Egg allergy

After a reaction: document exactly what was eaten

• Date and time, exact food or recipe, brand and photo of the ingredients list.
• Amount eaten, delay before symptoms, exact symptoms, medicines used and any emergency-department attendance.
• Above all, specify the form of egg: raw, in mayonnaise or mousse, soft-boiled, medium-boiled, omelette, hard-boiled, pancake, biscuit or long-baked cake.

White or yolk: what causes the allergy?

Most major allergens are found in egg white. The yolk may nevertheless be involved in some profiles, particularly through chicken serum albumin (Gal d 5).

Why can cake be tolerated but not omelette?

Temperature, cooking time and the food matrix modify certain proteins. Egg mixed with flour and baked for a long time does not behave in exactly the same way as scrambled egg or an omelette. Many children therefore tolerate extensively heated egg before less-cooked forms.

Can I try cake at home?

Not routinely. In some children who have only had mild reactions and do not have problematic asthma, reintroduction of extensively heated egg may sometimes be advised at home by a clinician. After a severe or respiratory reaction, a reaction to a very small amount, or in the presence of asthma, specialist reintroduction is preferable.

What is an egg ladder?

An egg ladder organises the gradual reintroduction of increasingly allergenic forms, generally starting with extensively heated egg in a food matrix such as a biscuit or cake, then moving to less-cooked forms. No single universal ladder is suitable for every patient; progression depends on the allergy profile and the care team's instructions.

What happens during allergy assessment?

• Clinical history: form of egg, amount, delay, symptoms, treatment and forms already eaten without a problem.
• Skin prick tests and specific IgE: these look for immediate sensitisation and are interpreted alongside the clinical history.
• Molecular allergology: Gal d 1 (ovomucoid) may help in some profiles, but no threshold alone determines tolerance of cooked egg.

What is an oral food challenge used for?

An oral food challenge may confirm or exclude an allergy, check whether extensively heated egg is tolerated, document the development of tolerance or determine which reintroduction step is possible. It remains the reference test when the history and tests are not sufficient.

Can egg cause a delayed reaction?

Yes, particularly in FPIES: repeated, delayed vomiting after eating the food, pallor, lethargy and sometimes diarrhoea. Skin prick tests and specific IgE may be negative in these forms. Specialist assessment is needed.

Are there cross-allergies with other eggs?

Quail, duck, goose and turkey eggs contain proteins related to those in hen's egg. Cross-reactivity may therefore occur. An egg from another species should not be offered spontaneously as a substitute without assessment.

Egg and chicken meat: should poultry be avoided?

Does egg allergy resolve?

Often yes, but at varying ages. Even when it persists for several years, the allergy should continue to be reassessed to identify when certain forms and then whole or less-cooked egg can be safely reintroduced.

What should be done when egg allergy is confirmed?

• Adapt avoidance to the actual level of tolerance rather than automatically removing every form.
• When confirmed by the allergist, keep forms that are already eaten regularly without a reaction.
• Have an action plan and adrenaline auto-injector when indicated.
• Reassess the allergy regularly and discuss progression or an OFC when the context allows.

Is oral tolerance induction available for egg?

For persistent IgE-mediated allergy, particularly in an older child, oral tolerance induction or oral immunotherapy may be discussed in some specialist centres. The 2025 EAACI guidelines generally suggest it after the age of 4 depending on the context. Desensitisation does not mean a guaranteed cure.

Reading labels

‘Contains egg’ means that egg is an ingredient. ‘May contain egg’ indicates a risk of accidental presence. Advice about precautionary statements must be adapted to the patient's profile.

Should foods already tolerated be removed?

Egg allergy and vaccines

Where may egg be found?

Before your appointment: the SOS Allergo checklist

• Exact product or recipe, brand or packaging, approximate amount of egg and form: raw, lightly cooked, well cooked or in a cake.
• Date and time, delay before symptoms, photos, treatments given and emergency-department report if available.
• Precise list of egg forms currently eaten without a problem; a photo of the cake and its recipe may be more useful than ‘they eat cakes’.