Natural rubber latex (NRL) is a milky fluid from the Hevea brasiliensis tree, which is widely grown in Southeast Asia and elsewhere in the world. It is used in thousands of everyday products and healthcare items.
There are two types of latex allergy:
This is a reaction to proteins in the latex. Symptoms come on quickly and can lead to anaphylaxis – the most serious form of allergy, which can be life-threatening.
This is usually a reaction to chemicals used in the manufacturing process. It’s not life threatening but it’s essential to speak to your GP if you have a reaction. Symptoms affect the skin and appear between 6 and 48 hours after touching latex. If you are exposed to latex repeatedly, symptoms can come on more quickly and last for longer.
An estimated 1-6 out of every one hundred people could be sensitised to latex, but not everyone who is sensitised will have symptoms. ‘Sensitised’ means your immune system has produced antibodies to latex after coming into contact with it and these could cause symptoms if you come into contact with it again in future.
The number of people with latex allergy rose from the 1980s when latex gloves became widely used, particularly among healthcare professionals. To meet the rise in demand, the way latex gloves were made changed and high protein powdered gloves were commonly used. The powder in the gloves could absorb the latex proteins and become airborne which is likely to have caused a rise in allergies.
Later, powder-free low-protein latex gloves became available, as well as latex-free alternatives, leading to a fall in latex allergy from the late 1990s. But if you have latex allergy you will still need to be careful to avoid latex.
The following groups are more likely to develop latex allergy:
This is known as allergic tendency. However, not everyone with allergies in their family will develop an allergy themselves, and if they do, it would not necessarily be the same allergy.
For example, children with spina bifida. Their risk depends on how much they are exposed to latex gloves and catheterisation devices.
Such as allergies to banana, avocado, tomato, potato, kiwi and chestnut, because the proteins in these foods are similar to the proteins in latex. This is known as latex-food syndrome.
People who often use latex gloves or other products containing latex are particularly at risk of developing latex allergy. For example:
The symptoms of Type I latex allergy usually come on quickly, within minutes of coming into contact with latex.
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. Any of the ABC symptoms may lead to collapse and unconsciousness 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. 
When powdered gloves were used, some people with Type I (immediate) latex allergy would have symptoms simply by being in the same room as the latex gloves. This should not be an issue now that powdered gloves are no longer used.
People with serious latex allergy might react if they are in an enclosed space near a balloon display, as latex balloons are often packed with powder to stop them sticking together. This can mean the latex proteins become airborne when the balloons are inflated.
Whether you think you have Type 1 or Type 4 latex allergy, see your GP who can refer you to a specialist allergy clinic if needed.
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.
Everyone with Type 1 (immediate) allergy symptoms should be referred to an allergy clinic and those with Type 4 (delayed) symptoms are usually seen in a dermatology clinic. There can be overlap in Type 1 and Type 4 symptoms which makes it difficult to make a diagnosis and means people with Type 1 reactions might be seen in a dermatology clinic.
Your GP can find an allergy clinic in your area from the British Society for Allergy and Clinical Immunology (BSACI).
Once you get a referral, the consultant will discuss your medical history and symptoms with you.
You may be offered skin prick tests and/or blood tests. You might also be offered a “challenge” test, where you are exposed to latex in strict conditions with medical supervision.
What can mean you’re at higher risk?
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.
Patch testing is used to diagnose Type 4 allergy. This is where the health professional applies diluted rubber accelerator chemicals which are added to latex during processing (not usually the natural rubber latex protein itself) to your skin. The test is run over several days because, with a Type 4 reaction, there is a delay between contact with the rubber chemical and when the symptoms appear. This can vary from hours to several days.
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 where you can 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.
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.
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)
Type 4 latex allergy is treated with emollients (moisturising treatments which you apply to the skin to soothe and hydrate it) and topical steroid creams. Where practical, you can take steps to avoid contact with latex to lower the risk of a reaction.
Once you have been diagnosed with latex allergy, you will need to avoid latex. Whenever you are having a medical procedure, tell your healthcare providers about your allergy, including doctors, nursing staff, anaesthetists and dentists. You may also want to tell your employer.
Here are just a few products that may contain latex.
Shoe soles and tyres are made with what is known as ‘dry’ rubber. Allergic reactions to dry rubber products are uncommon and mainly affect people with a serious latex allergy. When seeing a consultant, ask about your individual risk.
Latex urinary catheters are a common cause of allergic reactions and silicone catheters can be used as an alternative.
Some people with Type 1 (immediate) latex allergy also react to certain fruits and vegetables, including banana, avocado, tomato, potato, kiwi, chestnut, lychee, papaya, passion fruit, fig, melon, mango, pineapple, peach and lettuce.
This is known as cross-reactivity, where the proteins in latex have a similar structure to the proteins in these foods. If you are allergic to any of these foods, you may also be allergic to latex, and vice versa.
Symptoms normally affect the mouth after eating the food and are usually mild. They can include tingling or itching in the lips, tongue or throat. More serious reactions can occur, so discuss this with your doctor. You can also discuss which foods might cause you a problem.
Raw potatoes can cause contact reactions when people with latex allergy peel potatoes, but cooked potato is not usually a problem.
Not everyone with latex allergy has latex-food syndrome, and most people with latex-food syndrome will only react to a small number of foods.
Some flu vaccines have a latex needle sheath. In the Green Book, the UK Health Security Agency says the risk for people with latex allergy is extremely small, but that if you have a history of serious allergy to latex (anaphylaxis) you should be offered an alternative latex-free vaccine that covers the same disease where possible.
Discuss this at your local surgery before having the flu vaccine and request one that does not have a latex needle sheath.
The NHS Specialist Pharmacy Service provides a list of local anaesthetics used by dentists and notes whether latex is used to make the anaesthetic, its container and packaging.
Thinking ahead and having coping strategies can help you manage latex allergy.
For Type 1 (immediate) latex allergy
For Type 4 (delayed) latex allergy
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