What Is a Sesame Allergy?

Sesame is one of the most common foods that can cause allergic reactions.

Even if previous reactions have been mild, someone with a food allergy is always at risk for the next reaction being life-threatening. So anyone with a food allergy must avoid the problem food(s) entirely and always carry emergency injectable epinephrine. Sometimes people outgrow some food allergies over time, but sesame allergies are lifelong in many people.

What Happens With a Sesame Allergy?

When someone has a sesame allergy, the body's immune system, which normally fights infections, overreacts to proteins in the sesame. If the person eats something that contains sesame, the body thinks these proteins are harmful invaders and responds by working very hard to fight off the invader. This causes an allergic reaction.

Even a small amount of sesame protein can set off a reaction. Some of the highest-risk foods for people with sesame allergy include foods that commonly contain sesame seeds or sesame oil. These include foods like hummus and sesame bagels, and also:

• crackers, chips, and other snack foods
• Asian, African, Mexican, and Mediterranean cuisine
• sauces, dressings, and dips

What Are the Signs & Symptoms of a Sesame Allergy?

When someone with a sesame allergy has something with sesame in it, the body releases chemicals like histamine, causing an allergic reaction. An allergic reaction can be mild or severe. A person can have a severe reaction even if their previous reactions were mild. Symptoms of an allergic reaction can include:

• wheezing
• trouble breathing
• coughing
• hoarseness
• throat tightness
• belly pain
• vomiting
• diarrhea
• itchy, watery, or swollen eyes
• hives
• red spots
• swelling
• a drop in blood pressure, causing lightheadedness or loss of consciousness (passing out)

How Is an Allergic Reaction Treated?

A sesame allergy sometimes can cause a severe reaction called anaphylaxis. Anaphylaxis might start with some of the same symptoms as a less severe reaction, but can quickly get worse. The person may have trouble breathing or pass out. More than one part of the body might be involved. If it isn't treated with injectable epinephrine, anaphylaxis can be life-threatening.

If your child has a sesame allergy (or any kind of food allergy), the doctor will want them to carry two epinephrine auto-injectors in case of an emergency.

An epinephrine auto-injector is a prescription medicine that comes in a small, easy-to-carry container. It's easy to use. Your doctor will show you how. Always have two auto injectors nearby in case one doesn't work or your child needs a second dose.

The doctor can also give you an allergy action plan, which helps you prepare for, recognize, and treat an allergic reaction. Share the plan with anyone else who needs to know, such as relatives, school officials, and coaches. Wherever your child is, caregivers should always know where the epinephrine is, have easy access to it, and know how to give the shot. Also consider having your child wearing a medical alert bracelet. 

Time matters in an allergic reaction. If your child starts having serious allergic symptoms, like trouble breathing or throat tightness, use the epinephrine auto-injector right away. Also use it right away if symptoms involve two different parts of the body, like hives with vomiting. Then call 911 and have them take your child to the emergency room. Medical supervision is important because even if the worst seems to have passed, a second wave of serious symptoms can happen.

How Can Parents Keep Kids Safe?

If allergy testing shows that your child has a sesame allergy, an allergist will provide guidelines on what to do.

The best way to prevent a reaction is to avoid sesame. Avoiding sesame means more than just not eating it. It also means not eating any foods that might contain sesame as ingredients.

The best way to be sure a food is sesame-free is to read the food label. Check the ingredients list carefully. Note: Sesame labeling is only required to start in 2023, so it may not be labeled in products made before then. It also can be hidden in ingredients like “spices” or “natural flavors."

After checking the ingredients list, also look on the label for phrases like these:

• "may contain sesame"
• "produced on shared equipment with sesame"

Although these foods might not use sesame ingredients, the warnings are there to let people know they might contain traces of sesame. That can happen through "cross-contamination," when sesame gets into a food product because it is made or served in a place that uses sesame in other foods. Not all companies label for cross-contamination, so if in doubt, call or email the company to be sure.

Always be cautious. Even if your child safely ate a food in the past, manufacturers sometimes change their processes — for example, switching suppliers to a company that uses shared equipment with sesame. And two foods that seem the same might have differences in how they’re made. Because ingredients can change, it's important to read the label every time, even if the food was safe in the past.

What Else Should I Know?

Some things to keep in mind:

• If you keep sesame in your home, watch for cross-contamination that can happen with utensils and cookware. For example, make sure the knife you use to put hummus on bread is not used in preparing food for a child with a sesame allergy, and that sesame breads are not toasted in the same toaster as other breads.
• Don't serve cooked foods you didn't make yourself, or anything with an unknown list of ingredients.
• Tell everyone who handles the food your child eats, from waiters and waitresses to the cafeteria staff at school, about the allergy. If the manager or owner of a restaurant is uncomfortable about your request for sesame-free food preparation, don't eat there.
• Consider making your child's school lunches, as well as snacks and treats to take to parties, play dates, sleepovers, school events, and other outings.
• Work with the childcare supervisor or school principal to make sure the food allergy emergency action plan provided by your allergist is followed correctly.
• Always keep epinephrine with your child. It shouldn’t be in the glove compartment of your car, but with you or whoever is caring for your child.

You can learn more about managing food allergies online at:

• Food Allergy Research and Education Network (FARE)