What to Know About Mango Allergy

Two types of reactions may be called a mango allergy. One is a reaction to urushiol, an oil in mango peels that is also responsible for reactions to poison ivy.

The other is pollen food allergy syndrome (PFAS). PFAS typically occurs in individuals with certain pollen allergies, a common one being birch tree pollen allergy. The proteins in some fruits and vegetables, like mangoes, are similar to birch and/or mugwort pollen and cause a reaction.

A mango allergy can cause mild to severe symptoms, including hives, swelling, or even a life-threatening, whole-body reaction called anaphylaxis. Sometimes, individuals are allergic to the mango peel but can eat the fruit safely. Others experience a severe reaction to any contact.

What Are Symptoms of a Mango Allergy?

Allergic reactions to mangoes include:

• An immediate allergic reaction occurs within minutes of exposure to the allergen. It can range from mild itchiness to a severe, life-threatening reaction known as anaphylaxis after eating mango. However, anaphylaxis is extremely rare. Only about a dozen or so case reports have been published.
• A delayed allergic reaction can occur an hour or even several hours after eating mango. It often includes a rash in and around the mouth called contact dermatitis, which may be referred to as mango mouth.

Immediate Reaction

Symptoms of an immediate allergic reaction after eating mango can range from mild to severe and may include:

• Itchiness, tingling, and swelling of the mouth, lips, throat, and tongue
• Itchiness, tingling, and swelling of the face
• Swelling or tightening of the throat
• Wheezing
• Hives

Anaphylaxis

Symptoms of a severe allergic reaction may come on suddenly and can progress rapidly. If you have any signs of anaphylaxis after consuming a mango, it's important to seek urgent medical care.

Delayed Reaction

Symptoms of a delayed reaction to mango may include:

• Contact dermatitis rash (itchy, blisters, eczema-like)
• Vomiting
• Diarrhea

Contact dermatitis is the most common symptom of a delayed reaction and typically begins within eight to 12 hours after contact. Blisters may take longer to develop—up to 72 hours. Contact dermatitis can occur around the mouth or hands after handling the fruit.

Keep in mind that the urushiol in the peel of the mango often triggers the rash. Many people who have a tendency to develop contact dermatitis after eating mangoes don’t experience any symptoms if the fruit is cut away from the skin before being served.

What Does Mango Mouth Look Like?

Mango mouth describes the rash that can appear in and around the mouth after eating mangoes. It occurs because of an immune system overreaction. Your body thinks that the substance is dangerous and tries to protect you from it.

A skin rash from mango looks like a poison oak rash that occurs after eating the fruit. It may have small, itchy blisters that can ooze and last several days.

You may also experience pain, numbness, and tingling with mango mouth. In severe cases, the allergic reaction can cause symptoms of shortness of breath or a tightening of the airway that require immediate medical attention.

What Are Mango Allergy Symptoms in Babies?

It is very rare for babies to react to mango. Because mango reactions usually occur because of a sensitivity to pollen or to poison ivy, babies who have had much less time to be exposed to these other allergens are much less likely to react to mango.

If they do have a reaction, mango mouth symptoms would be similar in babies and adults, although babies' symptoms would likely be less severe. Allergic reactions can progress rapidly from uncomfortable to life-threatening. For some people, just trace amounts of an allergen can trigger a reaction.

Any signs of an allergic reaction in a baby should be treated seriously. If you suspect that your baby is having an allergic reaction:

• Stop feeding them immediately.
• Call 911 or go to the hospital right away.

Fortunately, except for peanut and tree nut allergies, most babies outgrow any food allergies by the time they are teenagers.

Unless instructed otherwise by your child's healthcare provider, you can begin incorporating mangoes and other fruits and vegetables when your child is ready to start solid food introduction.

What Causes a Mango Allergy?

Urushiol is an oil found in the sap, skin, stems, and leaves of mangoes. It can cause a reaction in those who are allergic.

A mango-induced rash occurs more commonly after contact with the plant or the peel rather than eating the fruit simply because of where the oil is located.

It is possible to have a reaction to fruit in childhood, but you can also become allergic to fruit all of a sudden later in life. This is uncommon but more likely if you have a family history of allergies.

What Is Pollen Food Allergy Syndrome?

A reaction limited to oral itching may be due to pollen food allergy syndrome. This is a response to proteins in pollen from mango plants. It's sometimes referred to as pollen food allergy syndrome.

A PFAS reaction usually gets better without treatment—often in just a few minutes. For some people, the allergic reaction can be avoided if they eat the food in a certain way that changes the trigger proteins (cooked rather than raw, for example). Others may experience the allergy either way.

Cross-Reactivity

There are more than 1,000 varieties of mangos. Most varieties have yellow-orange flesh you can eat and a peel that's green or red. Cross-reactive allergies may occur with mango and other plants in the Anacardiaceae plant family.

If you are allergic to plants in this group, you may also have a reaction to mangoes—and vice versa. For example, poison oak, poison ivy, and poison sumac all contain urushiol.

There also are similarities with mugwort or birch pollen.

People with a mango allergy may have a cross-reactivity with other fruits, vegetables, or nuts. Cross-reactivity varies per person, but may include one or more of the following:

• Cashew
• Pistachio
  
• Chestnut
• Peanut
• Peach
• Pear
• Apple
• Papaya
• Celery
• Carrot
• Avocado
• Banana
• Kiwi
• Tomato
• Passion fruit

Cross-reactivity can also occur with specific herbs or spices, such as:

• Paprika
• Anise
• Fennel
• Coriander
• Cumin

A latex allergy can also cause PFAS symptoms when eating a mango (also called latex-fruit syndrome). It's worth noting that cashew shells and the outer covering of pistachios also contain urushiol, potentially causing a reaction similar to mango.

How Is a Mango Allergy Diagnosed?

When starting solid foods, parents are encouraged to introduce new foods to babies one at a time to monitor for signs of an allergy. This eliminates the possibility that a reaction could be due to something else.

In children and adults, you may be able to tell if you have a mango allergy if your reaction happens immediately. However, if there is a delayed reaction, it may not always be evident that a rash is due to mango.

If you get a rash, you should see a healthcare provider as soon as possible.

Tests used to identify the cause of an allergy may include:

• Skin prick test: In this test, a small amount of an allergen is pricked into the skin with a needle, and you are monitored for signs of a reaction
• ImmunoCAP test: A blood test that detects specific antibodies to certain foods

How Is a Mango Allergy Treated?

Avoiding contact with mango peels is usually an effective way to prevent a rash. If you do get one, it is likely to go away on its own within a few days.

For itchiness from pollen food allergy syndrome or minor reactions, over-the-counter antihistamines, such as Zyrtec (cetirizine) or Benadryl (diphenhydramine), can help.

For more severe rashes, treatment options may include:

• Over-the-counter anti-itch creams to reduce discomfort, such as hydrocortisone
• A prescription-strength corticosteroid cream, which is a medication that gets applied to the skin to help with swelling and irritation
• Steroids taken by mouth

If you're at risk of an anaphylactic reaction, your healthcare provider will give you an epinephrine auto-injector (aka EpiPen) to keep with you. An EpiPen is a shot containing epinephrine.

When epinephrine is injected, it stops an allergic reaction. However, you must still contact emergency services immediately for additional care.

Summary

Mango allergies can trigger a rash or a more severe reaction known as anaphylaxis. You may react to urushiol oil in mango peels or have pollen food allergy syndrome. Your healthcare provider can provide allergy testing if you are unsure if you have a mango allergy.

Treatment for mango allergies includes antihistamines for itching or topical creams if the reaction causes mango-induced dermatitis. If you experience a severe reaction, you may need to keep an EpiPen on you. If you experience anaphylaxis, seek immediate medical treatment, even if your EpiPen resolves the symptoms.

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