Allergic to Your Smartwatch? You’re Not Alone

While reported cases remain sporadic, an increasing number of publications are highlighting contact allergies associated with connected or wearable devices. Pierre Marcant, MD, dermatologist at Lille University Hospital (CHU de Lille) in Lille, France, addressed the issue at the recent Francophone Congress of Allergology.

Unusual and Severe Clinical Presentations

Since the early 2020s, contact allergies have been reported in connection with wearable electronics such as headsets, earbuds, and smartwatches. Several publications specifically reference allergic reactions were linked to Apple devices. While not extremely common, these reactions have occurred frequently enough that Apple has published dedicated guidance on its website.

According to Marcant, these allergies can present in unusual ways — for example, leukoderma linked to a nickel allergy from a smartwatch. More severe reactions have also been documented. One patient developed acute facial eczema with an angioedema-like appearance after wearing headphones. This led to an emergency department visit, where the patient was mistakenly treated with icatibant under the assumption of bradykinin-induced angioedema.

Common Offending Agents

From an allergology perspective, the main allergens include nickel, thiurams, and especially acrylates— commonly found in smartwatch components. Although Apple notes that the Apple Watch and its bands are designed so that acrylate- and methacrylate-containing components do not directly contact the skin, reactions have still been reported.

Additional cases involve Apple AirPods, with other unexpected allergens such as gold also implicated. In some instances, chemical analysis is required to confirm the presence of substances like octylisothiazolinone, as documented in recent headphone-related reactions.

Healthcare Professionals Also Affected

Contact allergies to connected devices are not limited to end users. A number of occupational cases have been reported, including among retail workers in Spain who handled adhesives while selling smartphone screen protectors. In those instances, the culprit was identified as 4-acryloylmorpholine.

Such devices are also widespread in healthcare environments, where patients may experience allergic reactions — most often due to acrylates. For example, skin reactions to electrodes used in transcutaneous electrical nerve stimulation therapy are well-documented.

“These findings suggest that legislation should mandate labeling of noncosmetic consumer products to enhance user safety and transparency,” Marcant concluded.

This story was translated from Medscape’s French edition.