What Causes Gold Contact Allergy? - Gold Sodium Thiosulfate
There’s nothing more frustrating than coming to the realisation that your freshly acquired, suave gold jewellery is, in fact, the cause of unwanted allergic reactions.
Even if it flew under the radar when you were trying the piece on in a jewellery store, or even for the first days or weeks wearing it, some alloyed golds have the potential to trigger frustrating skin allergies down the track. This can sometimes be because the gold plating has worn down, exposing some of the hidden metals that lay beneath.
For this reason, it’s always best to ensure you know which metals you’re allergic to and exactly which alloys are contained within any gold jewellery you plan on purchasing. This way, you can guarantee that your jewellery won’t irritate your skin and cause you to resent it down the line – there are few things worse!
But how exactly do gold contact allergies work? What’s the science involved? Let’s get into the specific causes behind this unwanted side effect of wearing alloyed jewellery.
What is gold contact allergy?
The overall question many of you may have wondered reading the beginning of this article is most likely: can you be allergic to gold? To answer this question, You need to understand the different types of gold available for purchase.
Contact allergy to gold is a delayed-type hypersensitivity reaction following exposure to gold or its alloys, typically manifesting as allergic contact dermatitis (skin rash). To be clear, though, a reaction to gold isn't due to the gold itself, but rather other alloyed metals in the gold, such as nickel. Some gold contains trace amounts of nickel. So, if you have a metal or nickel allergy, contact with certain types of gold may cause a skin reaction.
Metallic gold is known for its electrochemical nobility, as well as its resulting lack of reactivity. For these reasons, it is usually accepted to be a non-allergenic metal. Consequently, contact dermatitis as a reaction to pure gold has always been rare, and is considered non-existent.
Who gets gold contact allergy?
Those of you allergic to gold are probably curious as to just why it is you in particular (and others like you) that this happens to. Individuals with gold contact allergy have, in most cases, already been exposed to gold in jewellery, dental restorations, or through their occupation.
Gold allergies are diagnosed most frequently in women (90%). This is probably due to women typically wearing more gold jewellery and generally having more piercings than men.
Those with gold allergies are often allergic to the more common alloys, such as nickel and cobalt. Cobalt has been found in some patch test series to be the second-most-common metal allergen after nickel, although the clinical relevance of this is still in question.
What causes gold contact allergy?
A gold allergic reaction can happen for any number of reasons. A gold allergy is a type IV hypersensitivity reaction, which often develops following skin piercing and the immediate wearing of gold studs. This process allows the dermis to come into direct contact with the gold.
Titanium dioxide – which is found in various sunscreens and cosmetics – can also potentiate the release of gold from jewellery. Copper in low-carat gold jewellery is also known to cause gold release, which can result in a gold allergy despite the limited gold content it contains. This is the worst case scenario!
Symptoms of gold sodium thiosulfate allergy
People with an allergy to gold often present with contact dermatitis (irritation of the skin), contact stomatitis (irritation around the mouth), or oral lichen planus (irritation within the mouth). Skin manifestations, such as a papular pruritic rash, are most commonly found on the ears, eyelids, or the area around the eyes, the fingers, and the neck. And as far fetched as it sounds, reactions in remote areas of the body – far from the contact area – are also possible.
It has been found that one in ten people with eczema had positive reactions when their standard patch tests included gold patch testing (as GSTS). Thus, gold is a potent sensitiser, second only to nickel sulphate.
Those with gold fillings, or individuals who wear gold, show an incidence of allergy that is higher than normal. This means that the gold in the fillings could be a major cause of gold allergy. At the same time, people with contact allergy to gold have a higher chance of sensitivity to other monovalent gold salts, such as gold sodium thiomalate, as well as to nickel and cobalt.
What are the complications of gold contact allergy?
Gold contact allergy can proceed to a persistent nodular reaction, particularly regarding piercings. Histological testing may also show a pseudolymphomatous or sarcoidal inflammatory reaction.
A cutaneous (skin-related) contact allergy to gold can also result in localised or generalised reactions from subsequent exposure to gold-containing implants or medications.
What is the treatment for gold contact allergy?
Treatment for a gold allergy is, as for all allergic contact reactions, avoidance of the allergen and treatment of the inflammatory reaction. Despite avoidance, gold contact reactions can be quite persistent.
Some individuals will be able to slowly reintroduce wearing gold jewellery for limited time periods, whereas others will have to avoid gold indefinitely - depending on the severity of the reaction.
Chronic dermatitis may require treatment from emollients and topical corticosteroids, whereas surgical excision may be required for persistent nodules.
Gold patch testing
Gold sodium thiosulfate (GST) of various concentrations in petrolatum is the most commonly used gold allergen in patch testing. Gold patch test allergens are a known irritant to atopic skin. The reaction to the allergic patch test can also be delayed, appearing up to 3 weeks after actual initial removal of the patch. On top of that, it can also be persistent, lasting months after the initial test has been conducted.
The clinical relevance of a positive patch test reaction to GST must then be assessed. The relevance of a positive gold patch test is low compared to many other allergens, and may explain the clinical presentation in only 10-15% of cases.
Persistent nodular reactions may require a skin biopsy of the affected site, with the purpose of excluding other diagnoses.
What to look for in jewellery
If you’ve got an allergic reaction to gold, the best way to prevent a reaction is to simply wear jewellery that doesn't irritate your skin. You can opt to avoid gold jewellery altogether, or only wear 18 or 24-karat gold.
Considering that the underlying cause is often a nickel allergy, though, you'll probably need to avoid other types of jewellery as well (this unfortunately also includes costume jewellery).
You should always seek out jewellery that's hypoallergenic, or nickel-free. You can also prevent a skin reaction by wearing stainless steel or titanium. Another tip for any watch wearers out there is to switch out metal bands for bands made of cloth, plastic, wood, or leather.
If your job requires constant contact with nickel or gold, opt to wear gloves that will reduce your likelihood of a reaction.
Always keep in mind that nickel is found in many everyday items, too, which can cause a reaction with skin-to-skin contact. These items include eyeglass frames, tools, keys, coins, belt buckles, razors, and even bra hooks.
Here it is also best to seek alternatives/take preventative measures in order to avoid nickel. For example, you could consider switching out your metal eyeglass frames for plastic or titanium frames.
Purity is king
As we mentioned, the most surefire way to guarantee that your gold jewellery won’t harm you is to go the extra mile concerning the purity of your piece. Since science has established that pure gold itself is not responsible for allergies, investing in pure gold jewellery the safest way to guarantee that jewellery won’t cause skin or body irritation. And for those of you ready to make that investment into pure gold jewellery, what better way to begin than with our 24-Karat Gold collection? By purchasing your gold jewellery from 7879, you are purchasing an item of gold jewellery that won’t cause nasty skin reactions. You can also rest assured that your jewellery is both sustainable and ethically sourced.
Head to the 7879 store and check out what’s waiting for you in our collection. Invest in something fashionable and permanent - invest in 24-karat gold jewellery.