Nickel Sensitization From Ear Piercing Department Of Dermatology Gentofte Hospital, Denmark A. Boss and T. Menne The main cause of nickel sensitization at the present time is ear piercing. In the San Francisco area, 11 % of females in the age group less than 24 years of age are nickel sensitized. Most frequently the sensitization was correlated with piercing of the ears. The present study evaluates the nickel sensitization rate in young females who have had their ears pierced. The investigation was performed in a school for hairdressers. The girls were aged between 16 and 22 years. At the time of the investigation, none had done any practical work as part of their training. Among the 107 pupils 98 had their ears pierced with a mean of 2.5 (range 1-7) holes per pupil. In 75% of the cases, the holes were made by a jeweler. The rest were made by friends, hairdressers or the pupils themselves. In no instances did a doctor make them. The initial reaction after the holes were made disappeared after 4 days in 45% of the cases. The healing time ranged from 2 days to 8 months. Seventy-one of the 107 reported either oozing or dermatitis when costume jewelry was used in the ears. The number of complaints was independent of the healing time, as well as the number of holes. Among the 53 patch tested, 32 had had some reaction to costume jewelry. The other 11 did not have any trouble either at the time of ear piercing or subsequently. Among the 53 patch tested, 11 had a positive reaction to nickel and 1 to cobalt. All the positive reactions were found among those with previous oozing or dermatitis of the ear lobes. A use test with the implicated jewelry was made on 13 pupils, 5 with a positive nickel patch test and 8 with a negative test. All had experienced trouble with some earrings. They were asked to wear the earrings for 48 hours. In the 5 with a positive patch test, all had an eczematous reaction from the earrings. Seven of the 8 with a negative nickel patch test had a similar eczematous reaction when exposed to earrings. COMMENTS The manner of ear piercing today and the use of nickel-plated jewelry results in a nickel sensitization rate of a minimum of 20% among young females. Most costume jewelry is made up of a nickel alloy. The outcome of the use test was surprising. Those with an unexpected positive use test may be nickel sensitive, having a false negative patch test. Another possibility is that the reaction is caused by local sensitivity, or may be due to irritation or infection. All the girls investigated intend to become hairdressers. Hand dermatitis in hairdressers is often related to nickel allergy. It is possible that the nickel allergy is not occupational at all, but due to sensitization from costume jewelry. We intend to follow the sensitized girls to see whether they develop hand dermatitis to a greater degree than those not nickel sensitive. Synopsis: Complete report available upon request.