Types of Different Color Dye Allergies

Children sticking out tongues dyed red and blue from their ice pop during Fourth of July parade
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While it is possible for a person to have a red dye allergy or other food coloring allergy, this is rare. I often see patients in my clinic who report allergic reactions after consuming food coloring, although this is often difficult to prove. Allergy testing is possible for food colorings, although extracts of the various food colorings may be difficult to obtain; the reaction to a food coloring can be either IgE mediated (allergic) or non-IgE mediated (cell-mediated). The following are the most common food colorings that have been reported to cause allergic reactions:

Tartrazine

Also known as FD&C Yellow Dye #5, tartrazine has been suspected as the cause of many reactions, including urticaria (hives) and worsening asthma and eczema.

A study published in 1976 in Clinical Allergy, looking at 140 asthmatics, showed a significant cross-reactivity between aspirin and tartrazine. A review of six studies published in 2001, however, found tartrazine did not negatively impact asthma in most individuals, but the authors also noted that firm conclusions could not be reached without more data. A more recent study published in 2009, looking at 26 people with asthma and sensitivity to aspirin, found they did not react adversely to tartrazine. Larger studies are needed.

Carmine

Carmine is a red dye food coloring made from a dried insect called Dactylopius coccus Costa, which can be found on prickly pear cactus plants. This coloring is also found in various cosmetics, drinks, red yogurt and popsicles. Reactions to carmine are truly allergic (IgE mediated) in nature.

According to a paper published in Acta Biomedica in 2019, it has sometimes caused urticaria, dermatitis and asthma. Anaphylaxis to carmine containing foods was noted following sensitization from a red-eye-liner.

Annatto

Annatto is a yellow dye food coloring made from the seeds of a South American tree, Bixia orellana. It is used in processed food, beverages and cheese. This additive has been found to cause allergic reactions, including anaphylaxis and urticaria.

Saffron

This yellow dye food coloring, obtained from the flower of the Crocus Sativa plant, has been reported as a cause of anaphylaxis.

A study published in the journal Allergy in 1997 found three of fifty workers in a saffron processing plant had developed allergic reactions to saffron.

Many other food colorings are less common, but possible, causes of allergic reactions. These include sunset yellow (yellow #6), amaranth (red #2), erythrosine (red #3), and quinoline yellow, among others.

Treatment

Severe reactions are treated much the same way as other food allergies. If reactions are severe, it may be necessary for a person to be prepared for a severe reaction (such as carrying injectable epinephrine and wearing a medical alert bracelet.

Otherwise, the mainstay of therapy for people with adverse reactions to food additives is the avoidance of the culprit food additive.

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  1. Moutinho IL, Bertges LC, Assis RV. Prolonged use of the food dye tartrazine (FD&C yellow no 5) and its effects on the gastric mucosa of Wistar rats. Braz J Biol. 2007;67(1):141-5. doi:10.1590/s1519-69842007000100019

  2. Suzuki K, Hirokawa K, Yagami A, Matsunaga K. Allergic contact dermatitis from carmine in cosmetic blush. Dermatitis. 2011;22(6):348-9. doi:10.2310/6620.2011.11022

  3. Williams KW, Sharma HP. Anaphylaxis and urticaria. Immunol Allergy Clin North Am. 2015;35(1):199-219. doi:10.1016/j.iac.2014.09.010

  4. Gohari AR, Saeidnia S, Mahmoodabadi MK. An overview on saffron, phytochemicals, and medicinal properties. Pharmacogn Rev. 2013;7(13):61-6. doi:10.4103/0973-7847.112850

Additional Reading

  • 1. Wilson BG, Bahna SL. Adverse Reactions of Food Additives. Ann Allergy Asthma Immunol. 2005; 95:499-507.
  • 2. Bush RK, Taylor SL, Hefle SL. Adverse Reactions to Food and Drug Additives. In: Adkinson NF, Yunginger JW, Busse WW, et al, eds. Middleton’s Allergy Principles and Practice. 6th edition. Philadelphia: Mosby Publishing; 2003:1645-1663.