Understanding a Salicylate Allergy

Salicylates are natural chemicals produced by plants to help protect them against disease and environmental stress. They are present in many foods, beauty products, and medications, such as aspirin.

Although salicylates are generally well-tolerated, they can cause significant reactions in those who are allergic.

This article will go over the symptoms and causes of a salicylate allergy. It will also discuss testing, treatment, and which foods to avoid.

What Is a Salicylate Allergy?

A salicylate allergy—which is sometimes incorrectly referred to as a salicylate intolerance—is a reaction that occurs when a person comes into contact with salicylates.

Salicylate allergies can be challenging to diagnose because salicylates are found in a wide variety of food and nonfood products.

Medications such as Pepto Bismol (bismuth subsalicylate) and aspirin that contain large amounts of synthetic salicylates appear to be closely linked with many salicylate allergies and intolerances.

It's important to note that salicylate allergies and intolerances are different. While a salicylate allergy is an immune system reaction that can be severe, a salicylate intolerance refers to how the product is broken down in your system and can cause gastrointestinal effects.

While some data suggest that foods high in salicylates can also cause a reaction, very little research supports this.

Symptoms

Symptoms of a salicylate allergy may include:

• Itchy, watery eyes
• Vomiting
• Stomach cramps
• Hives
• Runny nose
• Sneezing
• Coughing
• Diarrhea
• Light-headedness
• Wheezing
• Skin color changes

Severe reactions can lead to a life-threatening condition called anaphylaxis.

Causes

The cause of salicylic allergies remains unknown. However, true allergic reactions happen when the immune system overreacts to harmless substances called allergens.

When a person with an allergy comes in contact with an allergen, their immune system produces antibodies called immunoglobulin E (IgE) to attack the allergen. These antibodies then travel to cells that release a number of chemicals, triggering an allergic reaction.

What to Avoid

If you have a salicylate allergy, talk to your healthcare provider about whether you should be avoiding certain foods, products, and ingredients that contain salicylates.

List of Foods

Every person with a salicylate allergy is different. Avoiding all salicylate-containing foods is difficult and may not be necessary—you may be able to tolerate and enjoy many of them. Talk to your healthcare provider about whether you should eliminate salicylate-containing foods from your diet, which may include:

• Vegetables: Broccoli, cauliflower, spinach, cucumber, mushrooms, radishes, eggplant, and peppers.
• Fruit: Blueberries, avocado, prunes, grapefruit, strawberries, cherries, peaches, plums, raspberries, figs, kiwi fruit, and apples,
• Herbs and spices: Cayenne, cinnamon, clove, thyme, rosemary, paprika, curry powder, cumin, oregano, and turmeric.
• Beverages: Tea, wine, rum, beer, orange juice, apple cider, sherry, and coffee.
• Condiments: Soy sauce, jellies and jams, vinegar, tomato sauce, tomato paste, and honey.
• Other food sources: Gelatin, ice cream, mints, licorice, peanuts, almonds, pistachios, some cheeses, chewing gum, pickles, water chestnuts, and olives.

List of Products

Because salicylates can be absorbed through your skin, ask your healthcare provider if you need to avoid certain products that contain salicylates.

These include:

• Perfumes and fragrances
• Shampoos and conditioner
• Lotions
• Shaving cream
• Alka-Seltzer
• Sunscreen
• Cosmetics
• Pepto Bismol
• Ibuprofen
• Aspirin

List of Salicylate-Containing Products

To ensure you aren't accidentally exposed, you'll want to carefully read labels for ingredients in your products that may contain salicylate.

Salicylate-containing ingredients include:

• Acetylsalicylic acid
• Fruit flavorings
• Food colorings
• Benzyl salicylate
• Spearmint
• Phenylethyl salicylate
• Salicylic acid
• Magnesium salicylate
• Sodium salicylate
  

How to Test for Salicylate Allergy

Currently, there are no reliable tests to diagnose a salicylate allergy. However, some allergy testing methods can help rule out a salicylate allergy.

For example, your healthcare provider, including an allergist (a medical doctor specializing in diagnosing, treating, and managing allergies), may conduct an exposure, or provocation, test. In this test, you are exposed to small amounts of salicylic acid and monitored until an allergic reaction occurs or is ruled out.

An allergist may ask for your detailed medical history and ask you to keep a food diary to diagnose a salicylate allergy to foods.

If an allergy is suspected, you may be asked to complete an oral food challenge, which involves eating small amounts of food containing the allergen under close medical supervision.

How to Treat a Salicylate Allergy

Allergy treatment depends on several factors, including your allergy test results and how severe your symptoms are.

The most effective treatment for a salicylate allergy is to avoid salicylate. However, this is not easy because of its widespread use in foods, beauty products, and medications.

Food allergic reactions that produce minor symptoms often resolve on their own. Over-the-counter (OTC) antihistamines can be taken to treat mild symptoms.

Types of antihistamines include:

• Allegra (fexofenadine)
• Benadryl (diphenhydramine)
• Claritin (loratadine)
• Zyrtec (cetirizine)
  

For severe reactions, such as difficulty breathing or hives that develop all over your body, you should use an epinephrine injection (EpiPen), which is the only effective treatment for anaphylaxis. It should be administered within minutes of the onset of serious symptoms.

Summary

Salicylates are found in a wide array of foods, beauty products, and medications. Although they are considered safe and are generally well-tolerated, some people may be sensitive or allergic to them.

A person with a true salicylate allergy may be advised to avoid both food and nonfood items that contain high amounts of salicylates. This decision should be made after having a conversation with your doctor or allergist.

At this time, very little is known about a salicylate allergy. Its diagnosis is often difficult to make. If you believe you have a salicylate allergy, it's important to speak with your healthcare provider for a proper diagnosis.

A Word From Verywell

Salicylates are found in many different foods and other products. Because of this, it can be a difficult allergy to navigate. What may trigger one person, may not trigger another. If you have a salicylate allergy, it's a good idea to keep antihistamines and an EpiPen on hand. It's also important to closely work with your healthcare team to develop a personalized treatment plan.