Strawberries are a delightful and vibrant fruit loved by many, especially children. Their juicy sweetness and vibrant red colour make them a popular choice for snacks, desserts, and even as a topping for various dishes. However, for children with eczema or dry skin around the mouth, enjoying a fresh strawberry can lead to a red rash around the mouth.
Different reactions to strawberries
In babies and young children, most often these rashes are not due to a true allergic reaction but a contact reaction. Strawberries are rich in natural Vitamin C, also known as ascorbic acid which is acidic. The acidity can irritate the skin around the mouth and neck, particularly if it is dry or broken due to a teething rash or eczema.
Understanding the Symptoms of Contact Reactions
Contact reactions to strawberries typically manifest as:
- A flat red rash around the mouth, lips, or cheeks
- Usually not itchy
These symptoms usually appear within seconds to minutes after eating strawberries and can last for a few hours or lead to an eczema flare that can last for a few days. Unlike true food allergies there are no other allergic symptoms such as hives, swelling, vomiting, difficulty breathing or lethargy. Contact reactions are not life-threatening and do not involve the immune system’s response to allergenic proteins.
How do I know if my child has a contact reaction or a true allergy to strawberry?
If you suspect your child may be experiencing symptoms of a strawberry allergy, it’s recommended to arrange a consultation with your GP. They can assist with a referral to a specialised allergy clinic. At Children’s Allergy Doctors, we can quickly differentiate between contact and allergic reactions with our skilled clinicians and skin prick testing to strawberry, and can then advise on the best management.
Managing Contact Reactions
If your child experiences a contact reaction after eating strawberries, there are several steps you can take to manage their discomfort:
- Rinse the affected area: Wash the affected area gently with lukewarm water to remove any remaining strawberry residue. Avoid using harsh soaps or scrubbing vigorously, as this can exacerbate the irritation.
- Apply a soothing ointment: Over-the-counter topical moisturising ointments can help alleviate the redness.
- Avoid further contact: Encourage your child to refrain from touching or scratching the irritated area, as this can worsen the symptoms. Applying a cold compress may provide relief.
How to prevent future contact reactions to strawberry:
- Treat any eczema or dry skin around the mouth and next
- Apply an ointment around the mouth and neck before eating strawberries.
- Mix strawberries with less acidic foods: If your child enjoys eating strawberries, you can reduce the likelihood of contact reactions by mixing them with foods that are less acidic. This can help dilute the fruit’s acidity and lessen the irritation.
In older children or adults allergy to strawberries may occur, and like other food allergies, occurs due to the immune system’s mistaken identification of specific proteins as threats. There are two proteins in strawberries, Fra a 1 and Fra a 3, that have been identified as potential allergens. When these proteins come into contact with the immune system, they can trigger an allergic response.
To combat this perceived threat, your body generates antibodies aimed at neutralising the strawberry allergens. These antibodies then release histamine and other chemicals, setting off an allergic response and causing inflammation.
Risk Factors
Individuals face a higher likelihood of food allergies when they possess certain risk factors, including a family history of food allergies, an existing birch pollen allergy, a history of asthma, or a background of eczema. These predisposing factors can contribute to an elevated susceptibility to adverse allergic reactions when exposed to allergenic foods.
Cross Reactivity
Strawberries come from the Rosaceae family, and cross-reactivity with other plants from the same family is a possibility. This includes a range of fruits, including apples, cherries, almonds, peaches, plums, apricots, pears, blackberries and raspberries, which may trigger similar allergic responses.
Strawberries contain a protein similar to Bet v 1, which is also present in birch pollen. If your child has developed sensitivity to birch pollen, they could potentially experience symptoms of Pollen Food Allergy Syndrome (also called Oral Allergy Syndrome).
This might lead to reactions when consuming a variety of other foods, including apple, kiwi, pear, peach, plum, nectarine, apricots, cherries, tomato, celery, carrot, potato, parsnip, pepper, dill, cumin, peas, coriander, fennel, hazelnut, walnut, almonds, peanuts, raspberry, as well as lentils and beans.
Additionally, strawberries contain Lipid Transfer Proteins (LTPs), a group of proteins that are heat-resistant and commonly found in various plant species. If you experience adverse reactions to a range of fruits, vegetables, and nuts, and these reactions persist even after you’ve removed the peel and thoroughly cooked the food, you might be dealing with LTP Syndrome.
There are a variety of foods involved in LTP allergies including kiwi, strawberries, sunflower seeds, walnuts, apples, mulberries, bananas, peas, apricots, cherries, plums, almonds, peaches, pomegranates, raspberries, tomatoes, grapes, celery, peanuts, asparagus, cabbage, broccoli, chestnuts, lemons, tangerines, oranges, hazelnuts, lettuce, lentils, lupin, green beans, pears, mustard, wheat, and maize.
Common Strawberry Allergy Symptoms
If you happen to have a strawberry allergy, consuming strawberries can lead to a range of adverse reactions affecting your digestion, respiration, or skin such as:
- Itching
- Swelling
- A tingling or burning sensation in the mouth and lips
- Development of hives
- An itchy, runny, or congested nose
- Frequent sneezing
- Gastrointestinal distress, including an upset stomach, abdominal cramps, and vomiting
- Itchy mouth and throat
- Throat constriction or tightness
- Diarrhoea
In cases of mild allergic symptoms, your healthcare provider might recommend oral antihistamines as a treatment option.
Common Foods and Items with Strawberry
Strawberries find their way into our diets through various forms and are commonly consumed fresh, dried, or incorporated into an array of processed food products and desserts. Strawberries make appearances in a wide range of foods, including:
- Jellies, jams, and preserves
- Flavour syrups
- Juices
- Smoothies
- Ice cream
- Cakes
- Cheesecakes
- Pies
- Some salads
Strawberries, however, are not limited to culinary applications alone. Their versatility extends to other uses as well. The leaves of the strawberry plant can be consumed either raw or cooked and are even employed as a tea substitute.
Additionally, both the fruit and leaves are incorporated into various herbal remedies, harnessing their natural properties. Furthermore, the fruit itself is utilised as an ingredient in skincare creams and tooth-whiteners, highlighting its role in a broad spectrum of products.
Opting to steer clear of strawberries doesn’t mean you have to miss out on the enjoyment of other fruits. Instead, you can safely indulge in alternatives like bananas and melons, as they do not belong to the rose family and are less likely to trigger cross-reactivity.
Seek professional guidance on how to read food labels and identify potential sources of strawberries or cross-contamination in food products. This can help you make informed choices when selecting foods for your child.
How can we help at Children’s Allergy Doctors?
At Children’s Allergy Doctors, we offer comprehensive allergy information and an array of allergy services for various allergy-related conditions. We are dedicated to supporting you throughout each step of your journey, from the initial allergy diagnosis to assisting you with the management of food allergies and beyond.
If you would like to find out more about strawberry allergy or any other aspect of children’s allergies, or book an appointment, please contact our practice team on 0203 146 7721 or email admin@childrensallergydoctors.com.