Cockroach
Allergy Facts, Symptoms, and Treatment

There's a strong link between cockroach allergy, asthma, and allergic rhinitis (aka hay fever).1 Plus, cockroach allergy is an important risk factor for hospital admissions and emergency room visits, as well as a significant cause of asthma related symptoms.2,3 Cockroach allergy also seems to have a larger impact on inner-city youth as an estimated 70 to 80 percent of asthmatic children in inner-city areas are sensitized to cockroach, compared to only 21 percent in suburban environments.4

There are roughly 4,600 species of cockroach, but only a few are considered pests, and just five varieties are frequently found in homes: German, American, Oriental, dusky/smokey brown, and brown-banded.5,6 Of these five, the German and American varieties are the most common species to cause allergies and to infest human dwellings.3,6 Reddish brown in color, the American cockroach measures roughly 30 to 50 millimeters (approximately 2 inches), and the smaller German roach, which is often carried into homes in grocery bags, is typically 12 millimeters (less than 0.5 inches) and is light brown with two dark stripes. Most species prefer warm, humid, and dark environments, and they eat both plant and animal products, as well as items such as paper, clothing, books, dead insects, and human food.5

Allergenic cockroach proteins from cast skins, secretions, egg casings, whole bodies, and fecal materials can become airborne and cause allergy symptoms.2 Cockroaches also spread filth and ruin food and materials, as they disgorge portions of partially digested food, drop feces, and emit secretions that have an offensive smell.7 Unfortunately, cockroaches are commonly found in urban dwellings across the globe.6

Where are cockroaches found?

Cockroaches prefer warm, moist environments where food is available.7 Factors that increase cockroach infestations include building degradation and high population density.3 Active at night, cockroaches tend to live in groups. They often hide in cracks and crevices in walls, door frames, furniture, cupboards, steam tunnels, basements, televisions, electronic devices, drains, and sewer systems.7 Causing year-round symptoms, allergens can be found throughout dwellings in locales such as beds, furniture, and carpets, with the highest concentrations typically located in the kitchen.11 Even after extermination, however, cockroach allergens may remain in the environment for several months.6

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Are there other allergens I could be sensitized to?*

There's both interspecies and cross species reactivity with cockroaches. For example, if you're allergic to American cockroaches, you could also be allergic to German varieties. Plus, you may be allergic to other arthropods (e.g., shrimp and crab), insects (e.g., butterflies and silverfish), arachnids (e.g., dust mites), and mollusks (e.g., oysters and scallops). 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

*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?

If you are allergic to cockroaches, your healthcare provider may recommend a plan that includes the following.2,3,4,7,8,9,12,13

  • Locate and remove cockroach hiding places and food sources.
  • Store food in sealed containers.
  • Clean and remove pet food bowls after pets are done eating.
  • Remove clutter.
  • Exterminate and then seal holes and cracks to prevent reinfestation.
  • Deep clean the environment once cockroaches have been removed to reduce residual allergens.
  • Fix leaky faucets and pipes to remove an accessible water source for roaches.
  • Vacuum and sweep floors after meals, and immediately do the dishes.
  • Take out the garbage often, and cover trash cans tightly.
  • Clean food crumbs from counters, stovetops, and tables.
  • Use cockroach baits and traps to eliminate the pests.
  • Check groceries, laundry, and furniture for roaches before bringing them into the building.
  • Consider contacting a professional exterminator to implement an integrated pest management approach to remove facilitative factors (e.g., food, water), block entrances, and kill or trap pests when necessary.

Your healthcare provider may direct you to employ one of the following therapies to improve your allergy symptoms:

  • Antihistamines are commonly used to reduce symptoms such as sneezing, itching, and runny nose.
  • Nasal corticosteroids are used to reduce swelling in the nose and block allergic reactions.
  • Decongestants can be employed to relieve stuffiness.
  • Allergen immunotherapy, as directed by your healthcare provider, may help develop tolerance to cockroach exposure.

Looking for more allergy info and management tips?

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Cockroach Allergen Facts, Symptoms, and Treatment

Common Symptoms

Symptoms of cockroach allergy can include:8,9

  • Nasal congestion
  • Ear infection
  • Sinus infection
  • Sneezing
  • Runny nose
  • Itchy, red, or watery eyes
  • Itchy nose, mouth, or throat
  • Postnasal drip
  • Cough
  • Itchy skin or skin rash

For those with asthma, cockroach allergy may also cause any of the following symptoms:8

  • Difficulty breathing
  • Chest tightness or pain
  • Wheezing
  • Trouble sleeping cause by shortness of breath, coughing, or wheezing

There have been some cases of Oral Allergy Syndrome (OAS) in cockroach allergic patients who consumed crustaceans such as shrimp.6 This syndrome is caused by cross-reacting allergens in both crustaceans and cockroaches. Symptoms of OAS include the following:10

  • 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?

Cockroach allergens are strong inducers of sensitization and asthma, and cockroach allergy is an important risk factor for emergency room visits and hospital admissions.2

  1. Pomés A, Chapman MD, Wünschmann S. Indoor Allergens and Allergic Respiratory Disease. Curr Allergy Asthma Rep. 2016 Jun;16(6):43. doi: 10.1007/s11882-016-0622-9. PMID: 27184001; PMCID: PMC4976688.
  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. (115-121 p.) Available from: http://www.eaaci.org/documents/Molecular_Allergology-web.pdf.
  3. Baxi SN, Phipatanakul W. The role of allergen exposure and avoidance in asthma. Adolesc Med State Art Rev. 2010 Apr;21(1):57-71, viii-ix. PMID: 20568555; PMCID: PMC2975603. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2975603.
  4. Portnoy J. World Allergy Organization [Internet]. Milwaukee, WI: World allergy Organization; 2004 Dec [2018 Mar]. Available from: https://www.worldallergy.org/education-and-programs/education/allergic-disease-resource-center/professionals/allergen-avoidance.
  5. Encyclopedia Britannica [Internet]. Chicago: Encyclopedia Britannica Inc.; 2020 Nov 16. Available from: https://www.britannica.com/animal/cockroach-insect.
  6. Ozdemir O, Cockroach Allergy, Respiratory Allergic Diseases and Its Immunotherapy. Int J Immunol Immunother. 2014. 1:002. doi.org/10.23937/2378-3672/1410002. Available from: https://clinmedjournals.org/articles/ijii/ijii-1-002.php?jid=ijii.
  7. Rozendaal, J A, World Health Organization. (?1997)?. Vector control: methods for use by individuals and communities / prepared by Jan A. Rozendaal. World Health Organization. https://apps.who.int/iris/handle/10665/41968.
  8. Asthma and Allergy Foundation of America [Internet]. Arlington, VA: Asthma and Allergy Foundation of America; 2015 Oct. Available from: https://www.aafa.org/cockroach-allergy.
  9. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2018 Feb 1. Available from:
    https://acaai.org/allergies/types/cockroach-allergy.
  10. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2019 Mar 21. Available from: https://acaai.org/allergies/types/food-allergies/types-food-allergy/oral-allergy-syndrome.
  11. Arruda LK. Cockroach allergens. Curr Allergy Asthma Rep. 2005 Sep;5(5):411-6. doi: 10.1007/s11882-005-0015-y. PMID: 16091215.
  12. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2020 Jun 17. Available from:
    https://acaai.org/allergies/types/hay-fever-rhinitis.
  13. American Academy of Allergy, Asthma & Immunology [Internet]. Milwaukee WI, American Academy of Allergy, Asthma & Immunology. 2020 Sep 28. Available from: https://www.aaaai.org/conditions-and-treatments/library/allergy-library/indoor-allergens.
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