Hypoallergenic earrings: what actually matters

A word the court threw out

On 6 June 1975, the US Food and Drug Administration published a rule to pin down a word that was turning up on more and more make-up counters: hypoallergenic. A product could carry it, the rule said, only if tests on people showed it caused significantly fewer skin reactions than similar products.

Two cosmetics companies that sold "hypoallergenic" ranges, Almay and Clinique, took the FDA to court. They lost the first round and won on appeal. The appeals court ruled the regulation invalid, finding that the FDA had not shown that shoppers understood the word the way the rule defined it.

Nothing replaced it. The FDA's own advice today is plain: there are no federal standards or definitions for the term, and it means whatever a particular company wants it to mean. That story is about cosmetics, but the word crossed over to jewellery long ago, and it arrived there with no more meaning than it had on the make-up counter.

The good news is that sensitive ears don't need the word. For earrings, there is something far more useful: a measured limit on the metal that causes most of the trouble.

What the law measures instead

The metal is nickel. The Sheffield Assay Office describes it as now the most frequent cause of contact allergy in Europe, and the American Academy of Dermatology names earrings, earring backs and watches among the biggest culprits. Nickel is useful to jewellery makers: it can smooth and brighten a surface before plating, and added to gold it can whiten it to make white gold. It is also, as the UK trading standards guidance puts it, likely to be found in most metals in trace quantities.

So the law in Britain and the European Union does not ask whether an earring contains nickel. It asks how much nickel comes out of it. The rule sits in entry 27 of Annex XVII to the REACH regulation on chemicals, which the UK kept after Brexit as UK REACH. It sets two limits, measured as the weight of nickel released from each square centimetre of metal in a week.

A microgram is a millionth of a gram, so these are very small amounts. They are measured by a European standard test, EN 1811, in which the piece sits in artificial sweat. For coated pieces, a laboratory first puts the item through wear and corrosion meant to simulate two years of normal use, then tests it.

This is the real difference between an earring that suits sensitive ears and one that doesn't. Not the word on the card, but how much nickel reaches the skin.

The post: the strictest rule

An earring post is different from a ring or a pendant. It passes through the skin rather than resting on it, so the law holds it to a lower limit: less than 0.2 micrograms per square centimetre per week, against 0.5 for everything else.

It is worth knowing exactly what counts as the post. UK trading standards guidance describes the post assembly as the part designed to go into the piercing, plus any faces that hold the piece in and against it, such as the ball or the butterfly. In other words, the back is covered too. The UK guidance for piercing studios, published by the Chartered Institute of Environmental Health and endorsed by Public Health England, gives the same reading: the piece that goes through, and the earring back or the balls on the end of a bar.

Metals that are generally tolerated

No official body promises that any metal will suit every ear. But a few metals come up again and again in their advice, and it helps to know exactly who says what.

Two of those rows deserve a second look.

Steel. It surprises many people that steel made for surgical implants contains nickel, and a good deal of it. The reason it can still suit sensitive skin is that well made stainless steel holds on to its nickel. A 1994 study in the journal Contact Dermatitis found that low-sulphur 304 and 316L stainless steels released less than 0.03 micrograms of nickel per square centimetre per week in acidic artificial sweat, while nickel-plated samples released about 100. None of the nickel-allergic patients tested reacted to the low-sulphur steels. A high-sulphur grade, 303, released more, and some patients did react to it. "Stainless steel" on a label doesn't tell you which kind you have, which is why the nickel release test matters more than the name.

Gold. A carat number tells you how much gold is in the alloy, not what the rest of it is. The advice from American dermatologists is specifically for yellow gold. The Sheffield Assay Office notes that nickel added to gold can bleach it to make white gold, so a white gold earring is worth asking about.

Plating, and why it matters how long it lasts

Many earrings are a base metal with a thin coat of something finer on top: gold or silver plating over brass, for instance. The law allows this, with one condition that matters a great deal to sensitive ears. If the metal underneath releases nickel, the coating has to keep the release within the limit for at least two years of normal use.

That rule exists because coatings wear. A plated stud that behaves perfectly in its first month can start to cause trouble later, as the top layer thins where it rubs. If an earring that used to be comfortable starts to itch after a long time, worn plating is one possibility worth considering.

A piece described as solid, such as solid 18 carat gold or solid sterling silver, has no coating to wear through, though it can still be plated on top for colour.

Reading the label

Here is what the common words can and can't tell you.

• Hypoallergenic. We could find no definition of the word for jewellery in UK or EU law. The only official European guidance on it is for cosmetics, in a non-binding technical document agreed by a working group of EU countries. Even there, it says the claim "does not guarantee a complete absence of risk" of an allergic reaction.
• Nickel free. More specific, and more useful, but still worth a question. Trading standards guidance notes that nickel is likely to be found in most metals in trace quantities.
• Surgical steel. A description, not a standard. If a seller names a grade or a specification such as ASTM F138, you have something you can check.
• Complies with REACH, or tested to EN 1811. This is the claim that answers the real question, because it refers to the nickel release limits.

In the UK, whatever words a seller uses, consumer law forbids giving false or misleading information about a product. A business that says "hypoallergenic" or "nickel free" is responsible for the claim being true.

New piercings

A fresh piercing is an open wound, which is why the strictest limit applies to the post. The UK guidance for piercing studios lists titanium, niobium, platinum and solid 14 or 18 carat gold as acceptable materials, and advises against gold below 14 carat, which can contain metallic impurities that may lead to an allergic response.

The NHS advises choosing a qualified, experienced and licensed piercer, cleaning a new piercing twice a day, and using warm, salty water to soften any crusting. It also says not to pierce your own ears, because you are much more likely to get an infection.

It is easy to confuse a reaction with an infection, and the two need different responses. The NHS says it is normal for a new piercing to be tender, itchy and slightly red or darker than usual for the first few weeks. Signs of infection include swelling, pain, heat, blood or pus, or feeling hot, cold, shivery or generally unwell. If you think a piercing is infected, ask for an urgent GP appointment or contact NHS 111, and leave the jewellery in unless a doctor tells you to take it out.

When to get advice

Nickel allergy is a form of allergic contact dermatitis. The British Association of Dermatologists describes it as usually starting as an itchy rash that can look red, inflamed and blistered, or purple, deep brown or greyish on brown or black skin. Symptoms usually appear within hours or days of contact.

• A pharmacist can recommend treatments such as emollients if contact dermatitis is troubling you, the NHS says.
• A GP is the next step for symptoms that are persistent, keep coming back or are severe. They can try to find the cause.
• A dermatologist can identify the exact cause with patch testing, which the British Association of Dermatologists says is needed to pin down which substance is responsible. A GP can refer you.

The American Academy of Dermatology adds that a rash which blisters, becomes infected, or comes and goes should be seen by a dermatologist.

Past the label

Half a century after a court took the meaning out of "hypoallergenic", the word is still everywhere, and it still promises nothing in particular. What does carry a promise is a number: less than 0.2 micrograms for a post, no more than 0.5 for the rest, held for two years under a coating. Ask what the earring is made of, what the back is made of, and whether it meets the nickel limits. Those answers will tell your ears far more than the card ever could.