All About Hazelnut Allergy Symptoms and Treatment

Hazelnuts, with and without shells
Hazelnut Allergy Guide. Peter Rees / Getty Images

Hazelnut allergy is one of the most common nut allergies. Hazelnuts, which also are called filbert nuts and which look a bit like acorns when they're in the shell, can cause any of the usual symptoms of food allergies (from the mild to the severe).

Symptoms can occur within two hours of consuming hazelnuts or food containing them, and may include:

  • Skin: Hives or eczema
  • Eyes: Allergic conjunctivitis
  • Gastrointestinal system: Nausea, abdominal pain, vomiting or diarrhea
  • Airways: Wheezing, coughing or a runny nose
  • Mouth: Angioedema (swelling of lips, tongue or face)
  • Anaphylaxis: A severe allergic reaction that requires immediate medical care

Birch Pollen Allergy? You May Also React to Hazelnuts

Oral allergy syndrome (OAS) is a form of food allergy in which people who are sensitive to specific types of pollen react to certain foods that are related to those pollens. In the case of hazelnuts, many people with birch pollen allergies also react to hazelnuts.

Symptoms of hazelnut oral allergy syndrome are usually confined to tingling, itching or swelling of the lips, tongue, and throat. These symptoms may be treated with an over-the-counter antihistamine such as Benadryl. After taking an antihistamine, a person with this condition should be monitored for the next few hours to make sure that more serious allergic symptoms do not develop.

Occasionally, some people with oral allergy syndrome have more severe reactions that may include rashes, delayed gastrointestinal symptoms such as abdominal cramps and diarrhea, or, very rarely, anaphylaxis.

More severe, full-body reactions require immediate treatment with the drug epinephrine.

Treatment of Hazelnut Allergy

There is no cure yet for hazelnut allergy. Management of your hazelnut allergy involves avoiding hazelnuts and being prepared for future reactions.

Talk to your doctor or allergist if you have any symptoms after eating or touching hazelnuts.

You may need allergy testing to determine the severity of your reaction and to determine if you have allergies to other nuts.

Do You Need an Epinephrine Auto-Injector?

Some people with oral allergy syndrome have only localized reactions that have been successfully treated with antihistamines.

However, your doctor may prescribe an epinephrine auto-injector (commonly referred to by the brand name EpiPen) for you just in case of a more severe reaction. You will need to carry your auto-injector with you at all times.

Living with a Hazelnut Allergy

Nuts are one of the eight most common food allergies in the United States, and so are covered by current food allergy labeling laws. Food manufacturers are required to list nuts on their ingredient labels in plain English.

A hazelnut allergy warning on an ingredient label should look like this: "Contains: Nuts (hazelnuts)."

Some foods, such as those in restaurants or at someone's home, will not come with convenient ingredient lists on them. You should learn to recognize foods that commonly contain nuts. When ordering food in a restaurant, stay safe by always asking questions of your server or asking to speak to the chef about your hazelnut allergy.


Food Allergy Initiative. Tree Nut Allergy.

Geroldinger-Simic, M, et al. Birch pollen-related food allergy: Clinical aspects and the role of allergen-specific IgE and IgG4 antibodies. J Allergy Clin Immunology. Vol. 127, No. 3

NIAID-Sponsored Expert Panel. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel. The Journal of Allergy and Clinical Immunology. Volume 126, Issue 6, Supplement, Pages S1-S58, December 2010

Webber, Christopher and Ronald W. England. Oral allergy syndrome: a clinical, diagnostic, and therapeutic challenge. Ann Allergy Asthma Immunol. 2010;104:101-108

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