Sesame Seed Allergy and Cross-Reactivity

Sesame seeds have been used for a variety of reasons for thousands of years. They are available in 3 different colors — white, black, and brown. Sesame seeds are used by various cultures for food, including by Western societies as garnishes on fast food. Sesame oil is extracted from the seeds and used in recipes, as well as in pharmaceuticals and cosmetics.

Allergy to sesame is not a new problem. Though it was first described in 1950, it seems to be a growing problem. A recent study showed that sesame allergy was the fourth most common food allergy in Australian children, behind egg, milk, and peanut. Another recent study showed that sesame allergy in Israeli children is more common than peanut allergy, and only milk and egg allergy are more common food allergies. Sesame allergy seems to affect all ages, which implies that this food allergy is not commonly outgrown.

The symptoms of sesame allergy can include symptoms of urticaria/angioedema, allergic rhinitis, asthma, atopic dermatitis, oral allergy syndrome, and even anaphylaxis. Other people have experienced contact dermatitis as a result of direct exposure to cosmetics or pharmaceutical products containing sesame allergens.

Because sesame allergens are similar in biochemical structure to peanut allergens, people with sesame allergy are at risk for having allergic reactions as a result of eating peanuts, and vice-versa. This is known as cross-reactivity — when one substance is so similar to another that the immune system treats them both the same. There also appears to be cross-reactivity between sesame allergens and rye, kiwi, poppy seed, and various tree nuts (such as hazelnut, black walnut, cashew, macadamia, and pistachio). Therefore, people with sesame allergy should avoid the above foods until an allergist can perform allergy testing and/or oral food challenges to these related foods.