Metal Sensitivity

This month’s guest writers are from Saint Sabrina’s in Minneapolis, Minnesota:  

As piercers, we have lots of clients who come in to the studio and tell us things like, “My ears always get infected when I wear jewelry” or “I can only wear gold because my ears are sensitive.” or “I’m allergic to all types of jewelry.”  We hear these things from people who are very young as well as our older clients. While sensitivity to jewelry is not uncommon, fortunately it is usually easy to deal with, although in some cases it may require a bit of an investment in high-quality jewelry.


Why Oh Why?

In order to understand how to deal with metal sensitivity or allergic reactions, it’s helpful to understand what is going on to begin with. A sensitivity or an allergy to certain types of metal/jewelry is really no different than a seasonal allergy or food allergy. It means that there is something (an allergen) in the metal that irritates your body. As with any other allergy or sensitivity, your body’s immune system kicks in to gear to try and deal with the allergen. If your body is unable to deal with the allergen, then you have an allergic reaction.

The degree to which a piercing “freaks out” depends on how sensitive to the allergen you are, or in other words, how much it’s bothering your body. If it is only bothering your body a little, the symptoms can be very mild: slight itching,  a small amount of redness and/or the piercing will just feel a little “funny”. If your body is highly-sensitive to the allergen, the piercing may become very itchy, red, swollen, painful and it may throb. It may also secrete a mostly-clear, sticky liquid. In some cases the piercing hole will appear to get bigger as the skin tries to pull away from what is irritating it. It is this fairly severe allergic reaction that many people mistake for an “infection” when they have problems wearing jewelry in their earlobes, but also in other piercings.

As with most allergies, if your body is sensitive to something it gets worse as time goes on and the more you are exposed to the allergen. Because of this, many people find they are able to wear just about any type of jewelry when they are younger, but as they get older and spend more years exposing their body to whatever they are sensitive to, they began to have reactions more frequently and the reaction becomes more severe. Eventually, the reaction can occur with even the slightest amount of contact. Of course, there are some people who are very sensitive from birth and have problems as soon as they come in to contact with the allergen.


All Mixed Up


When it comes to metals used in body piercing (even standard earlobe piercings), almost every metal used is actually an alloy.  An alloy is made by mixing a bunch of different elements/metals in an attempt to create a new metal that has specific combination of  characteristics:  strength, flexibility, rust-resistance, weight, bio-compatibility  etc. Even gold, which many people consider to be  ”pure” is actually an alloy when it is used for jewelry. Gold, in it’s pure form (24 karat gold) is too soft for most jewelry applications, and definitely so for body jewelry. Niobium, and in a few limited applications, titanium, are the only truly “pure” metals used for piercing jewelry. Most of the titanium used in body jewelry is an alloy along with platinum.


So, instead of being allergic to “stainless steel”, it is actually one, or more, of the specific elements used to create the alloy that causes allergic reactions.


Who’s To Blame?


There is no way to know for certain what elements in a particular metal cause someone to have an allergic reaction without having some medical testing done. However, because many people have had these tests done, and through observation over the years, it is widely-accepted that it is the element nickel to which most people have an allergic reaction. Nickel is present, in varying amounts, in all kinds of stainless steel. Obviously knowing what the most common culprit is is makes it easier for us to find solutions.


“Uh, Why Use Stainless Steel Then?”


That seems like a pretty fair question. Stainless steel is used in body piercing jewelry because it is is readily available, relatively inexpensive, resists corrosion/rusting and is relatively easy to machine.

“But, but,’s got nickel in it! ”


Nickel is one of the elements that gives stainless steel it’s “stainless” (i.e, rust resistant) property. The inside of the human body can be a very corrosive environment and therefore something that resists corrosion is very important. So while it can create problems, nickel has some pretty serious benefits as well.

A reaction to nickle in a belt buckle.

Before declaring nickel the bringer of evil when it comes to body jewelry, there are a couple of things to keep in mind.


First of all, not all stainless steel is the same; there are different “grades” of it. For example, your silverware and kitchen knives are probably made out of stainless steel, however they probably are not made out of the same grade of stainless steel that you want to put in your body. Different grades of stainless steel are different alloys and therefore contain different mixtures of various elements. It is these differences, and how they react with each other and the body, that are important. So, the fact that stainless steel contains nickel doesn’t automatically make it bad for use in piercing jewelry.


There is a grade of stainless steel, called 316L, which can be used to create stainless steel that is considered “implant-grade”. Without boring you to tears with all the scientific details of what makes up “implant-grade” stainless steel, obviously it’s important that any stainless steel you put in your body (at least for an initial piercing, and ideally, always) should be implant-grade. It’s also important to emphasize that just because stainless steel is 316L that DOES NOT mean it is automatically implant-grade. There’s a good chance that most of the stainless steel jewelry you see at inexpensive mall stores and kiosks is not implant-grade quality stainless steel.

It’s also important not to be fooled by the label “surgical stainless steel”. There is no official designation for “surgical stainless steel”. If you wanted to start making body jewelry you couldn’t go to a steel supplier and find “surgical stainless steel”. That term was created by marketing departments of companies that wanted their products to seem more “safe” or more “medical”. Seeing jewelry (or anything else for that matter) labeled “surgical stainless steel” tells you absolutely nothing about the material it’s made of other than it’s SOME form of stainless steel.


Needless to say, all stainless steel jewelry we use for our initial piercings, and whenever otherwise possible, meets the specifications for being implant-grade. We have “mill certificates”, which are provided by the mills that produce the raw materials, verifying the material they supply to our jewelry sources meets the standards for being implant-grade.


Our Experience With Implant-Grade Stainless Steel


As we mentioned at the beginning of this blog, a lot of our customers have trouble wearing cheap jewelry from mall stores or elsewhere. Most people experience problems with this type of jewelry because of a higher nickel content found in low-quality jewelry. A reaction is also more likely to occur due to a poor polish/finish on the jewelry which makes it easier for the nickel in the stainless steel to interact with the body. Because most inexpensive jewelry is mass-produced overseas there are very few controls to help ensure the quality or content of the metal.


Most of the time, people who have trouble wearing “cheap” jewelry from the mall are able to wear our implant-grade stainless steel jewelry with absolutely no problems. The small percentage of nickel contained in implant-grade stainless steel, the way it bonds with the other elements in the alloy and the mirror-like polish/finish make it a great option for most people to wear…even those that have experienced problems wearing stainless steel jewelry in the past.

On our piercing release form we asks our clients if they have a known allergy to nickel or other metals. If someone indicates that they have a nickel allergy or that they are generally sensitive to metals, we will then ask them if they have reactions to the backings on watches, zippers or buttons on pants or reactions to bracelets or necklaces. If they indicate they can wear those things without any problem then we would consider them to probably be fine to wear implant-grade stainless steel. It is very uncommon for someone to react to implant-grade stainless steel if they are able to wear most other types of jewelry without a problem.


If a client knows for certain they have a nickel sensitivity or allergy, or they find that they do tend to react to the items previously mentioned, then we would suggest they choose jewelry made from an alternate material.

These of course are just “rules of thumb” and there is know way for us to be 100% certain how anyone will react to a certain material until they try wearing it. However, we use stainless steel extensively and using these “rules of thumb”, we rarely have a client who has an allergic reaction to jewelry.


What To Do, What To Do?


If it seems as though stainless steel isn’t going to be a good option, fortunately there are a number of other metals we can use for piercing jewelry. We are going to confine the discussion to other metals, although there are certainly lots of other materials that can be worn in piercings. The metals we are going to talk about are gold, titanium, and niobium. We are only going to give a brief overview of these materials as they apply to piercing. If you want to know more, there is a nearly limitless supply of information available on-line and you can always leave additional questions in the comment section.

Try Ti    


Titanium is a metal that is used extensively in the medical field: bone and joint replacements, dental implants, facial and cranial repair, pacemaker cases and limb prosthesis. Needless to say, if it can be used so extensively for such critical applications inside the human body, it should be great for use in body jewelry. While titanium is a pure element, there are a number of different alloys used in medical applications, including the one most commonly used for body jewelry: 6Al4V ELI. As with stainless steel, there are specific requirements that must be met in order for the titanium to be specified “implant grade”.


The titanium alloy used for body jewelry contains no nickel. That fact, combined with the bio-compatibly of titanium, make it a great alternative for those with nickel sensitivities/allergies. In addition, it is very lightweight, very strong and it can beanodized in a variety of different colors.

Titanium does tend to cost more than stainless steel, but unless it is a very large piece of jewelry, it’s not a great deal more expensive. Even with the additional cost, titanium is significantly less expensive than gold or platinum.


Niobium. Not a word you hear very often. Niobium, like titanium, is an element on the periodic table. Niobium is used in several medical applications, including pacemakers, demonstrating a very good bio-compatibility. This bio-compatibility makes it an option for use in body jewelry. Niobium can also be anodized to produce an array of different colors. While niobium cannot be anodized black, through a process of heating and rapid cooling it takes on a very dark/metallic gray color.

Unlike titanium, the niobium used in body jewelry is not an alloy; it is pure niobium.


At one point, niobium was used much more commonly in body jewelry than titanium. However, the cost of niobium has increased quite a bit over the past 10 years making it less appealing. In addition, niobium is even heavier than stainless steel and is more difficult to machine than both steel and titanium, making it less-ideal in many piercing applications than titanium.


Sold on Gold

When it comes to metal that is safe to wear in the body, gold is one of the most bio-compatible, chemically-intert metals on the planet. It is a great option for those folks that have metal sensitivities. Before we get in to the specifics of why gold works so well, let’s establish a couple of ground rules. When we are talking about gold for use in body jewelry, we are referring to 14kt or 18kt solid gold. Gold that is less than 14kt does not contain enough gold to be safe for most people and higher than 18kt is too soft for most body jewelry applications. Any gold jewelry less than 24 karat is going to be an alloy…a mix of gold and other metals. If you want a quick explanation of the “karat system”, check out this article.

We insist on solid gold jewelry because the metal that plated gold is applied to is usually very low quality.

The reason yellow gold works so well for so many people is the combination of gold’s great bio-compatibility and that there should be no nickel in a yellow gold mixture. Many people with metal sensitivities are convinced that they can only wear yellow gold jewelry for this very reason.  It is quite likely most of these folks would also be able to wear titanium, niobium or platinum without any issues.


You may have noticed that we have only mentioned yellow gold up to this point. There is a reason for that:

Yellow gold is the most common type of gold, with white gold being the next most common color. Many gold makers achieve the “white” coloring in white gold by adding nickel to yellow gold. So, for those who are sensitive to nickel, white gold may not be a great option. However, don’t give up on white gold! It is becoming more common to use palladium in place of nickel to achieve the coloring of white gold. Palladium is part of the platinum family and is very bio-compatible. The majority of our white gold jewelry is made with palladium instead of nickel.


Another color of gold that is becoming very popular is rose or red gold. This is a beautiful “coppery” colored gold. Rose gold is made by adding…you guessed it!…more copper to the yellow gold mixture. Assuming the yellow gold mixture doesn’t contain any nickel, this should be a safe color of gold for those sensitive to nickel. While not common, there are some people who do not react well to the extra copper in rose gold. To date, we have had no clients experience a problem wearing rose gold, but it is a possibility.

So Where’s the Silver Lining?


We have many clients who ask us about the use of silver in their piercings. While silver is used for lots of types of jewelry, it actually makes a poor choice for body jewelry. As you are probably aware, silver tarnishes easily…it begins to lose it’s shininess even if it’s simply sitting in a cabinet or drawer. This tarnishing happens if the silver is exposed to nothing more than air, so it shouldn’t be hard to imagine how much easier, and more severely, this tarnishing (called oxidizing) could happen inside the human body.


In addition to the irritation it can cause, when silver tarnishes/oxidizes inside the body, it is very common for it to leave a grayish-black “stain” in the skin. This is sometimes referred to as a “silver tattoo”. Obviously this isn’t the type of tattoo most people are interested in. Even sterling silver (92.5% silver, 7.5% copper) can oxidize inside the human body.

In addition to the issue of oxidation and reaction, silver is a very soft metal and therefore doesn’t tend to hold it’s shape well enough for many body piercing applications.

Sterling silver can be used for some body jewelry, but this tends to be limited to very specific designs typically intended for earlobe piercings and it should only be used in well-healed piercings.


Time for a Little Q & A


When we decided to write this blog, we posted to our Facebook page to see if anyone had specific questions related to metal sensitivities . We received a few inquiries, so here are the answers to those questions:


“Is there any material that should be avoided during stretching?”


This question is a little different than what we’ve been focusing on, but it’s still a great question. The short answer is yes, there are materials that should be avoided. The slightly longer answer is: materials such as horn, bone, antler, wood, fossilized mammoth, plastic and silicone should all be avoided when stretching.


The stress placed on tissue from a stretch, even an easy stretch,  can cause it to become swollen, inflamed and/or simply stressed. This can result in production of fluids, including blood in the case of an over zealous stretch. The materials mentioned above are at least somewhat porous with many of them being quite porous. This can allow any fluids being secreted to “soak” in to the jewelry. This organic matter will then sit in the jewelry and begin to rot. Needless to say, having rotting organic matter inside your freshly-stretched piercing is no good.


When it comes to stretching, stick with non-porous materials such as stainless steel, titanium, niobium, gold, platinum, glass or stone.


“I have jewelry sensitivities and am allergic to any kind of jewelry material but 14k gold, and surgical steel, bone and plastic. plus have facial piercings. What is the best choice for facial jewelry with those kind of limitations, without burning a giant hole in my pocket”


Hopefully after reading this, you will have a better understanding of why you may be having the reactions you have experienced in the past. If you are able to wear implant-grade stainless steel, that will tend to be the least expensive option. The important thing to to make sure it is of a good enough quality. Titanium should also work just fine for you and isn’t typically that much more expensive than stainless steel.


“How come the sensitivities sometimes seem worse?”


As we mentioned in the article, sensitivities often get worse over time as we are exposed to more of the thing(s) that we are sensitive or allergic to. If you are experiencing problems where some pieces of jewelry seem to bother you more than others, chances are it’s a result of the material make-up of what you are wearing. Certain pieces of jewelry may contain more of the thing(s) that your body doesn’t like, making the reaction worse.


Also, any time your body is already weak (i.e., sick, stressed, other allergies flaring up) it is likely that any type of sensitivity to metals will seem more severe.



This turned out to be a bit more of an undertaking than initially anticipated. But, if you finished the whole thing, you should reward yourself with cake. Or, something else delicious if you prefer. But, we all know cake is the best.