Key takeaways:
A sesame seed allergy is one of the top nine food allergies in the U.S. The FDA now requires food labels to include it on their ingredients list, which wasn’t always the case.
Sesame can hide in many different foods in different forms. For example, the seeds can be added to baked goods, ground up in tahini paste, or refined into an oil.
The symptoms of a sesame seed allergy can range from mild to severe. And people with a sesame seed allergy are unlikely to outgrow it, which differs from other food allergies.
If you think you may have a sesame seed allergy, it’s important to see a healthcare professional. They can help you arrange testing.
The top eight food allergies have been established for decades — peanuts, tree nuts, fish, shellfish, soy, dairy, wheat, and eggs. But now a sesame seed allergy is now part of that list. These top nine foods make up 90% of food allergies in the U.S. The FDA is trying to raise awareness of sesame seed allergy and change mandates for food labels. Here, we break down everything you need to know about a sesame seed allergy.
What is a sesame seed allergy?
Food allergies — including a sesame seed allergy — occur when the body identifies a protein in food as a dangerous invader. The immune system then overreacts and causes symptoms that can range from mild to severe. This reaction can even be life-threatening — a condition called anaphylaxis.
Symptoms of a sesame seed allergy can start within seconds to hours of eating a food with sesame. These symptoms can affect several different body systems:
Skin: rash, hives, and itching
Mouth and throat: lip swelling, tongue swelling, tightness in the throat
Gastrointestinal: vomiting, diarrhea, or stomach cramps
Lungs: wheezing, coughing, or difficulty breathing
Cardiovascular: low blood pressure, high heart rate
Most often, food allergies start in childhood. But symptoms can start in adulthood, too. About 1 in 400 people have a documented sesame allergy. Next, we go over how to know if you are one of them.
How do you know if you have a sesame seed allergy?
With a sesame seed allergy, a reaction will occur every time the allergen-containing food is consumed. And sometimes, the symptoms can get more severe with each reaction.
Proper diagnosis of food allergies is important to prevent life-threatening reactions. But identifying the exact trigger can also save you from unnecessarily cutting out entire food groups, which can make you miss out on important nutrients. Food allergies cause a lot of worry and anxiety, too.
If you’re experiencing symptoms of a possible food allergy, your primary care provider will often refer you to an allergist for testing. The allergist will go through the below steps to ensure you or your child receive a proper diagnosis.
Medical history and food journal
Allergies can be tough to identify since even the smallest amount of a certain food can trigger an allergic reaction. A healthcare professional might ask you to keep a food journal. This is a way to keep track of the foods you ate and any symptoms afterwards.
Skin prick test
The skin prick test uses a small amount of the protein from the allergen, which is then injected into the skin. A rash or wheel may develop within minutes after the injection. Depending on the size of the wheel, this can indicate an allergy. It’s a relatively painless test, but the spots might be itchy afterwards.
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These tests aren’t always accurate. There can be false negatives (no reaction develops even though you do have a true allergy) or false positives (a reaction develops when you don’t have a true allergy). Because there’s a chance of an inaccurate result, your healthcare team will take into account your medical history and food journal to diagnose your food allergies.
Ig-E blood test
There’s also a blood test that can help diagnose certain food allergies. The test looks for proteins — called immunoglobulin E (IgE) — made by your immune system in response to a food. Like the skin prick test, the results are often interpreted alongside information from your food journal.
Oral food challenge
A blinded oral food challenge is the best way (“gold standard”) to diagnose food allergies. This test is done in a medical setting with the supervision of a healthcare professional. People are slowly given increasing amounts of the food in question to see if allergy symptoms occur.
Other tests
It’s important to note that there are other methods of diagnosing allergies — and they aren’t always accurate. Tests that advertise hair analysis, applied kinesiology, saliva analysis, and so on aren’t effective.
What foods typically contain sesame seeds?
Sesame seeds are little white or black seeds. You may be familiar with them from a sesame seed bun or sesame bagel. But sesame seeds can hide in a lot of foods. And sesame is found as whole seeds, ground up, and as an oil. Examples of foods that can contain sesame include:
Tahini paste (ground-up sesame seeds that are used in global cuisines)
Hummus, which is generally made with tahini
Baked goods such as buns, bagels, and breads
Sushi that’s rolled or garnished with sesame seeds
Snacks including chips, crackers, bagel crisps, and snack bars
Seasonings like “everything” seasoning that contains a mixture of different seeds
Sesame oil
It’s important to note that sesame oil isn’t considered safe to consume for someone with a sesame allergy. With other food allergies — like peanut or soy allergies — highly refined oils can sometimes be safe because no protein remains in the oil. But sesame oil is usually not refined enough to eliminate the allergy-triggering proteins.
Food isn’t the only thing that contains sesame. Other products — like cosmetics, soaps, ointments, and medications — may contain small amounts of sesame. If you are unsure about a product, contact the manufacturer to confirm their ingredients.
What is the FDA’s new guidance on sesame seed allergies?
The FDA now requires sesame to be listed as an allergen on labels of packaged foods. Food manufacturers must list sesame in the ingredients list. You might also see an allergen declaration below the ingredients list. The label will read “CONTAINS: sesame” or “MAY CONTAIN: sesame.”
The FDA made this change for a few reasons.
Sesame allergies are similar to peanut and tree nut allergies in that they can be life-threatening. And most people don’t outgrow a sesame allergy as they get older. So, many adults need clear labeling to stay safe.
Also, with the wide availability of global cuisine options today, sesame is a common allergen included in spice blends for Asian and Mediterranean cuisines. Previously, these proprietary spice blends weren’t required to be listed on the food label.
Can you treat a sesame seed allergy?
You cannot cure a sesame seed allergy, but you can treat it. Treatment for any food allergy requires complete avoidance of the products that contain it. Some people will outgrow allergies. But when it comes to sesame seed allergy, only 1 in 5 children will outgrow them in adulthood.
But there’s treatment if a food allergy occurs. This includes an epinephrine injector (also known as EpiPen), antihistamine medications, inhalers, and/or corticosteroids. Accidental ingestion is common because sesame and sesame oil is used in so many foods.
If you think you or someone near you is having an anaphylactic reaction, call 911 right away and administer an EpiPen if you have one.
Healthcare professionals sometimes recommend that people with multiple severe food allergies receive oral immunotherapy. Oral immunotherapy involves eating increasing doses of the food allergen under close supervision to lower the severity of the allergic reaction. There’s also a new medication on the market, omalizumab (Xolair), which binds to the antibody in the blood that triggers an allergic reaction.
The bottom line
Sesame seeds are little white or black seeds found in a lot of foods — from the top of a hamburger bun to an ingredient ground into hummus. Sesame is now a part of the top nine food allergens in the U.S. This means it’s required to be listed on the ingredients list of packaged foods.
If you think you may have a sesame seed allergy, it’s important to see a healthcare professional for a proper diagnosis. This will include a food journal, skin prick testing, a blood test, and perhaps an oral food challenge.
Why trust our experts?
References
Allergy & Asthma Network. (n.d.). Food allergies.
Boyce, J. A., et al. (2010). 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.
Food Allergy Research & Education. (n.d.). Sesame allergy.
Kaman, K., et al. (2022). A practical focus on sesame allergy and a brief review of other seed allergies. Journal of Food Allergy.
National Institutes of Health. (2025). Omalizumab treats multi-food allergy better than oral immunotherapy.
NIAID-Sponsored Expert Panel. (2010). Guidelines for the diagnosis and management of food allergy in the United States: Report of the NIAID-sponsored expert panel. Journal of Allergy and Clinical Immunology.
U.S. Food and Drug Administration. (2024). The FASTER act: Sesame is the ninth major food allergen.
Warren, C. M., et al. (2019). Prevalence and severity of sesame allergy in the United States. JAMA Network Open.
