Egg white allergy

Woman breaking an egg high above a bowl so the white and yolk fall in a stream into the flour – egg can cause allergy

Egg whites are more likely to cause allergy symptoms than yolks because of the proteins they contain. That can be anything from a mild rash to anaphylaxis, a life-threatening allergic reaction. Even if you can tolerate yolk you must avoid it due to the risk of cross-contact with egg white.

If you have egg white allergy you may also have to avoid other types of egg too. Cross-reactions are rare but it’s possible to react to white from chicken eggs, goose, turkey, quail and duck. This is because the proteins or allergens are very similar.

In this article we’ll look specifically at egg white allergy. Getting a diagnosis will help you know how to manage and treat it. And we’ll look at whether an egg white allergy can ever go away.

What causes egg white allergy?

When your body becomes sensitized to egg proteins your immune system thinks they are something harmful. The body produces Immunoglobulin E (IgE) antibodies to defend itself.

Problem proteins in egg white

There are three main proteins in egg white that can cause allergic reactions:

  • Ovalbumin – the most abundant protein in chicken’s egg white
  • Ovomucoid – the dominant allergen in egg white or yolk
  • Ovotransferrin – another of the major allergens in egg white

An allergy blood test can look for which protein you’re sensitized to. One study found kids aged two to four years old had the highest sensitization rate among children to egg white, ovalbumin and ovomucoid. And kids with IgE antibodies to egg white and ovalbumin were at a higher risk of developing atopic dermatitis (eczema).

Egg yolk is also an allergen, but it’s not responsible for as many allergic reactions.

Simple guide to allergy testing for kids

Boy smiling at an allergist in a white coat who’s taking notes on a clipboard and telling him about allergy testing for kids

Diagnosing egg white allergy

Speak to your healthcare provider if you think you or your child may have an allergy to egg white. We’ve already mentioned allergy blood tests. Another type is a skin prick test.

Egg allergies mainly cause IgE reactions but also non-IgE or mixed reactions, which may not show up in these tests. So your healthcare provider may suggest an oral food challenge. This involves eating eggs in greater amounts whilst being watched for a reaction. Or they may need to do an internal examination using a camera (endoscopy) to make the diagnosis.

Be ready with details of your family medical history and any symptoms. A daily log of what you eat and drink may help.

Signs and symptoms of egg white allergy

Most egg allergy symptoms happen within two hours of exposure. But they can happen almost immediately, within minutes or seconds.

Symptoms can include:

  • Tingling or itching in the mouth
  • A raised, itchy red rash (hives) – sometimes the skin can turn red and itchy but not raised
  • Swelling of the face, mouth, throat or other parts of the body
  • Difficulty swallowing
  • Wheezing or shortness of breath
  • Feeling dizzy and lightheaded
  • Feeling sick (nausea) or vomiting
  • Abdominal pain or diarrhea
Woman with long hair sitting clutching her stomach. Food allergy symptoms can start almost immediately

Food allergy or intolerance?

Anaphylaxis: Severe allergic reactions to egg white

Egg white allergy from childhood or that starts as an adult can cause anaphylaxis. This is a severe allergic reaction affecting your whole body and it can be life-threatening. It tends to include more than one of these symptoms:

  • flushed, pale or itching skin (hives)
  • swelling of the tongue or throat
  • a weak or rapid pulse
  • diarrhea, vomiting or feeling sick
  • low blood pressure (hypotension)
  • narrowing of the airways, which may cause wheezing and difficulty breathing
  • feeling dizzy or fainting

Learning to recognize these symptoms early can help minimize severity of an anaphylactic reaction. You must use your emergency medication as soon as possible and seek immediate medical attention.

Tips for managing egg white allergy

Adapting your diet to avoid eggs is essential. Your healthcare provider may refer you to a nutritionist or dietician to help you maintain a balanced diet. You’ll find lots more advice on how to do that in our article about food allergy.

Children usually start school with an allergy action plan. Involve them in discussions around food as soon as they’re old enough. This builds confidence and helps them to raise concerns.

Know which foods contain egg

Get to know what’s inside the foods you eat by reading the food labels. You can use a translation app to identify allergens in other languages.

It’s not just meringues, mousses and macaroons that are made with egg whites. There’s the less obvious ones like some types of coffee drinks with very foamy topping. Egg white can also appear in unexpected places such as wine production (to stop it going cloudy), ground meat (as a natural preservative) and in the manufacture of edible packing films.

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Try egg white substitutes such as aquafaba, which is the water beans have been cooked or canned in. It imitates egg whites and is even suitable for making meringue.

Cook differently at home

Egg white is used for clarification, coating and whipping. Try egg white substitutes such as aquafaba, which is the water that beans, often chickpeas, have been cooked or canned in. It imitates egg whites and is even suitable for making meringue. Just make sure to read the food label first, as even some egg substitutes can contain egg proteins.

If you can’t make your home egg-free, wipe cooking utensils, plates and cutlery down carefully as allergens can linger on sponges after washing up. Always eat at a clean table. And don’t forget to wash your hands beforehand. Also label leftovers clearly and keep egg-free foods on a different shelf.

Manage the risks away from home

Call or email restaurants before you go so they have time to prepare your food safely. And tell them about your food allergy again when you get there. Any self-service food counters, such as salad bars or buffets, pose a risk of cross-contamination.

Request an egg-free meal when you travel or bring your own food. And wipe down all surfaces before eating from it. Keep your allergy medicine with you at all times and remember your spares.

Egg white allergy symptoms from non-food products

Egg protein can be in soap, creams, cosmetics, hair masks and shampoo. If you have a severe egg white allergy make sure you check the label before use. It’s also in some vaccines.

Vaccines and egg white allergy

The yellow fever vaccine contains egg protein. The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) say that people with severe egg allergy shouldn’t receive it. Your healthcare provider can provide a waiver for travel if needed.

Most flu vaccines contain a small amount of egg protein. But the CDC considers the risk to people with egg allergies to be low. That is, except to those who’ve had a severe allergic reaction to a flu shot in the past. In that case, don’t have one again. Anyone with a history of severe allergic reactions to egg should receive the vaccine in a medical setting. There are also two egg-free flu vaccines now.
Medicine cabinet with a cross on the half-open door – if you have egg white allergy, there may be antihistamine inside yours

Antihistamine and other allergy medicines

How do you treat egg white allergy?

Antihistamine can treat a mild reaction. This helps block the effects of histamine, which the body releases when it encounters egg proteins. Your pharmacist can advise you about the different types available. Anaphylaxis, which is the severe systemic type of allergic reaction, is treated with epinephrine.

Emergency treatment for severe egg white allergy

Epinephrine is another name for the hormone adrenaline, a naturally occurring hormone in your body. Your healthcare provider may prescribe it in the form of an auto-injector if they think you’re at risk of a severe allergic reaction.

Carry two auto-injectors with you at all times as one dose may not be enough. Always seek immediate medical attention even if the first dose of epinephrine makes you feel better in case of a delayed secondary reaction.

Family and friends should be taught how to use an auto-injector as this prepares them for emergencies. A medical alert bracelet or necklace signals to other people how to help you.

Keep the original packaging and pharmacy prescription label as you’ll need it if you travel overseas. That’s the general rule for any medication. For injectables, the advice is also to get a note from your healthcare provider.

Does egg white allergy ever go away?

Most children outgrow egg allergy by six years old.

There is currently no FDA approved long-term egg allergy treatment or therapy. Desensitization may help to build up tolerance and reduce symptoms over time. But any contact with a food allergen must be in medical setting as it carries the risk of causing a severe allergic reaction affecting your whole body. Ask your healthcare provider for information. We can also help you find an allergist, if you need one.

You can read more information on long-term treatments for egg allergy symptoms here.

Summary

Egg white allergy is more common than egg yolk allergy, and most common in young children and infants. And many kids will outgrow it. Managing egg white allergy means avoid egg entirely, even if you’re only allergic to the white, due to almost inevitable cross-contamination. People with severe egg allergy should also get medical advice before receiving certain vaccines. Antihistamines can help ease milder food allergy symptoms. The treatment for anaphylaxis is epinephrine.

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Last medically reviewed on 08/11/2022