Gold (Gold Sodium Thiosulfate) Allergy

Metallic gold is known for its electrochemical nobility, and resulting lack of reactivity. Thus, it is usually accepted to be a non-allergenic metal.

For this reason, contact dermatitis due to gold has been rare, and difficult to prove. It was Kligman who first found that gold chloride could cause sensitization.

Fowler later initiated the use of 0.5% w/w gold sodium thiosulfate (GSTS) in petrolatum as a test preparation to determine the presence of contact allergy to gold. At present, varying concentrations of GSTS in petrolatum are in use.

Symptoms of Gold Sodium Thiosulfate Allergy

Patients who are allergic to gold often present with contact dermatitis, contact stomatitis, or oral lichen planus.

Skin manifestations such as a papular pruritic rash are most commonly found on the ears, eyelids or the area around the eyes, the fingers, and the neck.

Reactions in remote areas far from contact are also possible. Gold allergy is more commonly found in women.

It has been found that one in ten patients with eczema had positive reactions when their standard patch tests included gold patch testing (as GSTS). Thus, gold is a potent sensitizer, second only to nickel sulfate.

Dental patients with gold fillings, or individuals who wear gold allergy, show an incidence of allergy that is higher than normal, which means the gold in the fillings could be a major cause of gold allergy.

At the same time, patients with contact allergy to gold have a higher chance of sensitivity to other monovalent gold salts, such as gold sodium thiomalate, as well as to nickel and cobalt.

Diagnosis and Treatment

The presence of a contact allergy to gold is confirmed by a positive patch test to GSTS, consisting of a persistent papular reaction.

The test reaction may often persist for months after the patch application. Patch size must be measured at 3 days, 1 week, and even at 3 weeks, because many reactions take a longer time than expected to appear when the patch test is used.

With intracutaneous testing, however, all reactions occur within the first week, and dermal nodules are often formed.

Percutaneous absorption of ionized gold is essential for the formation of a positive reaction.

An in vitro test for gold allergy looks for the appearance of blast transformation induced by gold salts.

Treatment of gold allergy comprises the use of local emollients and corticosteroids to suppress local allergic manifestations, as well as the treatment of any secondary bacterial infection.

Exposure to gold salts must be minimized in order to prevent future allergic reactions.


Further Reading

Last Updated: Feb 26, 2019

Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.


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  1. Lynn Mullins Lynn Mullins United States says:

    Well this article actually offered more information than my dermatologist was able to give me. I had the TRUE allergy patch test done 5 months ago. I had positive reactions to nickel and cobalt, and at the time gold, however my dermatologist said this was a false positive. Unfortunately, the skin reaction rash for gold has not gone away, and it's now 5 months later. I don't wear any jewelry, so I'm not exposed, which I thought would make it go away. I guess it's just a case of wait and see if the skin eruptions at the test site eventually go away.

    • Dee Merchant Dee Merchant United States says:

      Hi Lynn, wonder if you'd like to connect via email about your story? I do research and would like to know more about your story, Thanks.

    • Juie Wilson Juie Wilson United States says:

      I found out about my gold allergy during the true patch test (I was being tested for a different allergy). What a bummer! I had eye and lip swelling, mouth sores and an all-over prickly sensation. I wore gold every day for years, and I was shocked. After the true test, it took a full year for the skin marks from the test site to subside

      If I shake hands with someone wearing a gold ring, I will develop a red and irritated rash on my chest hours later. I wish there was a way to get over the allergy, as it is almost impossible to avoid gold completely.

      Thanks for the helpful info. My doctor handed me a sheet with little information and that was the end of it.

  2. Rajeev Raturi Rajeev Raturi United States says:

    I have allergic reaction to gold finger rings but at the same time there is no reaction with a gold chain or bracelet which I am wearing..

  3. Melanie Erickson Melanie Erickson United States says:

    I was diagnosed with an allergic reaction to gold sodium thiosulfate with a patch test. i have swollen eye lids and contact dermatitis on my lips (they constantly peel and chap). I also take Humira for Rheumatoid Arthritis. I was told on my little information sheet from the doctor that GST can be found in certain Rheumatoid medications which I cant stop taking. Is it possible the GST is found in this drug? Thank you for your help! I am suffering with my lip situation and swollen eyelids.

    • Britta Vedder Britta Vedder United States says:

      I’m so glad I came across your comment. I have been suffering with lip swelling, pain, and peeling for a year now. I did a skin test a couple months ago & found out I was allergic to gold. With my rings & earrings off, I’m 80% better. It’s been a couple months. Does it typically take longer??

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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