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Skin Troubles From Wearing Jewelry

From The American Horologist and Jeweler magazine, January, 1946

Skin Troubles From Wearing Jewelry
METAL AS WELL AS PLASTICS AS TROUBLE MAKERS

For a long time we have known that the use of jewelry has some hazards for the skin of the wearer though the percentage of those hazards is not high. Recently Dr. Louis Schwartz, one of the foremost experts in industrial skin troubles, and Dr. S. M. Peck, have published a study on dermatitis (inflammation of the skin) from wearing apparel and this study contains also a survey Oll the use of jewelry.

METAL AND PLASTICS 

The authors stress that the incidence of dermatitis due to wearing jewelry-and by the way, handling jewelry-is small compared to the millions of users. Dermatitis has been reported from metal and metal alloys used in jewelry and in eyeglass frames, wrist watches and straps. In most cases reported. the skin trouble was due to metallic jewelry, but Dermatitis can occur from some of the modern jewelry made from various plastics and other materials. Cases of dermatitis from earrings, necklaces. lockets, watches and spectacle frames have been reported.
Most of the reported cases of dermatitis from metallic jewelry have been attributed to nickel, according to Schwartz and Peck. Such cases of nickel sensitivity have been found among the wearers of watches and spectacle frames made of nickel alloys, among which is the socalled white gold. Schwartz and Tulipan, in an earlier report have mentioned the case of a worker handling platinic oxide who became sensitive to the material. But there are no instances of dermatitis in the medical literature which would be connected with the wearing of platinum jewelry.

TESTING WITH JEWELRY 

To recognize a harmful material which irritates the skin, a skin or patch test is being made. It is of increasing importance for recognition of this kind of skin disturbances. It allows to find out whether people who are working with certain materials, are particularly sensitive (allergic) to certain substances they have to work with-or whether people are sensitive to materials they are wearing on the skin.

The first test with jewelry is made with the suspected material itself. Articles are rarely if ever made of the pure metal, and even the so-called pure gold and platinum jewelry contains other metals. It is necessary, Schwartz and Peck point out, to determine the other metals which make up the alloy and patch test with each metal. In this regard they wish to call attention to the fact that in testing for nickel sensitivity the five cent piece is not a proper material, since it is made of 75 per cent copper and only 25 per cent nickel. To test for nickel sensitivity a 5 per cent solution of nickel sulphate should be used. Similarly a one cent piece is not proper metal for testing for a possible copper sensitivity, since a penny in addition to copper contains 5 per cent tin and zinc. All of the sjlver coins contain 10 per cent copper.

To carry out the patch test, a piece of cotton or gauze is dipped in a watery solution or an alcoholic extract of the suspected material-or a small portion of the suspected material may be used for the test-and this is applied to a clear spot on the arm or back. The sample is removed at the end of 48 hours-or sooner, if an inflammation of the skin has resulted.

A positive test is indicated by redness or vesiculation at the site of the contact of the skin and the suspected material. Nothing happens if the test is negative. Sometimes it takes considerable time and patience to find out the real cause of such unpleasant skin troubles.

WRIST WATCH DERMATITIS 

A physician described his own cases of severe dermatitis which he suffered from wearing a watch bracelet of a new synthetic, flexible substance. After the first signs had appeared, the· watch was removed and placed on the other wrist for four hours. The same trouble was repeated on the other wrist. The strange feature of this watch bracelet dermatitis was that the wearer became sensitive after the bracelet had been worn continuously for two months-without harm. The skin trouble developed at a time when the physician spent some hours in conference in an excessively hot room and perspired rather freely.

It would not have been justified if this man had returned the wrist watch bracelet to the jeweler where he had bought it. The great majority of customers had not the slightest trouble from wearing those straps whether they were made from leather, metal, or any other material.' Some years ago in England a customer sued his jeweler because an eczema (skin eruption) had developed on his wrist after the use of a new wrist watch. The eczema gradually proceeded to arm and shoulder, the man was even compelled to a temporary cessation of work (he was a surveyor). The watch was supposed to be a nickel-watch. Chemical tests showed that the case of the watch consisted of an alloy, composed of 55 per cent copper, 13 per cent nickel, 31 per cent zinc, and traces of lead and tin. The court found the watchmaker not guilty-and neither was the manufacturer of the wrist watch found guilty of negligence.

There were also observations in other countries that an eczema occurred after wearing a chromiumplated or nickel-plated wrist watch.

CHROMIUM PLATING

In one case ,an eczema occurred whenever the man wore a chromiumplated nickel wrist watch-while this did,not occur when he wore a cheap non-chromium-plated wrist watch. But no large-scale appearance of such skin troubles has occurred anywhere. 

Chromium plating is done by means of a hot solution of chromic acid at about 30 per cent concentration. The solution is very caustic and poisonous and easily causes eczemas and ulcers.
This hazard, however, does not apply to the finished product.

Observations have shown that contact dermatitis may occur by wearing chemically manufactured wrist watch straps or which elastiglass is an example. The Office of Dermatitis Investigation of the U. S. Public Health Service found that the acid gum ester of the resin was the irritant responsible for the skin reactions described. Dr. Greenfiel recently reported a series of cases of elastiglass dermatitis.
Some people wearing elastiglass wrist bands continuously for varying periods of ten days to eight weeks, developed an area of itching beneath the contact area, followed by blisters, reddening and swelling. Heat and moisture were' important factors in the production of skin reactions.

The irritation was slow in subsiding, generally requiring a period from two weeks to one month before the rash would fade completely. The same lesions would be reproduced within 24 hours when the offending wrist band was placed on a nonirritated part of the skin of the sensitive person. 

All in all we may say that injuries from jewelry, wrist watches, straps, etc. are not frequent. Where they occur, sensitivity of an individual is the most common cause. 

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