About a quarter of a percent of people in the U.S. are allergic to sesame. As of 2023, it was recognized in the U.S. as the ninth major food allergen, which means that food manufacturers must note on food labels if a product contains sesame. They may also note if something is made in a facility where sesame is handled.

If you or someone you love is allergic to sesame, it’s important to understand this allergy. Then, you can work with your allergist to make informed healthcare decisions. Here’s what you need to understand.

What To Know About Sesame Allergies

If you or your child has been diagnosed with a sesame allergy, it means the immune system reacts to proteins in sesame products. It’s this reaction that causes symptoms.

Sesame allergies can begin in both childhood and adulthood. Most people are diagnosed between 6 months and 3.5 years old. About 20 percent of kids who get diagnosed with a sesame allergy will outgrow it, usually by the time they’re 6 years old.

More than 80 percent of people with sesame allergies have other food allergies, too. Peanut and tree nut allergies are the ones you’re most likely to see.

People who are allergic to sesame products may also have or develop allergies to certain other seeds, including:

• Sunflower seeds
• Caraway seeds
• Flax seeds
• Poppy seeds

In addition, sesame is often added to products that aren’t foods, including perfumes, supplements, cosmetics, pet foods, and some medications. You’ll need to talk to a healthcare provider about what you need to consider about these items.

Symptoms of a Sesame Allergy

Most people who have a sesame allergy respond within minutes of being exposed to it. However, some people may only have reactions after their body starts to digest a sesame product. They can have severe responses that start up to 90 minutes after they consume a sesame product. Symptoms can last for minutes or hours.

The symptoms of a sesame allergy can vary widely, both in what people experience and how severe they are. People with a mild to moderate sesame allergy will usually experience some combination of the following:

• Digestive problems, like stomach pain, diarrhea, nausea, or vomiting
• Tingling or itching in or around the mouth
• Hives, a raised rash that itches
• Swelling in the face, including around the lips and eyes
• Mild tightness in the throat

People who have a more severe allergic response to sesame may experience anaphylaxis. This can be life-threatening, so it’s important to get medical care for yourself or your child if you see any of these symptoms:

• Trouble with the airway, including wheezing, coughing, a hoarse voice, or problems breathing
• Feeling lightheaded or losing consciousness
• Problems swallowing
• Loud breathing
• A cough that won’t go away
• Suddenly feeling sleepy
• Confusion

If severe symptoms occur, time is of the essence. Give any emergency treatment your healthcare provider has prescribed, then call an ambulance.

Diagnosing a Sesame Allergy

If you think you might have a sesame allergy, see an allergy specialist as soon as you can. They’ll ask about your symptoms and suggest tests. This may include skin-prick testing, blood tests, or challenge tests. Most of the time, they’ll order skin and blood tests first.

Some of the proteins that can cause up to one-third of sesame allergies don’t respond well to skin or blood testing. You can have a negative test result and still have an allergy. If you’ve seen allergic reactions to sesame products but some of your test results are negative, your doctor is likely to order a challenge test.

In a challenge test, you’ll go to a special location where they can help you if you experience a severe allergic reaction. Once there, you’ll try a small amount of sesame. If you show signs of an allergic reaction, this will prove you’re allergic to it.

Treating a Sesame Allergy

The best way to manage a sesame allergy is to avoid sesame products entirely. This can be hard even if you’re very careful, because sesame can be listed under different names and is found in many products.

If your doctor thinks there’s a high chance you’ll experience anaphylaxis, they’ll usually prescribe epinephrine. In the U.S., this usually looks like carrying around an auto-injector (Epi-Pen, Auvi-Q). Your doctor will show you how to use it and tell you when it’s needed. Most likely, you’ll get two of these, just in case you have a response that requires a second dose. There is also a nasal form of epinephrine.

If your symptoms are mild, your doctor may tell you to take an antihistamine. Your doctor will develop an allergy plan for you.

How To Check Labels for Sesame

One of the most important things you can do if you or someone you love lives with a sesame allergy is to learn how to read labels so you can avoid sesame products. Most labels will tell you if a product contains sesame or was made in a plant that also handles sesame products. Labeling may not be updated on some shelf-stable products, though, since sesame was only added to the allergy list in 2023.

Labels that have been updated will either list sesame in the ingredients list or nearby. If it’s nearby, it will be in a list that starts with “Contains …” or “May contain …”.

Sesame can have different names on food labels, especially in multicultural foods. Look for:

• Benne, benniseed, or benne seed
• Sesamol or sesamin
• Sim sim
• Gingelly or gingilly oil
• Sesamum indicum
• Anything just labeled with “seeds”
• Til

Many products can contain sesame. Some of these are intuitive, while others are items you might not think about. Sesame is in or is often in:

• Breads, like bagels or buns, and baked goods
• Tahini (sesame paste)
• Snacks, including chips, granola bars, candy, rice cakes, crackers, cookies, and more
• Spreads or dips like hummus
• Spices and flavoring
• Oils, like sesame and vegetable
• Sauces or marinades
• Soups
• Margarine or other butter-like products
• Tempeh
• Vegetarian burgers
• Processed meats, like sausages
• Risotto
• Gomashio
• Furikake
• Halva, or halvah
• Salads and salad dressings
• Baklava

Dining Out With a Sesame Allergy

If you want to eat at a restaurant, you’ll need to tell your server and anyone involved in the food preparation process about your allergy and let them know that you cannot consume anything that contains sesame or has been exposed to it. You might have to be very specific.

One MyFoodAllergyTeam member explained it this way: “Whenever I ask if there is sesame in a restaurant, I always have to specify seeds, oil, paste because people only think of sesame seeds.” Even if you’ve eaten there before, make sure to ask again. Another member shared, “I do have to remind them every single time and ask in advance what they are cooking … Forgot once and they had cooked their meat in sesame oil.”

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What foods do you avoid because of a sesame allergy? Let others know in the comments below.