VITAL SIGNS: SIDE EFFECTS; When Body Piercing Causes Body Rash

By DENISE GRADYOCT. 20, 1998They arrive at Dr. David Cohen's office decked out in metal, wearing rings and studs in their ears, eyebrows, noses, navels, nipples and nether parts. Often, they arrive scratching.Dr. Cohen, a dermatologist at New York University, is an expert on contact dermatitis, a condition that occurs when a substance a person is allergic to rubs against the skin.The result is itching, often with a rash that may swell and weep. The rash from poison ivy is a type of contact dermatitis.Dr. Cohen has treated so many fans of body piercing lately that he will lecture about them next week in New York, at a meeting of the American Academy of Dermatology, which has declared November ''National Healthy Skin Month.''AdvertisementMost of Dr. Cohen's pierced patients are allergic to their jewelry, specifically, to nickel, which is often used in inexpensive costume jewelry. Nickel is the metal most likely to provoke allergic reactions, followed by chrome, cobalt and palladium, which are also found in costume jewelry.AdvertisementA decade ago, 10.5 percent of Americans were sensitive to nickel, but now the figure is 14.3 percent, and doctors think the increase may be linked to the piercing craze, as more and more people expose more and more skin to cheap jewelry. Newly pierced skin is the most likely to react to nickel, Dr. Cohen said, and the best way to prevent the allergy is to wear pierced jewelry made only of stainless steel or gold, especially while a freshly pierced opening is healing.Please verify you're not a robot by clicking the box.Invalid email address. Please re-enter.You must select a newsletter to subscribe to.View all New York Times newsletters.It might seem a matter of common sense just to remove the jewelry if a rash develops, instead of going to the doctor. But the connection is not always obvious, Dr. Cohen said. For one thing, there is a time lag between wearing the jewelry and breaking out. ''You might wear it on Friday night, and you start itching on Tuesday,'' he said. Then, the rash can persist for weeks, and it is easily mistaken for an infection.Treatment consists of taking off the offending jewelry and putting a cortisone cream on the rash, Dr. Cohen said. If the area is very inflamed, no jewelry should be worn until the rash goes away, even though leaving it off may cause the hole to close. But if the allergic reaction is not severe, the jewelry can be replaced immediately with a piece made of stainless steel or gold that is 14-karat or more. Sterling silver is also safe for most people, but, Dr. Cohen said, jewelry sold as silver often turns out to contain nickel or chrome. Kits are sold to test for nickel, he said.Skin tests can diagnose metal allergies. ''We can test for 24 metals at once, on a patch of skin on a person's back that takes up the area of about three business cards,'' Dr. Cohen said. ''Then, you can avoid what you're allergic to.''Sometimes, Dr. Cohen said, people with a nickel allergy cannot resist wearing a favorite piece of jewelry for special occasions, even if they are allergic to it. They can get away with it once in a while, he said, by judiciously using cortisone cream. He does not scold them. ''People are very proud of piercing,'' he said. ''I think it's fine. It's their individual expression of themselves.'' DENISE GRADYWe are continually improving the quality of our text archives. Please send feedback, error reports, and suggestions to .A version of this article appears in print on October 20, 1998, on Page F00008 of the National edition with the headline: . Order Reprints| Today's Paper|Subscribe