Peach
Allergy Facts, Symptoms, and Treatment

Grown in the warmer temperate regions of the Northern and Southern Hemispheres, peaches are available in thousands of varieties.1 A stone fruit with white, yellow, or red flesh, peaches typically develop a fuzzy skin when ripe.1,2 While peaches are a moderate source of antioxidants, they provide 15 percent of daily vitamin C needs and 6 percent of daily vitamin A requirements.3 Eaten as fresh whole fruits and within various other foods such as juices, jams, jellies, and preserves, peaches are also canned and incorporated into baked goods.1,2 Along with fruits such as apple, pear, strawberry, apricot, plum, and cherry, peach is part of the Rosaceae family, which comprises the foods most frequently involved in food allergic reactions in adolescents and adults in Europe.2 In a 2014 European study assessing fruit sensitization rates, peach ranked as the most frequent inducer of sensitization with a rate of 7.9 percent.4

Where are peaches found?

Peaches are grown in the warmer temperate regions of the Northern and Southern Hemispheres, where major peach producing countries include China, Italy, Spain, and the United States.1 Peaches are consumed raw and in foods such as juices, jams, jellies, and preserves, but they're also canned and used in baked goods such as pies and cobblers.1,2 Plus, peaches are employed as a fruit extract in some biological cosmetics.4

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Are there other allergens I could be sensitized to?*

Some people with peach 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. The most common cross-reactivities with peaches are plant foods such as apples, apricots, carrots, cherries, peaches, peanuts, pears, raspberries, strawberries, hazelnuts, peanuts, and carrots.4

If you experience an itchy mouth or throat after eating peaches or other related fresh fruits or raw vegetables, you may suffer from Oral Allergy Syndrome (OAS), sometimes called Pollen Food Allergy Syndrome (PFAS). This condition is caused by your immune system's reaction to similar proteins, or components, found in plant foods and tree pollens.7 It is quite common, with up to 25 percent of children with allergic rhinitis (i.e., hay fever) also suffering from OAS when eating fruits or vegetables.8 Common pollen allergies that could cause OAS when eating plant food include tree pollens such as birch, alder, and hazel.4

Do I need to avoid all forms of peaches?

A peach consists of different types of proteins that all have different characteristics that may be associated with varying risk of causing severe allergic reactions. Some people with peach allergy may be able to eat peach if it is extensively heated (cooked), as high temperatures break down the causative proteins. Other proteins are mostly located in the peel, and peach may be tolerated if peeled. For other patients, peach may need to be avoided in all forms, as it could potentially cause a severe event, also called anaphylaxis. Your specific risk profile depends on which proteins you are allergic to.4

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 other pollens and foods you may react to.4

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.4

rPru p 1, rPru p4

  • Usually associated with mild symptoms, such as OAS, but sometimes also severe reactions.
  • Present in all pollens and plant foods, associated with cross-reactions, typically to birch and grass pollen.
  • Sensitive to heat and digestion, and cooked foods are often tolerated.

rPru p 3

  • Usually associated with severe reactions as well as OAS.
  • High concentration in the peel but also exist in pulp to a smaller extent. Peeled peach may be tolerated.
  • Stable to heat and digestion, cooked peaches can also cause symptoms.

rPru p 7

  • Usually associated with severe allergy reactions, such as anaphylaxis.
  • Stable to heat and digestion, likely also causing reactions to cooked peaches.
  • Cross-reactive marker between peach and cypress pollen.9

MUXF3 (CCD)

  • Positive specific IgE for peach in combination with MUXF3 CCD (Cross-Reactive Carbohydrate Determinant) being the only positive component test indicates that the cause of symptoms may be something other than peach.

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.10-13

  • 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.

Looking for more allergy info and management tips?

Visit the Living with Allergies section
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Peach Allergen Facts, Symptoms, and Treatment

Common Symptoms

Peach 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.5 Symptoms may involve the skin, gastrointestinal tract, cardiovascular system, and respiratory tract, and may include one or more of the following:5,6

  • 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

Symptoms may also include the following, which are associated with Oral Allergy Syndrome (OAS), aka Pollen Food Allergy Syndrome (PFAS):7

  • Itchy mouth and hives on the mouth
  • Scratchy throat
  • Swelling of the lips, mouth, tongue, and throat
  • Itchy ears

 

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.

*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 to systemic, it is recommended that an epinephrine prescription be considered for any patient with an IgE-mediated food allergy.10

  1. Encyclopedia Britannica [Internet]. Chicago: Encyclopedia Britannica Inc.; 2020 Feb 26. Available from: https://www.britannica.com/plant/peach.
  2. The University of Manchester [Internet]. Manchester, UK: The University of Manchester; 2006 Oct 18. Available from: http://research.bmh.manchester.ac.uk/informall/allergenic-food/?FoodId=37.
  3. Ensle K. Rutgers [Internet]. New Brunswick, NJ: New Jersey Agricultural Experiment Station, The State University of New Jersey; 2015 Jun. Available from: https://njaes.rutgers.edu/sshw/message/message.php?p=Health&m=301.
  4. EAACI, et al. Molecular allergology user's guide. Pediatr Allergy Immunol. 2016 May;27 Suppl 23:1-250. doi: 10.1111/pai.12563. PMID: 27288833. (199-212 p.) Available from: http://www.eaaci.org/documents/Molecular_Allergology-web.pdf.
  5. 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.
  6. 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.
  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-allergies/types-food-allergy/oral-allergy-syndrome.
  8. Roberts, Graham & Xatzipsalti, M & Borrego, Luis & Custovic, Adnan & Halken, Susanne & Hellings, Peter & Papadopoulos, Nikolaos & Rotiroti, G & Scadding, Glenis & Timmermans, Frans & Valovirta, Erkka. (2013). Paediatric rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy. 68. 10.1111/all.12235.
  9. Klingebiel, C., et al. Pru p 7 sensitization is a predominant cause of severe, cypress pollen-associated peach allergy. Clin Exp Allergy 2019: 49(4): 526-536.
  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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