Sesame allergy is a type of food allergy. Food allergy occurs when the body’s immune system wrongly identifies a food as a threat. When this happens, the body releases chemicals, such as histamine, in response. It is the release of these chemicals that causes the allergic symptoms.
Sesame allergy can start in childhood and usually carries on into adulthood. About two in ten children outgrow it, usually by the age of around six. Sesame allergy can also begin in adulthood.
Sesame allergy seems to have become more common over the last 20 years, but no one knows for sure how many people in the UK have it.
The symptoms of sesame allergy usually come on quickly, within minutes of eating the food.
Mild to moderate symptoms may include:
The term for this more serious reaction is anaphylaxis (pronounced anna-fill-axis).
Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves difficulty breathing or affects the heart rhythm or blood pressure. Any one or more of the ABC symptoms above may be present.
In extreme cases there could be a dramatic fall in blood pressure. The person may become weak and floppy and may have a sense of something terrible happening. This may lead to collapse and loss of consciousness and, on rare occasions, can be fatal.
AIRWAY - swelling in the throat, tongue or upper airways (tightening of the throat, hoarse voice, difficulty swallowing).
BREATHING - sudden onset wheezing, breathing difficulty, noisy breathing.
CIRCULATION - dizziness, feeling faint, sudden sleepiness, tiredness, confusion, pale clammy skin, loss of consciousness. 
Rarely, sesame seeds or oil can cause a less serious, delayed reaction. This usually includes symptoms of contact dermatitis, where the skin becomes red, swollen and sore.
Serious reactions to sesame seeds can also sometimes be delayed and start up to 90 minutes after eating them. This could be due to the time it takes to digest the seed case.
It’s important to get a referral even if your symptoms were mild because it can be hard to tell if future allergic reactions could be more serious.
Once you get a referral, the consultant will discuss your medical history and symptoms with you. They might suggest skin prick tests, blood tests, and food challenge tests to help diagnose the allergy. Once the diagnosis is confirmed, there are no tests that can tell how serious your allergy may be.
Proteins called oleosins are responsible for about a third of sesame allergies. The skin and blood testing for these allergens does not work well and the tests may be negative even when there is allergy. Food challenge tests can help to confirm the diagnosis if your sesame allergy is caused by these proteins.
Some clues that you might be at higher risk of more serious reactions are:
If you have asthma, and it is not well controlled, this could make an allergic reaction worse. Make sure you discuss this with your GP or allergy specialist and take any prescribed medicines.
If you have mild allergic symptoms, you may be prescribed antihistamine medicine that you take by mouth. If you are at higher risk of anaphylaxis, you may be prescribed adrenaline to use in an emergency.
Adrenaline comes in pre-loaded adrenaline auto-injectors (AAIs) that are designed to be easy to use. Make sure you know how and when to use them.
Ask your healthcare professional to show you how to use your specific brand of AAI. You can also find help on the manufacturer’s website and get a free trainer device to practise with.
You must carry two AAIs with you at all times, as you may need to use a second one if your symptoms don’t improve after five minutes or get worse.
The adrenaline auto-injectors prescribed in the UK are:
Emerade®
Emerade® is available in 3 doses: Adult: 500 mcg of adrenaline (suitable for adults over 60kg) Adult: 300 mcg of adrenaline Junior: 150 mcg of adrenaline (suitable for children weighing 15kgs – 30kgs/ 2.4 – 4.5 stone)
EpiPen®
EpiPen® is available in two doses: Adult: 0.3mgs of adrenaline Junior: 0.15 mgs of adrenaline (suitable for children weighing 5kgs – 25kgs / 1 stone 3lbs – 3 stone 13lbs)
Jext®
Jext® is available in two doses: Adult: 300 mcg of adrenaline Junior: 150 mcg of adrenaline (suitable for children weighing 15kgs – 30kgs / 4 – 4.5 stone)
Once you have been diagnosed with sesame allergy, you will need to avoid it and the foods that contain it.
Avoid sesame oil as well as the seeds. It’s usually unrefined and contains the proteins that trigger allergic reactions. Sesame seeds can be black, white, brown or red.
Read the ingredient lists on food packets carefully every time you shop. Sesame is included in the list of top 14 major food allergens in the UK. This means it must be highlighted on ingredients labels, in bold for example.
Read the ingredient list every time you buy a product as manufacturers change their recipes often.
Restaurants, cafes, hotels, takeaways, and other catering businesses are required by law to provide information on major allergens including sesame. Ask staff directly if the food you’d like to buy contains sesame seeds or oil and if there is a risk of cross-contamination and let them know that even small quantities can cause a reaction. Don’t be afraid to ask staff to check with the chef.
Take extra care when buying foods that are sold loose, such as bread and baked products at delicatessen counters and in-store bakeries. The seeds may not be obvious. They could be hidden in the dough for example, and products can be contaminated with seeds from other products at the counter.
Sesame seeds are difficult to control in food production. They often become ‘electrostatic’, causing them to cling to charged surfaces such as other foods and clothing, which makes it difficult to prevent cross-contamination. If a food product carries a warning such as “may contain sesame”, it’s best to avoid that food.
Heating does not destroy the part of sesame that cause allergies which means they can still cause allergic reactions when they’re cooked.
Some people with sesame allergy also react to other seeds, peanuts, or tree nuts. You may be able to eat these safely but discuss this with your allergy specialist or GP to make sure.
Take care when eating any new nuts or seeds for the first time. If in doubt, talk to your GP about allergy testing.
Some cosmetics and personal care products contain sesame. In the ingredients list on the label, look for the Latin name Sesamum indicum. It is not known whether they could cause an allergic reaction so it’s best to avoid them just in case.
Sesame oil is also used in some medicines, so ask your pharmacist for information about the ingredients.
If you think you might be allergic to sesame, visit your GP.
If you are prescribed adrenaline auto-injectors, carry two at all times.
Check food labels for sesame and ask for allergy information when you eat out.
Always be guided by your allergy specialist on which foods to avoid.
If you have asthma, make sure it’s well managed.
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