Body Piercing Allergic Reactions

Body piercing allergic reactions are possible and typically due to the metal the jewelry is made of (nickel, in particular). This isn't a whole-body allergic response, but one tied to a sensitivity—an overreactive immune response that can cause localized itching, redness, and other symptoms.

Why some people are sensitive to nickel or other metals is not clear. But since a piercing touches external and internal tissue, the immune reaction to it may be stronger than with something that only touches the surface of the skin, like a bracelet.

This article reviews the symptoms associated with a body piercing allergic reaction and how to reduce your risk of one. It also discusses how a metal allergy can be diagnosed.

Close up of woman's nose and septum piercings
Luciano_Marques / Getty Images 

Symptoms of an Allergic Reaction to a Piercing

Body piercings involve the placement of metallic objects anywhere on the body, but most commonly in the ears, the nose, and the navel. Since metals are frequently the causative triggers for ​contact dermatitis, it's possible for people to experience allergic reactions to body piercing jewelry.

These allergic reactions usually cause the skin in contact with the piercing to become:

  • Red
  • Itchy
  • Dry
  • Swollen
  • Flaky

They can also rarely trigger systemic nickel allergy syndrome, in which a person absorbing high nickel levels (for example, from a tongue piercing) can develop chronic gastrointestinal symptoms and fatigue.

It is estimated that as many as 18% of people in North America are allergic to nickel.

Minimizing Risk of Allergic Reaction

To avoid potential body piercing allergic reactions, be sure to ask what kind of metal the jewelry you selected is made of.

Surgical-quality stainless steel is often optimal because it usually contains a very low nickel content.

Once your piercing has healed and you are able to change your jewelry, consider opting for pieces made from:

  • 14- or 18-karat gold
  • Titanium
  • Niobium

Cheaper, "costume" jewelry is more likely to be made with nickel.

Evidence suggests that the more you are exposed to a metal, the more likely you may be to develop an allergy to it. So it's possible that you may have no reaction to your first few piercings, but then react to a later one.

The more piercings you have, the higher your risk of developing an allergic reaction to one.

Once you experience an allergic reaction from a piercing, you will always be at risk of developing a reaction to the offending material.

Once you identify an allergy to a metal, do your best to minimize the use of jewelry made from that material. That means carefully selecting what you get pierced with and wear, as well as considering lowering the total number of piercings you plan to get.

Allergic reactions aside, remember to always seek services from a reputable piercer and ask about hygiene and infection-control practices aimed at reducing the risk of potentially dangerous communicable diseases.

Diagnosing Metal Allergies

Contact dermatitis to nickel (and other metals) is diagnosed using patch testing.

The dimethylglyoxime test is a commercially available test that can determine the presence of nickel in jewelry and other metallic devices.

Piercings can result in infection, and since symptoms overlap, it can be difficult to tell the difference between an infection and an allergic reaction. Both conditions can cause swelling, redness, warmth, itching, and burning.

However, allergic reactions won't improve with the use of topical antibiotic ointments. Often, that is the first clue that a person has an allergy and not an infection.

Finally, if a person has more than one piercing and experiences symptoms in most or all of those locations, that's another indication that an allergy is at play.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Markel K, Silverberg N, Pelletier JL, Watsky KL, Jacob SE. Art of prevention: A piercing article about nickel. Int J Womens Dermatol. 2019 Mar 16;6(3):203-205. doi: 10.1016/j.ijwd.2019.03.001

  2. Yale Medicine. Allergic contact dermatitis.

  3. Mata Perez, L. D., França, A. T., & Zimmerman, J. R. (2014). Systemic nickel allergy syndromeThe World Allergy Organization Journal8 (Suppl 1), A89. doi:10.1186/1939-4551-8-S1-A89

  4. American Academy of Dermatology Association. Nickel allergy: How to avoid exposure and reduce symptoms.

  5. American Osteopathic College of Dermatologists. Nickel allergy.

  6. Saito M, Arakaki R, Yamada A, Tsunematsu T, Kudo Y, Ishimaru N. Molecular Mechanisms of Nickel Allergy. Int J Mol Sci. 2016;17(2). doi:10.3390/ijms17020202

  7. Tam d, Yu J, Ko LN, Schalock PC. Patch testing with an extended metal allergen series at the Massachusetts General Hospital (2006–2017)Dermatitis. Dec 2020.359-366. doi:10.1097/DER.0000000000000609

  8. Lucerna A, Espinosa J. Acute atraumatic pinna (auricular) perichondritis. World J Emerg Med. 2018;9(2):152-153. doi:10.5847/wjem.j.1920-8642.2018.02.013

Additional Reading
  • Amara A, Khoury N, Amara S, Martin G. Clinical Dilemma: Systemic Contact Enterocolitis – A New Disease Term? Presented at the 2008 American College of Allergy, Asthma, and Immunology.

By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.