Chocolate allergy: causes, treatments and prevention

Do you have a milk or peanut allergy? Are you a cocoa aficionado? This definitely interests you. We explain everything about chocolate allergy.

Last update: 12 September, 2022

Chocolate allergy is a controversial and complex issue. allergic symptoms are attributed to ingredients such as milk, nuts, peanuts or nickel and not the cocoa itself.

Cocoa is the basic ingredient of chocolate. In 100 grams of cocoa there are 20.4 grams of protein, 25.6 grams of lipids, 11.5 grams of carbohydrates, minerals such as phosphorus, calcium and iron, among other substances.

Now, there are different types of chocolate ranging from black, with more than 80% of its weight in cocoa, to white, without pure cocoa, with milk and sugar. All of these elements are potential sources of allergy.

How does allergy to chocolate occur?

Foods generate a tolerance response. In an allergic person, they will be recognized as pathogens, triggering an inflammatory response.

Factors such as genetics and the microbes we have in our intestines are involved in this susceptibility to developing food allergies. We speak of an allergy when exposure to chocolate or its components always triggers an abnormal response from the immune system.. The best known form is that in which immunoglobulin E antibodies are produced.

In classic allergy, immunoglobulin E molecules released in response to food bind to receptors on cells such as mast cells and basophils. Substances such as histamine are released. This is what causes the rapid onset of allergic manifestations, ranging from a skin rash to anaphylaxis.

Mild forms of allergy to chocolate are expressed in the skin with rashes and rash.


The symptoms of food allergies, including to chocolate, involve almost every organ in the body. Urticaria, with itching and redness of variable extent, may occur on the skin.

In more severe cases there may be edema or generalized swelling, called “angioedema”. This can compromise life when it affects the respiratory system.

Gastrointestinal symptoms, beginning with nausea and mild abdominal pain, are common. Vomiting and diarrhea will follow.

Signs of allergic rhinitis, such as increased nasal secretions and itchy nose, are accompanied by a cough. Furthermore, there may be cardiovascular complications, such as a sudden drop in blood pressure and circulatory collapse.

Allergies associated with chocolate

The most common allergy-causing foods are milk, eggs, peanuts, tree nuts, shellfish, wheat, soy, and fish. At the same time, products containing these ingredients will cause reactions.

Milk, peanuts, and tree nuts are regularly found in chocolate.

People with a nickel allergy can develop systemic nickel allergy syndrome or chronic dermatitis from eating chocolate. Less described is allergy to cocoa. There are reports of sensitization through occupational exposure.

In parallel, Lopes et al. report 3 patients with an allergic immune response to cocoa, mediated by immunoglobulin E. In all 3 cases there was a positive oral provocation test. People presented pruritus, edema and respiratory symptomsrequiring treatment with antihistamines and adrenaline.

What is the treatment for chocolate allergy?

The treatment of allergy to chocolate has several edges. For symptom relief medications such as antihistamines and corticosteroids are helpful. However, in case of anaphylaxis, the first line treatment is epinephrine or adrenaline.

Long-term, the most important thing is to avoid the food that causes the allergy. As feeding can be problematic, the help of a nutritionist is always advisable.

Another option is immunotherapy. The patient will be put in contact with small increasing amounts of the food that causes the allergy, until tolerance is achieved.

Allergic tests for diagnosis are usually done on the skin, measuring the reaction of the tissue to exposure to the agent.

Can I prevent chocolate allergy?

Due to the multifactorial nature of food allergies, their prevention is a constant subject of research. Preventive measures are focused on childhood, as this is when there is more scientific evidence.

In 2021, the recommendations of the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology and the Canadian Society of Allergy and Clinical Immunology were published. The entities indicate that it is important to introduce peanuts and boiled eggs at 6 months of age. Along with this, it is necessary that the diet of young children includes a wide variety of foods.

On the other hand, in the guide of the European Academy of Allergy and Clinical Immunology, also published in 2021, it is suggested avoid regular use of formula containing cow’s milk protein to supplement breastfeeding during the first week of life.

What do I do if I already have an allergy?

If the person is already allergic to chocolate, additional precautions will have to be taken to avoid complications:

  • read the labels of the products that are consumed.
  • Be cautious when you are going to eat a food for the first time.
  • Be careful if you eat products bought on the street.
  • talk at school and the people in the environment about the allergy.

Remember that it will always be necessary to consult your trusted doctor if you have any questions and follow their recommendations.

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