Symptoms, Diagnosis, and Treatments of Spice Allergies

black pepper
An allergy to spices—like black pepper—is rare. Matthew Leete/DigitalVision/Getty Images

A spice is any part of a plant that is used for the purpose of seasoning or flavoring food. Spices may be obtained from the bark, leaves, seeds, roots, buds, fruit or another part of the plant. Compared with spices, an herb is usually obtained from the leafy part of a plant and is also used to season or flavor foods. Most people use the terms spice and herb interchangeably.

As with other foods, allergy to spices is possible.

While spice allergy is considered to be fairly rare, affecting between 5 to 10 people for every 10,000 people, it is probably under-diagnosed. Many species have biological functions that enhance their ability to result in sensitization. For example, black pepper inhibits cell transport of ions, causing swelling of cells; capsaicin enhances its own intestinal absorption, possibly resulting in higher rates of sensitization.

Exposure to spices can occur in a variety of ways, most commonly as a result of eating foods containing spices. However, exposure can also occur through contact with the skin, such as with handling foods and from cosmetics that contain spices, as well as through inhalation of airborne spices from occupational exposures (such as in the food industry or spice factories).

Symptoms of Spice Allergy

Everyone remembers the cartoons from their childhood where certain characters were made to sneeze after getting a nose full of black pepper.

And, most people have experienced, during one time or another, the symptoms of a runny nose and watery eyes after eating spicy foods, such as horseradish or chili pepper. These symptoms are not caused by the immune system, but rather from irritant effects on mucous membranes. Skin rashes can also occur as a result of irritant contact dermatitis from direct skin exposure to spices found in foods or cosmetics.

True allergic reactions can also occur as a result of eating spices, inhaling spices or skin contact with spices. Allergic symptoms from eating spices most likely would include urticaria and angioedema, but could also include gastrointestinal symptoms, respiratory symptoms, as well as anaphylaxis. Inhalation of spices could result in symptoms of asthma, as well as swelling of the airway, including angioedema. Skin contact with spices could result in urticaria, atopic dermatitis, as well as allergic contact dermatitis at the site of skin contact.

Diagnosis of Spice Allergy

The diagnosis of spice allergy is suggested by the symptoms that a person experiences with exposure to the spice. It is possible to perform allergy testing to many spices, either with a commercial allergen extract or with making a homemade extract with a fresh spice. Hot spices, such as cayenne pepper, cannot be used for skin testing because of their irritant effect. Blood testing for the presence of allergic antibodies to spices is also available to a limited extent. Patch testing to spices can be performed to diagnose contact dermatitis to spices, likely with homemade extracts given the lack of commercially available versions.

Treatment of Spice Allergy

Treatment of spice allergy mainly involves the avoidance of the spice in question. The treatment of immediate symptoms of allergy would be identical to the treatment of food allergy, including the use of antihistamines and injectable epinephrine for severe reactions. Treating contact dermatitis caused by spice allergy would include the use of topical corticosteroids or possibly systemic corticosteroids for severe symptoms.

Avoidance of specific spices may be very difficult, given that many foods simply list "spices" or "natural flavoring" on the ingredient list. In addition, dining out at restaurants for a person with a spice allergy may be virtually impossible as many chefs may not be willing to divulge their "secret recipe" of a mixture of spices.

Avoiding spices in products other than foods may also be difficult since spices are found in a number of household toiletry items such as toothpaste, mouthwash, fragrances, cosmetics and body lotions.

Relationship of Spices, Pollens, and Other Foods

Since spices are derived from plant sources, it makes sense that certain spices may be related to one another, as well as to pollens and other plant-based foods. These relationships may lead to cross-reactivity, meaning that an allergy to specific pollens might lead to an allergy to related spices. The following list shows the cross-reactivity between spices, pollens, and other foods:

  • Oregano and thyme
  • Onion and garlic
  • Paprika and mace
  • Mustard and rapeseed
  • Mustard and tree nuts
  • Sesame and tree nuts
  • Cottonseed and walnut
  • Birch pollen and various spices
  • Mugwort pollen and various spices
  • Celery and various spices
  • Carrot and various spices
  • Fenugreek (often associated with curry) and peanut

Read about allergy to food additives and preservatives.


Chen JL, Bahna SL. Spice Allergy. Ann Allergy Asthma Immunol. 2011; 107:191-199.