Egg Allergy

What is an egg allergy?

An egg allergy is a common type of food allergy. Your immune system overreacts to proteins in eggs. Hen (chicken) eggs are the most common cause of an egg allergy. However, other animal eggs, including duck, turkey or quail, may cause your immune system to overreact.

An egg allergy can be fatal. If you have severe allergic reaction symptoms, such as swelling in your throat, call 911 (or your local emergency number), or go to the emergency room (ER) immediately.

How common is an egg allergy?

Egg allergy is the second most common food allergy in children. But healthcare providers estimate that around 2% of children are allergic to eggs, so it’s still relatively rare. It’s more common in children than adults.

However, around half of children will develop an egg tolerance by age 5, and up to 70% will outgrow their egg allergy by age 16. About 70% of egg-allergic children may be able to ingest egg protein in extensively heated (baked) products.

What does an egg allergy look like?

An egg allergy reaction usually begins within minutes after you eat eggs.

The severity of symptoms can vary between people. Mild symptoms may include:

• Abdominal pain.
• Diarrhea.
• Coughing.
• Hives.
• Itching (pruritus).
• Nausea or vomiting.
• Rash.
• Tingling or swelling of your lips, tongue or throat.

Severe symptoms may include anaphylaxis. Without immediate treatment, anaphylaxis can be fatal. Other severe symptoms may include:

• Confusion.
• Difficulty breathing.
• Difficulty swallowing (dysphagia).
• Dizziness.
• Drop in blood pressure (hypotension).
• Loss of consciousness (syncope).
• Shortness of breath (dyspnea).
• Tightness in your chest or throat.

What causes an egg allergy?

If you have an egg allergy, proteins in eggs cause your immune system to overreact (this is what causes an allergic reaction). The proteins that cause egg allergies are mostly in egg whites.

If you have an egg allergy, your body creates immunoglobulin E (IgE) after your first exposure to eggs. IgE is an antibody your immune system makes. Your body makes many different types of IgE, which target specific allergens. IgE antibodies bind to mast cells (allergy cells) in your skin, respiratory tract (airways) and cardiovascular system. When they encounter egg proteins, they release histamine. Histamine is what causes your allergy symptoms.

IgE reactions happen quickly after you eat eggs. Reactions may include anaphylaxis.

Egg intolerance

Other reactions to eggs (egg intolerance) aren’t the result of the allergy antibody. Your reaction to eggs is slower than an IgE-mediated reaction. It may take up to 48 hours to develop, and the symptoms usually only affect your intestines (gastrointestinal, or GI, system). They may include:

• Stomach pain.
• Cramps.
• Diarrhea.
• Nausea and vomiting.

Which egg proteins cause an egg allergy?

The main egg allergy proteins include:

• Ovomucoid. Egg whites contain ovomucoid.
• Ovotransferrin. Ovotransferrin doesn’t break down from exposure to high temperatures. You usually can’t eat raw or cooked eggs if you’re allergic to ovotransferrin.
• Ovalbumin. Ovalbumin breaks down at high temperatures, so you may be able to eat cooked eggs without developing an allergic reaction.
• Lysozyme. Around 30% of people who have an egg allergy are sensitive to lysozyme.

Who does an egg allergy affect?

An egg allergy can affect anyone. However, it’s more common in children younger than 5. Many children with an egg allergy will outgrow it as they get older and their digestive system matures.

If one of my children has an egg allergy, do all of them?

No. You should introduce all your children to eggs in the same way, even if you, their other biological parent or one of their siblings has an egg allergy.

How is an egg allergy diagnosed?

Talk to a healthcare provider if you or your child have symptoms of an egg allergy. They may refer you to an allergist (immunologist). They’ll ask you questions, including:

• Does anyone else in your biological family have egg or other food allergies?
• Has a healthcare provider ever diagnosed you with food allergies?
• What are your symptoms?
• When do you notice your symptoms start to appear?
• Do you take over-the-counter (OTC) medications to treat your symptoms?
• Do you keep a food journal?

What tests will be done to diagnose egg allergies?

An allergist may use different allergy tests to help diagnose an egg allergy according to your symptoms. These tests may include:

Skin prick (scratch) test

This test exposes your body to small amounts of egg proteins.

Your allergist will first clean a test area of your skin with iodine or alcohol. The test area is usually on your forearm or upper back.

Your allergist will place a droplet of liquid egg proteins on your skin. They then scratch your skin lightly. The droplets will enter your skin through the scratch. You’ll only feel slight discomfort, and you won’t bleed.

In addition to the egg allergens, the allergist will apply a positive and negative control to your skin. Controls help an allergist compare reactions. A positive control usually contains a histamine solution that causes an itchy, raised spot (wheal) on your skin within a few minutes. A negative control usually contains a saline solution that doesn’t cause a response.

After skin testing, you’ll wait 15 minutes. The allergist will then measure any wheals on your skin from the egg test or the controls with a ruler.

A skin prick test takes less than an hour.

Blood test

During a blood test, your allergist will use a thin needle (slightly smaller than the size of a standard earring post) to withdraw a small amount of blood from a vein in your arm. The blood sample goes to a laboratory. The lab adds egg proteins to your blood sample and measures the levels of IgE antibodies in it.

It may take a week or longer to get the results from a blood test.

Graded oral challenge

To definitively diagnose or rule out an egg allergy, your allergist may recommend a graded oral challenge in the office (food challenge).

You’ll eat a small amount of egg during a graded oral challenge. It may be an egg that isn’t thoroughly cooked (like a soft-boiled egg) or a baked egg. Your allergist will then watch to see if you develop a reaction. If you test positive to an unbaked egg, your allergist may recommend a baked egg challenge to see how your body reacts.

A graded oral challenge may take up to four hours.

How do you get rid of an egg allergy?

If you or your child has an egg allergy, the only way to prevent a reaction is to avoid eggs and any products that contain eggs. The United States Food and Drug Administration (FDA) requires all food manufacturers to clearly list all common food allergens on food labels.

Some foods or products that don’t contain eggs may share processing facilities with egg products. Look for labels that say, “Made in a facility that processes eggs,” or, “Manufactured on equipment that processes eggs.”

Many children outgrow their egg allergy, so your child may not need treatment. If your child isn’t outgrowing their allergy, talk to an allergist about food desensitization treatments, including oral immunotherapy (OIT).

What specific medications are used to treat a severe egg allergy?

If you have a severe egg allergy, your healthcare provider will prescribe you an epinephrine auto-injector (EpiPen®). Epinephrine quickly reveres the symptoms of anaphylaxis. Your provider will explain when and how to use this device. You should keep your epinephrine injector with you at all times.

If you have egg intolerance or a non-IgE-mediated egg allergy, you don’t need epinephrine.

What are the side effects of epinephrine injections?

Epinephrine injection side effects may include:

• Anxiety.
• Dizziness.
• Dry mouth (xerostomia).
• Headache.
• Increased sweating (diaphoresis).
• Nausea.
• Fatigue.

If these symptoms occur, they’re typically mild and go away quickly.

How can I prevent an allergic reaction to eggs?

The best way to prevent an allergic reaction to eggs is to avoid foods, drinks, medications and any other products that contain eggs or egg proteins.

Check the ingredient labels on all packaged foods. If you’re unsure whether a product contains eggs, avoid it until you can confirm with the manufacturer.

Is it safe to get a flu shot if I have an egg allergy?

Yes, it’s safe to get a vaccine for influenza (the flu). Many flu shots contain small amounts of egg proteins. But even if you have an egg allergy, it’s completely safe. If you still have concerns, talk to a healthcare provider about egg-free flu shots. Egg-free flu shot alternatives include Flublok® Quadrivalent and Flucelvax® Quadrivalent flu shots.

What can I expect if I have an egg allergy?

It can be challenging to have an egg allergy. Symptoms may be mild or severe, and there’s no way to predict how your body will react. If you’ve had a mild allergic reaction to eggs before, that doesn’t mean future egg exposures will be mild — they may be severe. If you’ve had a severe allergic reaction to eggs, you have a greater risk of having a severe reaction to eggs again in the future.

However, with caution, you or your child can still safely go through your daily routines. Healthcare providers can recommend resources, support groups and dietitians to help you with your day-to-day meals.

As young children age, their digestive systems mature, and they may outgrow their egg allergy. Visit an allergist for annual testing to see if your child outgrows their egg allergy.

How do I take care of myself if I have an egg allergy?

The following tips can help you take care of yourself or your child if you have an egg allergy:

• Always be aware of what you’re eating and drinking.
• Check the nutrition labels before you eat a product, even if the food didn’t cause a reaction the last time you ate it. Manufacturers may change recipes and add eggs.
• If your child has an egg allergy, teach them not to accept food from their friends or classmates.
• When dining out, notify your server that you have an egg allergy and ask detailed questions about ingredients and food preparation.
• Wear a medical alert bracelet with information about your egg allergy, or carry a medical alert card.
• Add your food allergy to your cell phone’s medical emergency setting or app.
• Talk to a healthcare provider about how to prepare for a reaction. They may prescribe an epinephrine auto-injector. You should carry it with you at all times in case you have a severe reaction.

What foods should you avoid if you have an egg allergy?

Some common foods that may contain eggs include:

• Baked goods.
• Breaded foods.
• Cake and pie fillings.
• Custard.
• Eggnog.
• Marshmallows.
• Mayonnaise.
• Meat alternatives (veggie meats).
• Pasta.
• Pretzels.
• Processed meats.
• Pudding.
• Salad dressings.

When should I see a healthcare provider?

See a healthcare provider if you develop symptoms after eating eggs or products that contain eggs.

When should I go to the ER?

Go to the ER or call 911 (or your local emergency number) if you start showing symptoms of anaphylaxis or feel like you can’t breathe.

What questions should I ask a healthcare provider?

• How can you tell that I have an egg allergy?
• When can I introduce eggs to my child?
• Will my child outgrow their egg allergy?
• Are there any support groups for people or parents of children who have an egg allergy?
• Can you recommend a dietitian?

How do I know if I have an egg sensitivity?

You may have an egg sensitivity if you develop mild symptoms after eating eggs. Talk to a healthcare provider if you think you have an egg intolerance.

How long does an egg allergy stay in your system?

About 70% of children who have an egg allergy outgrow it by the time they’re 16. However, some people may never outgrow their egg allergy.

Can you develop an egg allergy later in life?

Yes, you can develop an egg allergy later in life.

A note from Cleveland Clinic

An egg allergy can be an annoying or even scary condition. Symptoms may be mild or severe. You may feel frustrated not knowing what’s causing your symptoms, but a healthcare provider can help. They can conduct tests to confirm an egg allergy. They can also refer you to a dietitian who can help you learn what’s best for you to eat and drink.