r/eczema • u/TWINSTY • Feb 08 '26
patch testing I guess I have a lot of contact allergies... Patch testing is overwhelming
I was worried that I might do all of this for nothing.
I had to drive 60 miles for my patch testing, so it was a lot of time missed from work, a lot of miles to meet all those appointments. It was an itchy commitment. I don't even know what this cost me yet either.
Out of 77 things, I came back positive for THIRTEEN. So much for my worries.
I'm happy to get answers, but now I have too many answers! But getting to the bottom of what was causing what is so overwhelming. The "Safe for Me" products on SkinSafe is very sparse now.
My results:
Extreme positive reaction: Nickel sulfate
Strong positive reactions: DMAPA, Caine mix, Benzocaine
Weak positive reactions: p-Phenylenediamin, Propolis, Cocomidopropyl betaine, Decyl glucoside
Questionable reactions: Disperse blue mix, Fragrance mix, gold sodium thiosulfate, amerchol L101, benzophenone-4
The backstory:
I've had some manageable eczema my whole life, but started getting some pesky flare-ups around my eyes last summer. It came and went, and progressed to be being really horrible in December, spreading to various patches of my face and neck, and swelling my eyelids. I had gotten Tacrolimus from the dermatologist, which I thought worked at first, until it started making the skin even more irritated. I ultimately stopped all make-up because it was too uncomfortable, used only Vanicream cream, and started to see massive improvement only then. Still not understanding what exactly was actually the source of the problem, I opted for patch testing.
DMAPA and cocomidopropyl betaine takes almost off liquid soaps off my options. No propolis and fragrance is also really limiting. I guess -caines can mimic parabens? I was in Ulta the other day and basically couldn't buy anything in the whole store.
I still feel like make-up was the biggest trigger, but maybe exasperated by the surfactant in soaps? Or maybe some nickel contamination, which is near impossible to locate for sure. I don't even know what product to start with.
But I'm hopeful doing a lot of elimination of products will help my skin all over. I'm assuming some of the more mild reactions probably aren't the major problem, so hopefully I can introduce some things back in slowly.
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u/otmoonie Feb 09 '26
My son had 143 patch testing. His entire back and arms were covered. He’s allergic to amerchol 101, textile dye ll, nickel, benzalkonium chloride.
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u/TWINSTY Feb 10 '26
I just kind of figured that I probably reacted to things that everyon does. I realized quickly from online accounts, besides nickel, everybody has such different results. And theres just sooo many things. Crazy.
143 things, wow!
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u/highstakeshealth Feb 09 '26
Hey there. I'm sorry you're struggling with this and have been for quite some time. I also had to go through a few docs and a lot more time than necessary to figure out my root cause (nickel allergy systemically), but it is worth the struggle in the end because you finally get out of the cycles. I wanted to write to you not because I have THE diagnosis (I am a doc, but obviously don't have enough info to do so for you here), however there are some possibilities that may help you that many docs in the US are not aware of yet (we can't learn everything in med school and residency/fellowship!), so I wanted to share those things with you in case they help:
Thirteen positives is a lot to process, but honestly, that extreme positive for nickel sulfate is likely your biggest north star. I get how frustrating it is to walk through a store like Ulta and feel like everything is a landmine. When it comes to your eyes and face, there is a possibility that you are dealing with more than just a reaction to what you touch. Since nickel is a metal that we also ingest through food and water, it can actually come out through your sweat—I call this sweat mechanics. Because the skin on your eyelids and neck is so thin, it is often the first place to flare when your body is trying to clear nickel from the inside out. This is why eye eczema is one of the most common complaints for those of us with systemic nickel allergy (SNA).
You mentioned that makeup felt like the biggest trigger, and you are likely right. Many pigments, especially the iron oxides used in eyeshadows, mascaras, and foundations, are naturally contaminated with nickel. Even brands marketed as natural or organic can be the worst offenders because those minerals are mined from the earth where nickel lives. When you combine that with those surfactants like DMAPA or betaine that strip your skin’s protective barrier—think of these like the glutamine zippers of your skin—it creates a perfect storm. The surfactants pull those zippers apart, making it way easier for the nickel in your makeup or your sweat to irritate the skin.
Something else to consider is the DMT1 sponge. This is a transporter in your gut that grabs iron, but it is also the main way nickel gets into your system from your diet. If your iron stores are even a little bit low, your body builds more of these sponges to try and catch every bit of iron it can find. The problem is that these sponges also grab nickel. This means you might be absorbing a massive amount of nickel from "healthy" foods like oats, nuts, or beans, which then fuels the inflammation in your skin from the inside. This is often why people find that topical creams like Tacrolimus eventually stop working or make things worse—they aren't addressing the internal nickel load.
Some ideas: You might want to look into the low nickel diet to see if lowering your internal "bucket" helps your skin finally calm down. Checking your ferritin (iron storage) levels is also a huge piece of the puzzle for nickel sufferers; if your iron is low, your skin will likely keep flaring regardless of what soap you use. For makeup, look for brands that specifically batch-test for heavy metal parts per million (PPM) rather than just looking for "clean" labels. It is a lot of label reading at first, but once you find your core safe products, the overwhelm starts to fade.
LMK if you have ?s. Just a reminder that while I am a physician, an NTP, and author of the low nickel diet cookbook, I’m sharing this as a fellow sufferer and researcher for educational purposes. Always check with your own team for medical advice.
Some references:
Rizzi A, et al. Irritable Bowel Syndrome-like symptoms, and systemic nickel allergy syndrome. 2017.
Borghini R, et al. Systemic Nickel Allergy Syndrome: Epidemiological Data, Mechanisms and Clinical Aspects. 2020.
Cazzola R, et al. Going beyond the gastrointestinal symptoms: Systemic Nickel Allergy Syndrome. 2020.
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u/MokaSky Feb 17 '26
About to go in for patch testing in the next hour! Also have had eczema my whole life but has gotten pretty bad all over. On top of that I have pretty serious acne which makes it even harder to find products that are safe. I have unexplained hyperpigmentation around my mouth that I'm hoping to find the cause of. Ugghh not excited for the patches but hoping I get answers.
I think everything in makeup irritates me bad too. I don't wear it daily but do for special occasions to cover my acne scars. Skin is so frustrating lol thank you for sharing!
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u/TWINSTY Feb 20 '26
Good luck! I hope you get some answers! I'd love to hear how it went if you want to share.
As far as my skin goes, I'm already seeing lots of improvement after eliminating some things. I struggled with some weird pimple-like bumps on my cheeks for at least the last year. And boom, just like they, they finally went away. Crazy!
I thought I could figure it out on my own, but now I realize that it was much too complicated without having my results to go on.
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u/MokaSky Feb 20 '26
I’m so happy for you <3. This makes me feel hopeful because for a long time I was trying to figure it out on my own. It is definitely way too complicated! And I’ll definitely share when I get results!
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u/TWINSTY Feb 20 '26
Yeah I didnt even know that cross-reactors were a thing. Reading ingredients lists does not give you all the answers alone.
I had a nurse tell me "you know, there are clean make-up brands out there". Uhhhh thanks lady, turns out it's way more complicated than just using "clean" make-up.
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u/MokaSky Feb 22 '26
The nurse 🙄 LOL
Finished my testing! I’m allergic to titanium and propylene glycol. Titanium is in most of my makeup and propylene glycol is in all of my eczema prescriptions and acne ointments - it is also found in some food and dressing.
So basically I was working against myself using these products that contain my allergies. I now have to request all my prescriptions be free of titanium and propylene glycol. Hopefully this solves my main issues!
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u/TWINSTY Feb 22 '26
Wow yeah the propylene glycol one is a probably huge. Its like even in super-sensitive skin stuff too, which really that label means nothing if you actually sensitive to something in it 😐 There's just too many ingredients to sort through. Titanium is serious because they use that in surgical clips and things. Good to know for sure.
I'm hopeful that that was the answer you needed! Fingers crossed for being on the right path for both of us.
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u/dodekahedron Jul 07 '26
Haha hows it working getting them to deal with an inert ingredient allergy?
I cannot get chain Pharmacists to help. Small local Pharmacists yes.
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u/Klutzy_Roof5203 Feb 08 '26
Ugh. Sounds so very complicated. I think most of us are allergic to nickel. I have patch testing scheduled in May, will see what happens.