The table below shows the main nickel-containing foods that are removed during elimination diets and consumed in moderation by people who are found to be sensitive to them.
Main sources of dietary nickel
|Grains||Whole grains, especially wheat, oat, buckwheat and corn|
|Legumes||Beans, lentils, peas, soy beans and soy products|
|Vegetables||Asparagus, broccoli, Brussel sprouts, cauliflower, spinach, tomatoes, canned vegetables|
|Fruits||Pears, bananas, canned fruits|
|Meat and fish||Shellfish, canned fish and meat|
|Chocolate, cacao and black tea||Especially dark chocolate|
|Nuts and seeds||All types|
|Canned foods||All types|
|Cooking utensils||Stainless-steel cooking utensils used for cooking acidic foods|
|Tap water||The first liter of tap water drawn from any faucet in the morning|
Treatment involves avoiding contact with products containing nickel and teaching patients how to use alternative products. In the case of SNAS, the elimination diet, to be followed under the supervision of a specialist, is becoming increasingly effective. The elimination diet involves an almost total abstention from the foods listed in the table for about 2 to 3 weeks and a gradual and occasional reintroduction of the different foods so as not to overload the body.
The American Academy of Dermatology recommends avoiding prolonged contact with nickel-containing objects as much as possible to avoid hypersensitisation that could turn into an allergy:
1. Choose jewelry carefully
2. Control clothing (both dyes and metallic materials present)
3. Cover metal electronics
4. Replace household items containing nickel with items made from other materials
5. In case of high sensitivity, avoid foods containing high amounts of nickel
6. Also pay attention to tap water and cigarettes!
Due to the variability in the nickel content of different foods and the complexity of the symptomatic manifestation, it is always advisable to consult with a dietitian in order to implement the elimination diet and follow a complete and balanced plan.
1. Tramontana M, Bianchi L, Hansel K, Agostinelli D, Stingeni L. Nickel Allergy: Epidemiology, Pathomechanism, Clinical Patterns, Treatment and Prevention Programs Endocr Metab Immune Disord Drug Target 2020; 20(7): 992-1002
2. The ESSCA Writing Group. The European Surveillance System of Contact Allergies (ESSCA): results of patch testing the standard series, 2004. J Eur Acad Dermatol Venereol. 2008 ;22: 174–181.
3. Falagiani P, Di Gioacchino M, Ricciardi L, Minciullo PM, Saitta S, Carni A, Santoro G, Gangemi S, Minelli M, Bozzetti MP, Massari S, Mauro S, Schiavino D. Systemic nickel allergy syndrome (SNAS). A review. Rev Port Imunoalergologia 2008; 16 (2): 135‐147
4. Christensen OB, Moller H. External ed internal exposure to the antigen in the hand eczema of nickel allergy. Contact Dermatitis.1975; 1: 136‐41.
5. Zirwas M, Molenda M. Dietary Nickel as a cause of Systemic Contact Dermatitis. J Clin Aesthet Dermatol. 2009 Jun 2(6): 39-43