Gold allergy
Contact allergy to gold salts in jewellery.
About gold allergy
Gold, despite its reputation as inert and hypoallergenic, can cause allergic contact dermatitis through soluble gold salts released from jewellery. This is a delayed, type IV reaction that may appear 12 to 72 hours after contact, though gold allergy can be slow to declare itself and sometimes produces a grumbling, low-grade rash rather than an obvious flare. It is found more often in women, reflecting patterns of jewellery wear, and positive patch tests are not uncommon, although they do not always correspond to obvious symptoms.
The rash is itchy and red, sometimes with small bumps, scaling or swelling, and typically appears where gold jewellery sits, such as the earlobes, fingers, wrists and neck. Interestingly, gold allergy can also show up as eyelid or facial dermatitis, thought to arise when tiny amounts of gold are shed and transferred to more sensitive skin. Repeated contact can make the reaction persistent.
Diagnosis is by patch testing carried out by a dermatologist, using gold sodium thiosulfate rather than skin-prick testing. A positive result should be interpreted alongside the person's actual symptoms, as not everyone who tests positive needs to stop wearing gold. Management involves reducing contact with gold jewellery where it clearly causes problems, and treating flares with emollients and, if advised, topical steroids. See your GP or a dermatologist if a jewellery-related or facial rash is persistent or unexplained.
Common triggers
- Gold and products containing it
Symptoms
- Red, itchy rash (contact dermatitis)
- Dry, cracked or scaly skin
- Blistering or weeping in severe cases
- Burning or stinging where skin met the trigger
Avoidance & management
- Avoid skin contact with the trigger
- Wear gloves or use barrier creams
- Choose products labelled free from the allergen
- Rinse skin promptly after contact
- Use emollients or prescribed steroid creams
Sources & references
Allergy safety: what everyone should know
Mild-to-moderate reaction signs
- Itching, hives or a raised rash
- Swelling of lips, face or eyes
- Tingling mouth, sneezing, runny nose
- Stomach pain, nausea or vomiting
Anaphylaxis — call 999 (UK) or 112 (EU) immediately
- Difficult or noisy breathing, wheeze, persistent cough
- Swelling of the tongue or tightness in the throat
- Dizziness, collapse, pale and floppy (young children)
- Use an adrenaline auto-injector (e.g. EpiPen) at once if prescribed, then call an ambulance even if symptoms improve
Allergy or intolerance? A true allergy involves the immune system and can escalate quickly; an intolerance (e.g. lactose intolerance) is unpleasant but not life-threatening. The symptoms overlap, so self-diagnosis is unreliable.
Getting tested: home-testing kits based on IgG are not diagnostically valid. If you suspect an allergy, ask a GP for referral to an allergy clinic for skin-prick or specific-IgE testing and a supervised food challenge where appropriate.