Sesame Allergy

Medically Reviewed by Poonam Sachdev on May 02, 2024
Written by Allison Torres Burtka
8 min read

A sesame allergy is a food allergy to sesame seeds or sesame oil, which come from the sesame plant. When you have this allergy, your immune system reacts to sesame as though it were a harmful substance and tries to fight it off. This causes an allergic reaction. 

Sesame allergy affects about 2 out of every 1,000 people in the U.S., making it the ninth most common food allergy.

For some people, the allergy is lifelong. About 20% to 30% of children who have a sesame allergy outgrow it, usually around age 6. You can also develop a sesame allergy as an adult.

Are sesame seeds nuts?

Sesame is considered a seed, not a nut. A nut is a dry fruit with one seed and a hard shell, like a walnut. People with sesame allergy sometimes are allergic to nuts and other seeds as well. 

Symptoms of sesame allergy are unpredictable. They vary from person to person and can be mild or serious. They include:

  • Wheezing or trouble breathing
  • Coughing
  • Hoarseness or tightness in your throat 
  • Stomach pain, vomiting, or diarrhea
  • Hives, red spots, or itching
  • Swelling of the lips, tongue, or throat
  • Itchy, watery, or swollen eyes
  • A drop in blood pressure, which can make you feel lightheaded or pass out

Sometimes, a sesame allergy leads to a serious allergic reaction called anaphylaxis. When this happens, your immune system releases a flood of chemicals that can cause your body to go into shock. Anaphylaxis can be life-threatening. Even if you've had only minor reactions before, you're at risk for a serious reaction any time you consume sesame. 

Sesame allergy symptoms usually start within minutes after you eat something containing sesame. But they may start up to 2 hours later, or even later in rare cases.

 

Your immune system makes antibodies, proteins that recognize and fight germs. When you have a sesame allergy, your immune system overreacts to sesame. It releases antibodies called immunoglobulin E (IgE).

Whenever you eat even a little sesame, these antibodies tell your immune system to release lots of histamines and other chemicals into your bloodstream. These chemicals cause inflammation in places like your skin, eyes, lungs, throat, and digestive tract, leading to the symptoms of sesame allergy.

Scientists aren't sure why some people develop food allergies, but they often run in families. And if you have other food allergies or allergic reactions, including things like hay fever or eczema, you're more likely to have sesame allergy. 

 

 

To diagnose sesame allergy, your doctor will  likely examine you and ask about your family and medical history and any symptoms you’ve had. They also may order an allergy test. There are a couple of types: 

Skin test. For this test, a health care provider will put a small amount of sesame onto your back or arm, then prick the skin there with a small needle so a little of the sesame gets under your skin. If you have a skin reaction at the site, you may have a sesame allergy.

Blood test. This lab test measures how much IgE antibody forms in a sample of your blood in reaction to sesame. It might take a week or two to get results.   

Skin and blood tests can't always detect a sesame allergy, so your doctor also may use an oral food challenge. This is considered the most accurate way to diagnose a food allergy. 

You usually do an oral food challenge in an allergist’s or doctor’s office so that they can watch you closely during the challenge. You eat a tiny amount of the food in question, then the amount is increased over time while your doctor monitors you for an allergic reaction. The office has emergency medication and equipment ready in case you have a serious reaction.

 

 

There's no cure for sesame allergy. The main way to manage it is to avoid sesame. But you'll need to be prepared in case you eat some without realizing it.

Your doctor may give you an allergy action plan, a document that helps you prepare for the possibility of an allergic reaction. The plan spells out which symptoms are considered mild and which are serious and includes instructions for what to do if you have either type. For children with sesame allergy, this plan is meant to be shared with teachers, coaches, and childcare providers.

Treatment for a mild allergic reaction might involve taking an antihistamine. A more serious reaction often calls for an epinephrine auto-injector pen, which your doctor will prescribe for you to keep on hand.

If you go into anaphylactic shock, you need to be treated right away with epinephrine and then go to an emergency room. Even if your symptoms seem to be under control, a doctor needs to watch you in case you have another wave of symptoms.

The main complication of sesame allergy is anaphylaxis, a serious reaction that involves your whole body. It might start out looking like a less serious reaction but can quickly get worse.

With anaphylaxis, you may have one or more of what are called the ABC symptoms:

  • A is for airway. You might have swelling in your tongue, throat, or airways. Your throat may feel tight, your voice may sound hoarse, and you could have trouble swallowing.
  • B is for breathing. You could have trouble breathing. Your breathing might be noisy or you might make a wheezing sound.
  • C is for circulation. You might feel dizzy, sleepy, or confused. You could faint or pass out. Your skin may feel pale and clammy.

With very serious anaphylaxis, your blood pressure could get very low. You might become weak and floppy or lose consciousness. Rarely, it can be fatal. 

Anaphylaxis is an emergency. If you or someone you're with has these symptoms, seek medical care right away and inject epinephrine as instructed by a doctor. Anyone with a sesame allergy should carry two epinephrine auto-injectors at all times. 

You're at higher risk for getting anaphylaxis if you've ever had it before or if you have asthma, especially if it's not under control.

 

 

 

Sesame seeds and sesame oil are common ingredients in many foods. Since January 2023, food manufacturers have been legally required to list sesame as an allergen on food labels. 

Labels on foods made before 2023 may not list sesame. Nonperishable foods made before then, like spices that may still be in your pantry, might contain sesame but not be labeled as such.

At restaurants,  tell the server or chef about your sesame allergy, so they can make sure that your food doesn’t contain sesame or come in contact with it. Consider bringing “chef cards” with you to restaurants. You give these cards to your server, and they share then with whomever is preparing the food to help them understand your allergy. 

At social events where someone else is preparing food, always ask about sesame ingredients. Consider bringing your own food if you’re not sure.

Foods to avoid

Sometimes foods that contain sesame are obvious, like sesame seed bagels. But it's not always so easy to tell if sesame is among a food's ingredients. If you have a sesame allergy, avoid foods that contain:

  • Sesame seeds
  • Sesame oil, often used in Asian dishes
  • Sesame flour
  • Tahini, a sesame paste (sometimes spelled tahina or tehina)
  • Sesame salt, or gomasio
  • Benne, benne seed, or benniseed
  • Gingelly or gingelly oil, often used in Indian dishes
  • Halvah, a candy made from sesame paste

Watch for these alternative terms for sesame on labels or menus:

  • Sesamol
  • Sesamum indicum
  • Sesemolina
  • Sim sim
  • Til

Foods that might have sesame

Certain foods and types of foods often contain sesame. Be extra careful with them, and check labels or ask the server or chef if they contain sesame. These include:

  • Asian, Indian, and Middle Eastern cuisines
  • Hummus
  • Falafel
  • Baked goods, like bagels, bread, rolls, and hamburger buns
  • Breadcrumbs
  • Chips and crackers
  • Cereals, such as granola
  • Protein and energy bars
  • Dips and dressings
  • Vegetarian burgers and tempeh
  • Flavored rice and noodles
  • Margarine
  • Processed meats
  • Sushi
  • Spice blends and flavorings

Along with avoiding certain foods, avoid cross-contact as well. For example, make sure you’re not using a knife that someone else used to cut a hummus sandwich. 

Other things that might trigger a sesame allergy

You could come in contact with sesame through things other than food. These products sometimes contain sesame, such as sesame oil:

  • Medications
  • Nutrition supplements
  • Cosmetics and personal care products, like soaps, lipsticks, and moisturizer
  • Perfumes
  • Pet foods

Check labels to see if they list Sesamum indicum, the scientific name for sesame. 

Sesame substitutes

There are several alternatives to sesame ingredients:

  • Use poppy seeds and chia seeds as substitutes for sesame seeds. 
  • Instead of sesame oil, use another flavorful oil, like olive or avocado.
  • In place of tahini, try sunflower butter or soy nut butter.

When you're allergic to sesame, your immune system overreacts when you eat something that contains it. In some cases, the reaction can be serious. The best way to prevent a reaction is to avoid foods that may contain sesame seeds or sesame oil. Your doctor can give you an allergy action plan, a document that helps you prepare for the possibility of an allergic reaction.

Is it common to be allergic to sesame? 

Sesame is the ninth most common food allergy in adults and children in the U.S.

Is sesame OK for nut allergies?

If you have a nut allergy, that doesn’t mean you're allergic to sesame as well. But some people are allergic to both sesame and certain nuts. 

Can you suddenly become allergic to sesame seeds?

Sometimes adults develop allergies suddenly. One study found that about 25% of adults with sesame allergy developed the allergy as adults. Scientists aren't sure why this happens.

If you suddenly get a food allergy as an adult, it may be because you have oral allergy syndrome, also called pollen-food syndrome. This means you’re actually allergic to a certain type of pollen, but the proteins in that food are similar to the proteins in pollen, so your body reacts with allergy symptoms

What triggers sesame allergy?

Any food that contains sesame seeds or sesame oil can trigger a reaction. That includes common foods like hamburger buns, hummus, and many stir-fry dishes.  

When did sesame become a major allergen? 

In January 2023, sesame became the ninth major food allergen that must be plainly labeled on packaged foods in the U.S.