Allergen

Bathroom Fixtures: Faucets, Shower Knobs, Towel Rods, Flush Buttons, Grab Bars

The main contact allergens in bathroom fixtures are nickel, potassium dichromate, and cobalt.

Nickel has been the number one contact allergen for many years and is present in most metal objects. Very high-quality metals such as high-end stainless steel reduce the risk of a nickel reaction because the nickel tends to be bonded very well. This strong bonding reduces the chances of the nickel rubbing off. This is important because nickel is dissolved by sweat (a “microbial corrosion”), resulting in its absorption and penetration into the skin, which is what causes the allergic reaction.

Potassium dichromate is in the shiny chrome finish of many bathroom handles and fixtures (but also lots of other things that aren’t as obvious; make sure to click this link to learn more if this is one of your allergens).

While cobalt tends to be more obvious because it produces blue colors in pottery, porcelain, enamels and glass, it is also frequently (and perhaps less obviously) combined with other metals to make alloys. Also, count on anything nickel-plated to contain cobalt.

Note that other contact allergens can be present in the form of residue and airborne particulates from bathroom disinfectants, cleaners, and air fresheners. Many of these contain limonene, linalool, citrus, perfume, preservatives, and formaldehyde. “Natural” or more eco-friendly cleaners tend might still have essential oils or other flower or fruit extracts that are fragrance or related to them. Be guided by your patch test results.

What can help?

• Some bathroom fixture sellers suggest wrapping metal parts in duct tape, plastic, or another material. This might work but make sure you’re not also allergic to adhesives, rubber, or other allergens in the wrapping material.
• You could use a white cotton towel or organic, light-colored or uncolored cotton fabric when touching handles, rods, and other metal items. Hang a piece of cloth near the toilet flush, shower knobs, and faucet, etc. to help remind you.
• There are a growing number of nickel blocking solutions that could provide a barrier between you and the material, including Nickel Alert and Nik-L-Block. The latter has a testing solution for nickel, one for cobalt.
• Try making your own cleaning solution. You can find several recipes online but here’s one that has no contact allergens:
  • In a spray bottle or pail, mix just under a cup of baking soda with 1/2 cup of Essence Superwash. When combined well …
  • Add two tablespoons of vinegar and 1/2 cup of water. Shake well to mix thoroughly.

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If you have a history of sensitive skin…

…don’t guess! Random trial and error can cause more damage. Ask your dermatologist about a patch test.

To shop our selection of hypoallergenic products, visit vmvhypoallergenics.com. Need help? Ask us in the comments section below, or for more privacy (such as when asking us to customize recommendations for you based on your patch test results) contact us by email, or drop us a private message on Facebook.

For more:

• On the prevalence of skin allergies, see Skin Allergies Are More Common Than Ever. 
• For the difference between irritant and allergic reactions, see It’s Complicated: Allergic Versus Irritant Reaction.
• For the difference between food, skin, and other types of reactions: see Skin & Food Allergies Are Not The Same Thing. 
• On the differences between hypoallergenic, natural, and organic, check out Is Natural Hypoallergenic? and this video in our YouTube channel. 
• To learn about the VH-Rating System and hypoallergenicity: What Is The Validated Hypoallergenic Rating System?

Main References: 

Regularly published reports on the most common allergens by the North American Contact Dermatitis Group and European Surveillance System on Contact Allergies (based on over 28,000 patch test results, combined), plus other studies. Remember, we are all individuals — just because an ingredient is not on the most common allergen lists does not mean you cannot be sensitive to it, or that it will not become an allergen. These references, being based on so many patch test results, are a good basis but it is always best to get a patch test yourself.

1. DeKoven JG, Warshaw EM, Reeder MJ, Atwater AR, Silverberg JI, Belsito DV, Sasseville D, Zug KA, Taylor JS, Pratt MD, Maibach HI, Fowler JF Jr, Adler BL, Houle MC, Mowad CM, Botto N, Yu J, Dunnick CA. North American Contact Dermatitis Group Patch Test Results: 2019-2020. Dermatitis. 2023 Mar-Apr;34(2):90-104. doi: 10.1089/derm.2022.29017.jdk. Epub 2023 Jan 19. PMID: 36917520.
2. Uter W, Wilkinson SM, Aerts O, Bauer A, Borrego L, Brans R, Buhl T, Dickel H, Dugonik A, Filon FL, Garcìa PM, Giménez-Arnau A, Patruno C, Pesonen M, Pónyai G, Rustemeyer T, Schubert S, Schuttelaar MA, Simon D, Stingeni L, Valiukevičienė S, Weisshaar E, Werfel T, Gonçalo M; ESSCA and EBS ESCD working groups, and the GEIDAC. Patch test results with the European baseline series, 2019/20-Joint European results of the ESSCA and the EBS working groups of the ESCD, and the GEIDAC. Contact Dermatitis. 2022 Oct;87(4):343-355. doi: 10.1111/cod.14170. Epub 2022 Jun 24. PMID: 35678309. https://pubmed.ncbi.nlm.nih.gov/35678309/
3. DeKoven JG, Silverberg JI, Warshaw EM, Atwater AR, et al. North American Contact Dermatitis Group Patch Test Results: 2017-2018. Dermatitis. 2021 Mar-Apr 01;32(2):111-123.
4. DeKoven JG, Warshaw EM, Zug KA, et al. North American Contact Dermatitis Group Patch Test Results: 2015-2016. Dermatitis. 2018 Nov/Dec;29(6):297-309.
5. DeKoven JG, Warshaw EM, Belsito DV, et al. North American Contact Dermatitis Group Patch Test Results 2013-2014. Dermatitis. 2017 Jan/Feb;28(1):33-46.
6. Warshaw, E.M., Maibach, H.I., Taylor, J.S., et al. North American contact dermatitis group patch test results: 2011-2012. Dermatitis. 2015; 26: 49-59.
7. W Uter et al. The European Baseline Series in 10 European Countries, 2005/2006–Results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis 61 (1), 31-38.7 2009.
8. Wetter, DA et al. Results of patch testing to personal care product allergens in a standard series and a supplemental cosmetic series: An analysis of 945 patients from the Mayo Clinic Contact Dermatitis Group, 2000-2007. J Am Acad Dermatol. 2010 Nov;63(5):789-98.
9. Warshaw EM, Buonomo M, DeKoven JG, et al. Importance of Supplemental Patch Testing Beyond a Screening Series for Patients With Dermatitis: The North American Contact Dermatitis Group Experience. JAMA Dermatol. 2021 Dec 1;157(12):1456-1465.
10. Verallo-Rowell VM. The validated hypoallergenic cosmetics rating system: its 30-year evolution and effect on the prevalence of cosmetic reactions. Dermatitis 2011 Apr; 22(2):80-97.
11. Ruby Pawankar et al. World Health Organization. White Book on Allergy 2011-2012 Executive Summary.
12. Misery L et al. Sensitive skin in the American population: prevalence, clinical data, and role of the dermatologist. Int J Dermatol. 2011 Aug;50(8):961-7.
13. Warshaw EM1, Maibach HI, Taylor JS, Sasseville D, DeKoven JG, Zirwas MJ, Fransway AF, Mathias CG, Zug KA, DeLeo VA, Fowler JF Jr, Marks JG, Pratt MD, Storrs FJ, Belsito DV. North American contact dermatitis group patch test results: 2011-2012.Dermatitis. 2015 Jan-Feb;26(1):49-59.
14. Warshaw, E et al. Allergic patch test reactions associated with cosmetics: Retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2004. J AmAcadDermatol 2009;60:23-38.
15. Foliaki S et al. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. J Allergy Clin Immunol. 2009 Nov;124(5):982-9.
16. Kei EF et al. Role of the gut microbiota in defining human health. Expert Rev Anti Infect Ther. 2010 Apr; 8(4): 435–454.
17. Thavagnanam S et al. A meta-analysis of the association between Caesarean section and childhood asthma. Clin Exp Allergy. 2008;38(4):629–633.
18. Marks JG, Belsito DV, DeLeo VA, et al. North American Contact Dermatitis Group patch-test results, 1998 to 2000. Am J Contact Dermat. 2003;14(2):59-62.
19. Warshaw EM, Belsito DV, Taylor JS, et al. North American Contact Dermatitis Group patch test results: 2009 to 2010. Dermatitis. 2013;24(2):50-99.
20. Verallo-Rowell V. M, Katalbas S.S. & Pangasinan J. P. Natural (Mineral, Vegetable, Coconut, Essential) Oils and Contact Dermatitis. Curr Allergy Asthma Rep 16,51 (2016) . https://doi.org/10.1007/s11882-016-0630-9.
21. Park G, Oh DS, Lee MG, Lee CE, Kim YU. 6-Shogaol, an active compound of ginger, alleviates allergic dermatitis-like skin lesions via cytokine inhibition by activating the Nrf2 pathway. Toxicol Appl Pharmacol. 2016 Nov 1;310:51-59. doi: 10.1016/j.taap.2016.08.019. Epub 2016 Aug 22. PMID: 27562088.
22. de Groot AC. Monographs in Contact Allergy, Volume II – Fragrances and Essential Oils. Boca Raton, FL: CRC Press Taylor & Francis Group; 2019.
23. De Groot AC. Monographs in Contact Allergy Volume I. Non-Fragrance Allergens in Cosmetics (Part I and Part 2). Boca Raton, Fl, USA: CRC Press Taylor and Francis Group, 2018.
24. Zhu TH, Suresh R, Warshaw E, et al. The Medical Necessity of Comprehensive Patch Testing. Dermatitis. 2018 May/Jun;29(3):107-111.

Want more great information on contact dermatitis? Check out the American Contact Dermatitis Society, Dermnet New Zealand, the Contact Dermatitis Institute, and your country’s contact dermatitis association.

Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’s founding dermatologist-dermatopathologist. She has two children, Madison and Gavin, and works at VMV with her family and VMV’s signature “skinfatuated, skintellectual, skingenious” team. In addition to saving the world’s skin, Laura is passionate about health, cultural theory, human rights, happiness, and spreading goodness (like a VMV cream)!