Humans have been wearing earrings for millennia; it is thought that earrings may have been the very earliest form of jewelry. Earrings for sensitive ears are a modern development. The first earrings were probably made of stone chips or animal bone or antlers, and objects thought to be earrings have been found at prehistoric sites across Europe. It isn’t known for sure how the first earrings were worn or when humans began piercing the earlobe for the purpose of inserting decorative objects. The first objects definitely identified as earrings have been found at ancient Sumerian sites in what is now Iraq, dating to about 3000 BCE.

Earrings and ear piercing have had different meanings across cultures and across history. They have been used to demonstrate wealth and status, to mark rites of passage, as protective amulets against peril, and simply as a form of self-expression. In the 21st century almost all women, and many men, have pierced ears and wear earrings. Ear piercing is a simple process done at costume jewelry stores in shopping malls and at tattoo and piercing salons.

Most people have no problems; their piercings heal uneventfully and they go on to wear whatever type of earrings they wish. A few, however, have nickel sensitivity and experience itching and a rash at their piercing site. One European study found that about 7% of the study participants had nickel sensitivity. When having a piercing done, reduce the likelihood of nickel allergy by making sure that the jewelry used for the new piercing is either 18K gold or surgical-grade stainless steel.

What is nickel sensitivity? It’s an allergy to nickel and certain other metals such as cobalt, palladium and chromium that are commonly used in making jewelry and clothing fasteners such as snaps, bra hooks, belt buckles, watchbands and eyeglass frames. In any allergic reaction, the body interprets the allergen or foreign substance as harmful and responds with inflammation. In the case of nickel and other metals, the inflammation takes the form of a rash around the exposed area. Once a person is diagnosed with nickel sensitivity, the only solution is to avoid contact with jewelry and other objects containing nickel.

Sometimes nickel sensitivity becomes apparent immediately after the piercing is done; in other cases it can develop after years of wearing pierced earrings. Persons who have nickel sensitivity need to choose their jewelry, and especially pierced earrings, carefully. Look for earrings labeled “nickel-free” or “hypo-allergenic.” They will be made of such metals as surgical-grade stainless steel, titanium, 18K or higher yellow gold, sterling silver, copper and platinum. Avoid white gold, as it often contains nickel.

All fine jewelers and many costume jewelry shops carry hypo-allergenic and precious metal jewelry. It may be slightly more expensive than base metal jewelry, but it’s worth the price. Persons who already have a collection of earrings and develop a nickel allergy may be able to have the findings–the hook, post or clasp of the earring–changed to precious metal. Crafty types can do it themselves; hypo-allergenic earring hooks can be purchased at most craft stores, and the only tool needed to change them is needle-nose pliers. If the earrings are antique or contain precious stones, or are the post type, a professional jeweler should do the work. If they have high sentimental value it may be worth the cost.

Nickel sensitivity need not stop a person from wearing earrings; it simply means that care must be taken when choosing them.