Sesame Seed Allergy

Symptoms usually occur straight after eating the food but can occur up to one hour later. The reaction tends to be mild and may include a rash (hives or “nettle” rash) or swelling, especially around the face. Some children have an itchy throat; others may vomit or have diarrhoea. Severe reactions (anaphylaxis) are less common and include difficulty breathing (with wheeze or swelling in the throat), feeling faint or dizzy.

Children may tolerate sesame seeds in bakery products but are allergic to crushed sesame seeds in hummus. Unlike other oils, sesame oil is made by cold-pressing sesame seeds and is not refined, so may cause allergies.

People can also develop delayed skin reactions to using creams and toiletries containing sesame seed oil, or Sesamum indicum in Latin.

Most people with sesame seed allergy will only have mild reactions. Severe reactions affecting the child’s breathing occur in about 15% of cases, particularly in those with poorly controlled asthma. More severe reactions may also occur if the child has a cold, following intense exercise, at times of stress or in teenagers after drinking alcohol. Severe reactions need urgent medical attention.

Children with sesame seed allergy may also be allergic to other seeds. They may also be allergic to peanuts and tree nuts. Seek medical advice before excluding any of these other foods as this may not be necessary.

The diagnosis is based on a history of a typical reaction after contact with sesame containing products. Positive allergy tests skin prick or blood IgE tests support the diagnosis, but should not be used alone, as people can have positive allergy tests but tolerate the food without getting a reaction.

Skin prick tests are safe and can be done in clinic provided that the child has not had any antihistamines for a few days. Blood tests are not affected by antihistamines, but the results are only available a week or so after the clinic appointment. If the diagnosis is uncertain an oral sesame seed challenge is sometimes recommended.

The following foods are made from (bold), or should be checked for sesame:

When eating out, check the ingredients. Middle Eastern, Chinese, Thai and Japanese foods can all contain sesame seeds.  Sesame seeds can also be called Benne, Gingelly, Ajonjoli, Juljulan, Zelzlane, Sumsum, Simsim in Arabic, Zhī Má, Hú Má in Chinese, Goma, Shima in Japanese and Til in Hindi, Sanskrit Urdu.

Children and parents will be given a written management plan in clinic and prescribed appropriate medication which should be available at all times.

If sesame seeds are accidentally eaten, the food should be spat out straight away and an antihistamine taken as soon as possible.

Severe symptoms:

• Difficulty breathing (wheezing, noisy breathing, blue colour)
• Swelling in the throat (noisy breathing, drooling)
• Feeling faint or dizzy, looking very pale (lie the child down with their legs raised).

If any of these severe symptoms occur get help straight away and dial 999 stating “anaphylaxis” (ana-fil-ak-sis).

It is important to inform the nursery/school and any after school clubs. Any other carers such as grandparents, relatives and school friends’ parents will also need to know.

Most children with sesame seed allergy (over 80%) will not outgrow the problem. If there has been no reaction for a long time and allergy tests to sesame seed are negative an oral food challenge may be suggested by your doctor.

There is no cure for sesame seed allergy, but research is underway which may lead to the development of new treatments.