Mango Allergy

Allergic Reaction to Mangoes

Cut mango on bamboo tray
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The mango is a popular tropical fruit in the United States and in warmer climates around the world. Initially cultivated in India thousands of years ago, mangoes are now grown in many temperate climates around the world, including Southeast Asia, Mexico, Spain, Australia and Brazil. It is often referred to as “the king of fruits” because it can be eaten in many different forms, including as a fresh fruit, blended in shakes and smoothies, as well as in juices, jams and even dried and pickled.

Despite its popularity, allergic reactions to mangoes aren’t very common. However, reactions have been described as a result of eating mangoes – in 3 very different forms.

Anaphylaxis to Mango

Severe allergic reactions as a result of eating mangoes are caused by the IgE antibody. People with this type of allergic reaction experience symptoms shortly after eating the mango fruit (usually within a few minutes), and may include wheezing, shortness of breath, chest tightness, urticaria, angioedema and other symptoms of anaphylaxis. The treatment of these allergic reactions would be identical as other forms of severe food allergies.

The diagnosis of a severe IgE-mediated reaction to mango would be made with a skin test or blood test. Since there is no commercial mango allergy extract available for skin testing in the United States, skin testing must be performed using a “prick-prick” method with the fresh fruit.

In this technique, a skin-testing device is pushed into a fresh piece of mango fruit, then immediately scratched or punctured onto the skin of the patient. The skin test reaction is interpreted in 15-20 minutes, with a positive reaction showing a wheal (hive) and flare (redness) formation at the skin test site.

Avoidance of eating mango fruit is required for people who have experienced anaphylaxis as a result of eating mangoes. However, there are other foods that share cross-reactivity with mango, including cashews and pistachios. In addition, because mango fruit can be accidentally eaten, as it is a common ingredient in fruit punch, fruit smoothies, and fruit salads, having injectable epinephrine available to treat a severe allergic reaction is recommended for people with a mango allergy.

Contact Dermatitis to Mango

Another type of reaction that can occur after eating mangoes is contact dermatitis. This reaction, which resembles a poison oak rash, most often occurs on the face within a few hours of eating a mango and usually lasts for a few days. The rash appears as small itchy blisters on the skin that may ooze and peel over the next few days. The cause of this reaction isn’t IgE antibodies as with anaphylaxis but is caused by certain white blood cells (CD4+ T cells) that react to certain chemicals (mostly urushiol) found within the mango peel, mango tree bark, and mango fruit just underneath the peel. Urushiol is also the chemical found in poison oak, poison ivy, and poison sumac, so people who are very sensitive to contact with these plants are more likely to experience contact dermatitis to mangoes.

 While this type of reaction to mangoes isn’t dangerous or live threatening, it certainly can be uncomfortable and annoying.  The treatment of contact dermatitis from mangoes is topical or systemic corticosteroids, depending on the severity of the reaction. The diagnosis is most commonly made clinically, meaning that if a person with facial dermatitis reports symptoms after a few hours of eating a mango, testing is not likely necessary. However, patch testing with a piece of mango fruit or mango skin would be helpful in the diagnosis of contact dermatitis from mangoes.

Oral Allergy Syndrome to Mangoes

The oral allergy syndrome (OAS) is an IgE-mediated reaction, similar to that causing anaphylaxis, but with only mild symptoms of mouth itching, burning and fullness.

These symptoms typically occur almost immediately after eating a fresh piece of mango and typically resolve without treatment after a few minutes. Progression to anaphylaxis is rare in cases of OAS, because the allergen (protein) that a person is reacting to is typically very fragile, and broken down by a person’s saliva very quickly. As a result, symptoms typically only occur in the mouth.

OAS occurs as a result of similarities between the proteins in the fresh mango fruit and in pollens or latex protein. When OAS occurs because of a pollen allergy, a person is most likely to be allergic to either birch (tree) pollen or mugwort (weed) pollen. Latex allergy can also cause a person to experience OAS symptoms as a result of eating mangoes – this condition is termed the “latex-fruit syndrome”.

The diagnosis of OAS to mango is often made clinically when a person allergic to birch pollen, mugwort pollen or latex experiences OAS-like symptoms when mango is eaten. In addition, skin testing must be performed using a “prick-prick” method with the fresh fruit as outlined above.

While the OAS is rarely a dangerous condition, people who experience these symptoms as a result of eating mangoes are generally advised to avoid mangoes, given the small chance (<10%) of progressing to anaphylaxis.


Sareen R, Shah A. Hypersensitivity Manifestations to the Fruit Mango. Asia Pac Allergy. 2011;1:43-9.

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