibach. "In the
 early 1990s, the European Union Nickel Directive was passed in an effort to
 decrease the prevalence of nickel sensitization in consumer and
 occupational products in Europe, with results indicating the directive is
 working. However, no such regulations exist in the United States to limit
 nickel exposure -- leaving millions of people at risk for dermatitis from
 common goods, such as earrings."
 
     For the study, Dr. Maibach and his collaborator, Jacob Pontoppidan
 Thyssen, MD, purchased inexpensive earrings from 34 different stores and
 artists in San Francisco in October 2007. Inexpensive earrings were
 classified as those under $50; in contrast, expensive earrings were
 classified as those made of gold or platinum available from fine jewelry
 stores. A total of 277 earrings were purchased from four different
 categories of vendors -- a downtown market with licensed local artists
 producing custom-made jewelry; jewelry stores in China Town targeting
 mainly tourists; national and international clothing and accessory chain
 stores targeting mainly girls and women under age 40; and similar stores
 targeting mainly women over age 40.
 
     All earrings purchased were examined with the dimethylglyoxime (DMG)
 test -- a routine spot test using solutions to detect the presence of
 nickel and other alloys. Of the 277 earrings that were tested, 85 (or 30.7
 percent) demonstrated at least one spot that tested DMG-positive for
 nickel. Dr. Maibach noted that the highest proportion of DMG-positive
 earrings was purchased from local artists, with 69 percent of these
 earrings testing positive for nickel. A large portion (42.9 percent) of
 earrings purchased from stores in China Town also tested positive for
 nickel.
 
     When the number of DMG-positive earrings was examined from accessory
 and clothing stores targeting younger women under age 40 and those stores
 targeting women over age 40, Dr. Maibach found a large discrepancy.
 Specifically, 24.1 percent of the earrings purchased at the stores
 targeting younger women tested positive for nickel; whereas only 1.7
 percent of earrings from stores targeting women over 40 tested DMG
 positive.
 
     "Except for one store targeting girls and young women where a
 significant number of DMG-positive earrings were found, the proportion of
 earrings that tested positive for nickel was generally higher among
 individual China Town stores and local artists than in individual national
 and international chain stores," said Dr. Maibach. "We also found no
 correlation between the country where the earrings were manufactured and
 the frequency of DMG-positive reactions or whether the price of the
 inexpensive earrings correlated with testing positive for nickel exposure."
 
     Dr. Maibach added that in one accessory store, none of the 44 earrings
 priced between $5 and $8 were DMG positive, whereas numerous earrings
 priced between $15 and $25 in another accessory store were DMG positive.
 
     "From our findings, we could not establish a 'safe-limit price' as a
 guide for consumers who want to avoid excessive nickel exposure when
 purchasing inexpensive earrings," said Dr. Maibach. "But it's safe to say
 that young customers purchasing earrings at a considerable price range in
 U.S. chain stores are potentially at risk of nickel exposure and
 sensitization."
 
     Studies show that nickel sensitization increases the risk of hand
 eczema, but Dr. Maibach argued that avoiding nickel -- which is found
 almost everywhere -- can be difficult. He acknowledged that there are some
 patients with nickel dermatitis who refuse to give up their jewelry, even
 when they know it is the cause of their condition. Since the best way to
 avoid nickel sensitization and subsequent dermatitis is to prevent nickel
 exposure, Dr. Maibach suggested the following tips:
 
 
-- Look for jewelry and clothing labeled "nickel-free" or "hypoallergenic" -- Wear only stainless steel, platinum or gold jewelry if you know you are allergic to nickel -- Discontinue wearing jewelry that causes any noticeable skin irritation, such as redness or itching -- Use 1% hydrocortisone cream or ointment, which can be purchased over-the-counter, to treat nickel-induced dermatitis -- See your dermatologist if symptoms worsen or do not improve within three to five days of not wearing jewelry Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or http://www.aad.org. SOURCE American Academy of Dermatology