• Kristina David

Do I have systemic contact dermatitis or systemic nickel allergy syndrome? Where do I begin...

Updated: Oct 13, 2019

Where to start, what specialist to see, and what diagnostic test to request.



Do you struggle with uncontrollable eczema? Are you allergic to jewelry? Did you develop worsening eczema from eating healthier or changing to a plant-based diet? Do you have irritable bowel syndrome or another gut related disorder? Do you suffer from fatigue or joint pain?

These are some common symptoms that a person with a rare type of allergic contact dermatitis to metal may have. This condition is known as systemic contact dermatitis or systemic nickel allergy syndrome (SNAS).

Systemic contact dermatitis (SCD) is characterized by developing symptoms, most commonly skin rashes, from exposures to an allergen by various routes, not limited to physical contact. Ingesting, infusing, inhaling and implanting are other ways in which we are exposed to allergens. Individuals with SCD will experience symptoms, such as a relapse in eczema, when exposed to allergens via any route. For example, if a person with a nickel allergy has SCD or systemic nickel allergy syndrome (SNAS), they could experience a flare in rashes 1-4 days after eating foods high in nickel, such as chocolate, nuts, seeds, beans, soy, and whole grains.


If you suspect you have SCD to metal, (most common metal allergies are #nickelallergy and #cobaltallergy), you must first……


1. Request patch testing with a dermatologist.


2. After confirming what you are allergic to via patch testing, adhere to strict avoidance strategies. Be diligent to not touch, wear or apply any products in your environment that contain the allergen(s) you are sensitized to. Contact Allergen Management Program is a helpful tool to ensure your products are safe.


3. If all else fails and you still have uncontrollable eczema, discuss trialing a low nickel or low cobalt diet with your doctor. It is helpful to bring research articles on SCD to cobalt and systemic nickel allergy syndrome (#SNAS) to review with your doctor.


4. Once you get the okay from your doctor to begin a low nickel or low cobalt diet, find the best resources. A few of my favorite are:


Low Nickel Diet & Lifestyle – Living & Eating Well with Nickel Allergy/SNAS

INDD – Italian Nickel Detox Diet

Nickel Navigator

Rebelytics – Low Nickel Diet Scoring System

Cobalt Allergy Help – Facebook group

Rebelytics Low- Cobalt Diet

Cobalt Companion


It may take around 6 weeks - 4 months to notice any significant improvement in rashes after starting a low nickel or low cobalt diet. Histamine intolerance could play a role in worsening eczema as well. A helpful resource for a low histamine diet is:


SIGHI-Leaflet Histamine Elimination Diet




Managing this complex allergy can be overwhelming and confusing. If you need help, contact me. I am a registered nurse and certified health coach specializing in systemic contact dermatitis and systemic nickel allergy syndrome. Schedule your free consultation today!



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