Egg
Allergy Facts, Symptoms, and Treatment

Providing protein, essential minerals, and vitamins, eggs are a cheap and easily accessible food source that's eaten in most parts of the world and incorporated into a host of processed foods.2 In addition to acting as emulsifiers, binders, and coagulants in foods, eggs often are applied to the top of baked goods to give them a shiny appearance.4

In the United States and Europe, most eggs come from chickens. However, in parts of Europe and Asia, duck eggs are also consumed, and goose eggs are eaten in many European countries.1 Nevertheless, people with an allergy to chicken eggs could also be allergic to eggs from other animals such as quail, turkey, duck, and goose, making the aforementioned varieties unsafe for the majority of egg allergic individuals.5,6

Despite their many uses and nutritional value, eggs are one of the top eight food allergens in the United States, and they're the second most common food allergy (after cow's milk) in infants and children.5,7 In fact, global data shows that egg allergy affects 0.5 to 2.5 percent of young children. Prevalence is even higher in Australia, where the allergy impacts 8.9 percent of infants.6 The good news, however, is that roughly 70 percent of children outgrow their allergy by the age of 16.5

Where are eggs found?

Although allergic individuals may only be allergic to one portion of the egg, i.e., the yolk or the egg white, it's impossible to completely separate the two without cross-contamination. Thus, those with an egg allergy should be cautious with all parts of the egg.5

The following ingredients may indicate the presence of egg and should be avoided by egg allergic individuals:3,4 albumin, apovitellin, binder, cholesterol free egg substitutes, coagulant, dried egg solids, dried egg, egg, egg white, egg yolk, egg wash, eggnog, emulsifier, fat substitutes, globulin, lecithin, livetin, lysozyme, meringue powder, ovalbumin, ovoglobulin, ovomucin, ovomucoid, ovotransferrin, ovovitelia, ovoitellin, powdered eggs, silici albuminate, simplesse, surimi, trailblazer, vitellin, and whole egg.

Foods that may contain eggs include:4 baked goods, baking mixes, batters, bearnaise sauce, bouillon, breakfast cereals, cake flours, candy, cookies, creamy fillings, custard, egg noodles, eggnog, French toast, Hollandaise sauce, ice cream, lemon curd, macaroni, malted cocoa drinks (e.g., Ovaltine), marshmallows, mayonnaise, meringues, muffins, noodles, omelets, pancakes, processed meat products (e.g., bologna, meat loaf, meatballs, sausages), puddings, salad dressings, sherbets, souffles, soups, sweets (e.g., fondant creams, truffles), tartar sauce, Turkish delight, waffles, and wines.

Egg proteins may also be found in shampoos, cosmetics, and pharmaceuticals such as laxatives. In addition, frying surfaces can pose a cross-contamination risk. For example, if eggs are fried on a restaurant griddle, a burger fried on that same surface could be contaminated with egg protein if the grill wasn't cleaned properly.4 Some vaccines may also contain egg proteins that can cause serious events if egg allergic individuals are injected with these vaccines.10

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Are there other allergens I could be sensitized to?*

Some people with egg allergy may also experience symptoms when eating other seemingly unrelated foods. This is called cross-reactivity and occurs when your body's immune system identifies the proteins, or components, in different substances as being structurally similar or biologically related, thus triggering a response.2 The most common cross-reactivities with egg are eggs from other animals such as quail, turkey, duck, goose, and seagull, all of which are unsafe for the majority of egg allergic individuals. Chicken meat cross-reactivity is rare.5,6

Do I need to avoid all forms of egg?

An egg consists of different types of proteins that all have different characteristics that may be associated with varying risk of causing severe allergic reactions. While some individuals are allergic to all forms of egg (raw, cooked, and baked), a high percentage of allergic children can tolerate extensively heated egg, e.g., in a baked product such as a muffin, as high temperatures break down the causative proteins.2 For another patient, egg should be avoided in all forms, as it could potentially cause a severe event, also called anaphylaxis.5 While some patients never outgrow their egg allergies, roughly 70 percent of children do so by the age of 16.5 Your specific risk profile depends on which proteins you are allergic to.2

Knowing the proteins, or components, within each allergen that are triggering your symptoms can help guide your management plan. With that in mind, and based on your symptom history, your healthcare provider may suggest something called a specific IgE component test, which can help reveal your potential risk profile.2

Already have your specific IgE component test results?

Your component test results will include the name of the components (a series of letters and numbers and/or name). Your healthcare provider will likely review the results with you, but here you'll find an at-a-glance breakdown you can use as a reference. Simply match the component names to the list below to see what they mean in terms of symptom management.2

nGal d 1 (Ovomucoid)

  • Stable to heat, risk for reaction to all forms of egg.
  • High levels of IgE may indicate that allergy is unlikely to be outgrown.

nGal d 2 (Ovalbumin)

  • Sensitive to heat, extensively heated egg may be tolerated.
  • Risk for clinical reaction to raw or slightly cooked egg and certain vaccines.

nGal d 3 (Conalbumin)

  • Sensitive to heat, extensively heated egg (i.e., baked) may be tolerated.

nGal d 4 (Lysozyme)

  • Sensitive to heat, extensively heated egg (i.e., baked) may be tolerated.7
  • Please note that lysozyme may be used as an additive in certain pharmaceutical products.7

Test results should be interpreted by your healthcare provider in the context of your clinical history. Final diagnosis and decision on further management is made by your healthcare provider.

*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.

How do I manage my allergy?

Because there is no cure for food allergies, your healthcare provider may recommend a plan that includes the following.11-14

  • Read ingredient labels and "may contain" advisory panels on food and nonfood products carefully, and avoid all foods and products containing any form of the allergen. Note that these lists and panels may not appear on the same side of a product's packaging and that manufacturers frequently change ingredients. If you're unable to obtain a list of ingredients, it's safest to avoid that item.
  • Avoid cross-contamination when cooking by using two sets of cooking and eating utensils, with one exclusively for the allergic individual. Wash all dishes and utensils in hot soapy water between uses.
  • Craft an action plan with a list of steps for you and others to take should you accidentally ingest the allergen. Print out a copy of the plan and carry it with you.
  • Talk with restaurant chefs about your allergy and order food that's simply prepared and void of any form of the allergen. Avoid desserts, as they often contain or have come into contact with food allergens.
  • Plan ahead for traveling to ensure your food allergy will be managed and any emergency medication is always available.
  • Wear a medical ID bracelet identifying the allergen to which you're allergic.
  • Carry any recommended or emergency medication with you at all times.
  • Teach children with food allergies which foods to avoid. Work with caregivers and school staff to eliminate or reduce exposure to the allergen and to ensure they understand when and how to use medication to treat symptoms.

Your healthcare provider may direct you to take one of the following medications:

  • Epinephrine auto-injector when there are signs of an acute severe event, aka anaphylaxis (see below). Ensure your family members know how to administer it in case of an emergency.
  • Antihistamines as a supplement may be useful in relieving mild symptoms (e.g., itch); however, they do not halt the progression of an allergic reaction.
  • Bronchodilator (albuterol) as a supplemental therapy for respiratory symptoms, especially in those with a history of bronchospasm or asthma.

If you're with someone who's having an allergic reaction and shows signs of shock, act fast. Look for pale, cool, and clammy skin; a weak, rapid pulse; trouble breathing; confusion; and loss of consciousness. Do the following immediately:

  • Call local emergency services.
  • Ensure the affected individual is lying down with legs elevated.
  • Administer epinephrine immediately for any obvious signs of anaphylaxis.
  • Check the affected individual's pulse and breathing and administer CPR or other first-aid measures if necessary.

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Egg Allergen Facts, Symptoms, and Treatment

Common Symptoms

Egg allergy can range from mild to severe and may vary over time, resulting in mild symptoms during one episode and severe symptoms in another. Although food allergy symptoms can start a few minutes to several hours after ingestion, most begin within two hours.8 Symptoms may involve the skin, gastrointestinal tract, cardiovascular system, and respiratory tract, and may include one or more of the following:8,9

  • Abdominal pain, diarrhea, nausea, vomiting, stomach cramps
  • Hives (allergic urticaria), itching, eczema
  • Wheezing, nasal congestion, shortness of breath, repetitive cough
  • Shock, circulatory collapse
  • Tight, hoarse throat, trouble swallowing
  • Pale or blue skin coloring
  • Dizziness, lightheadedness, fainting, weak pulse
  • Anaphylaxis, a potentially life-threatening event

Particularly in children it is common that egg allergy may cause atopic dermatitis, also called eczema.7 Reactions including urticaria (aka hives) have been reported from merely touching egg without actually consuming it.4

How do I know if I'm allergic?*

Together with your symptom history, skin-prick testing or specific IgE blood testing can help determine if you are allergic to a particular allergen. If you are diagnosed with an allergy, your healthcare provider will work with you to create a management plan.

It's important to note that some children with egg allergy may outgrow their allergy, and food containing this allergen can be reintroduced. Therefore, periodic retesting and oral food challenges are recommended to track any progress toward outgrowing egg allergy.10

*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.

Is there a risk for a severe event?

Because food allergic reactions are unpredictable and symptoms range from local reactions to systemic, it is recommended that an epinephrine prescription be considered for any patient with an IgE-mediated food allergy.11

Egg is reported as the trigger in 7 to 12 percent of all anaphylaxis cases related to children.6 Plus, if you have asthma, you may face a higher risk of severe egg reactions. Compared to eating well-cooked egg, consuming raw or undercooked egg may elicit more severe reations.7

  1. Encyclopedia Britannica [Internet]. Chicago: Encyclopedia Britannica Inc.; 2020 Jul 23. Available from: https://www.britannica.com/topic/egg-food.
  2. EAACI, et al. Molecular allergology user's guide. Pediatric Allergy Immunol. 2016 May;27 Suppl 23:1-250. do: 10.1111/pai.12563. PMID: 27288833. (167-168 p.) Available from: http://www.eaaci.org/documents/Molecular_Allergology-web.pdf.
  3. Kids with Food Allergies [Internet]. Arlington, VA: Asthma and Allergy Foundation of America; 2015 Feb. Available from: https://www.kidswithfoodallergies.org/egg-allergy.aspx.4. Steinman HA. Hidden allergens in foods. J Allergy Clin Immunol. 1996;98:241-50.
  4. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Available from: https://acaai.org/allergies/types-allergies/food-allergy/types-food-allergy/egg-allergy.
  5. Tan JW and Joshi P. (2014), Egg allergy. J Pediatric Child Health. 50: 11-15. doi:10.1111/jpc.12408.
  6. Caubet J-C, Wang J. Current understanding of egg allergy. Pediatric clinics of North America. 2011;58(2):427-443. doi:10.1016/j.pcl.2011.02.014.
  7. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Available from: https://acaai.org/allergies/types/food-allergy.
  8. Mayo Clinic [Internet]. Rochester, MN: Mayo Foundation for Medical Education and Research; 2019 Nov 2. Available from: https://www.mayoclinic.org/diseases-conditions/food-allergy/symptoms-causes/syc-20355095.
  9. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 2010 Dec;126(6 Suppl):S1-58..
  10. Wright BL, Walkner M, Vickery BP, Gupta RS. Clinical Management of Food Allergy. Pediatr Clin North Am. 2015 Dec;62(6):1409-24. doi: 10.1016/j.pcl.2015.07.012. Epub 2015 Sep 7. PMID: 26456440; PMCID: PMC4960977
  11. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Available from: https://acaai.org/allergies/types-allergies/food-allergy/food-allergy-avoidance.
  12. Harvard Health Publishing [Internet]. Boston, MA: Harvard Medical School; 2020. Available from: https://www.health.harvard.edu/healthbeat/6-tips-for-managing-food-allergies
  13. Mayo Clinic [Internet]. Rochester, MN: Mayo Foundation for Medical Education and Research; 2019 Sep 14. Available from: https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468.
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