Oral allergy syndrome consists of tingling lips or mouth often associated with irritation, burning or soreness following contact with certain foods.
In oral allergy syndrome, antihistamines can help to dampen the symptoms; hydrocortisone 0.5-1% is safe to use on the face and its absorption through the skin is negligible, if used sparingly. Stronger steroid creams are best avoided.
Several of the food reactions in the oral allergy syndrome seem to have strong connections with common pollens, which cause hay fever. Tree pollens are often linked with the following foods (they are grouped together if they belong to the same family):

• Apple, pear
• Plum, peach, apricot, cherry
• Parsley, carrot, celery
• Potato, tomato, pepper, aubergine
• Some nuts especially hazelnut
• Peas, beans, peanut
• Sunflower
• Kiwi

Grass pollen has links with reactions to peanut, melon (honeydew, cantaloupe), watermelon and kiwi. Ragweed pollen, which causes symptoms in late summer, is also associated with melon, watermelon and cucumber.

Occasionally reactions can be severe and require the use of adrenaline. However, peeling the food, avoiding eating it when it is too ripen and subjecting it to brief boiling or microwave oven is known to reduce its allergenicity. Pesticides and sprays are not a likely cause!

It is believed that, in a significant proportion of people with oral allergy syndrome, reactions to foods are “driven” by the underlying allergy to pollens. This raises an interesting question:

Q: Is it possible to control the food allergy if we could control the allergy to pollen?

If you have already explored all other basic options and have avoided many of the above foods but you are left with a menu too limited to offer a healthy choice of foods, desensitisation against pollens (also known as immunotherapy) is available in a few NHS immunology departments and some independent clinics in the UK. Concerns about its safety have probably been exaggerated and it deserves to be considered in case, treating the pollen allergy can help to minimise one’s reactions to foods. In our clinics we use two other methods of immunotherapy, which have an excellent record of safety and efficacy (see section of immunotherapy)

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