Peanut allergies have become a growing concern, especially in schools. To keep children safe, many schools have banned peanut butter and other peanut products. But even with these precautions, there’s still a lot of confusion about peanut allergies. In this article, we’ll explain what peanut allergies are, why they’re a concern, and what you need to know to stay informed and safe.

If you have or care for a child with peanut allergies, here are some facts to keep in mind.

1. Are Peanuts Nuts?

Despite their name, peanuts are not actually nuts — they’re legumes. Peanuts grow in a pod and belong to the pea family, which also includes beans and lentils. Both nuts and legumes contain protein, but the specific proteins found in peanuts (Ara h1, Ara h2, and Ara h3) can trigger reactions in people who are allergic.

2. How Long Does a Peanut Allergy Reaction Last?

Allergic reactions to peanuts happen when a person’s immune system mistakes peanut proteins for something that could harm the body.

Symptoms of a food allergy reaction can also differ in how long they take to start and how long they last. Some reactions may occur in a few minutes, while others may take a couple of hours to develop.

Peanut allergy reactions can cause a wide range of allergy symptoms that can vary from person to person, including:

• Skin hives and discoloration
• Itchy or tingling mouth or throat
• Stomach cramps, vomiting, or diarrhea
• Shortness of breath or tightness in the throat
• Runny nose
• Anaphylaxis — A life-threatening reaction that can cause the throat to close and blood pressure to drop

Many of the symptoms of allergic reactions to peanuts can vary from mild to severe. A mild reaction to peanuts doesn’t always mean the next one will be mild too. In fact, a mild reaction can sometimes be followed by a life-threatening one. It’s hard to predict how a food allergy will affect someone each time.

3. Are Peanut Allergies Becoming More Common?

Approximately 2.5 percent of children in the United States are believed to have a peanut allergy, making it one of the most common food allergies. Research shows that the number of children diagnosed with peanut allergies in the U.S. has increased by 21 percent since 2010, and the rate has been going up since 1997.

The number of children diagnosed with peanut allergies in the U.S. has increased by 21 percent since 2010.

There are several theories as to why allergies to peanuts and other foods are becoming more common in children. One theory is that damage to the skin barrier, which protects the body from allergens, may be playing a role. An increase in chemicals in detergents and synthetic clothing may affect the skin barrier and cause damaged and dry skin in children.

Another theory is that young children today are not eating as many different foods at a young age, including peanuts and other foods that can cause allergies. Children in urban areas also have less exposure to animals, which may help them build a healthy and well-balanced gut microbiome. However, keep in mind that these are theories and have not been scientifically proven.

4. Can You Develop a Peanut Allergy Later in Life?

Peanut allergies can develop at any time in a person’s life, even as an adult. This is less common, but it can still happen, and it could happen to you.

Several members of MyFoodAllergyTeam have shared their experiences of developing peanut allergies as adults. One member shared, “My mother, my uncle, and another person I know all developed the allergy in their 30s or 40s. I’m in my 40s, so I’m concerned that I could eventually develop one.” Another shared, “I am an adult with a newly acquired peanut and tree nut allergy.”

If you think you might be having an allergic reaction, you should talk to a doctor no matter your age.

5. Are Peanut Allergies Linked to Other Allergies?

Peanut allergies are often linked to other food allergies. Although peanuts do not grow on trees, approximately 40 percent of children with allergies to tree nuts (such as walnuts, almonds, pecans, or cashews) are also allergic to peanuts.

However, having a peanut allergy does not usually increase the risk of being allergic to other legumes, such as peas, lentils, or soybeans. However, peanut allergies do raise the risk of being allergic to lupin, also known as lupin or lupini beans, which are common in Italian and other Mediterranean cuisines.

Peanut allergies may also be linked to egg allergies and atopic dermatitis, the most common form of eczema. A family history of food allergies can increase a child’s chances of having a peanut allergy.

6. Are Peanut and Tree Nut Allergies the Most Dangerous?

Peanut and tree nut allergies are serious because they can lead to anaphylactic shock — also known as anaphylaxis. Anaphylaxis is a potentially life-threatening reaction that can quickly cause the respiratory system to shut down. While death from anaphylaxis is rare, approximately 90 percent of deaths from anaphylactic shock happen to people with peanut or tree nut allergies.

Research shows that about 54 percent of children who had a severe initial reaction to peanuts will have at least one more during their lifetime. Another small study found that as many as 52 percent of children had life-threatening anaphylaxis symptoms within five years of their first peanut allergy reaction. Research from 2019 found that 23 percent of children with peanut allergies receive emergency care every year.

7. Does a History of Asthma Raise the Risk for a Fatal Reaction?

While reactions from exposure to peanuts can be life-threatening, fatalities are rare. One large-scale study showed that people with a history of asthma are at a higher risk of a fatal peanut allergy reaction. However, it’s important to note that most food allergy-related deaths happen to people whose past allergic reactions were mild. The severity of allergic reactions is unpredictable, so it’s vital to be ready for emergencies, especially if the person has asthma or other conditions.

While reactions from exposure to peanuts can be life-threatening, fatalities are rare.

8. Is Emergency Planning Essential?

If you, your child, or a child you care for has a peanut allergy, it’s important to be prepared for anaphylactic shock with an emergency plan. Your doctor can help you create an emergency plan that you can share with other family members, teachers, emergency responders, and hospitals. This plan should include key information about your child’s allergy and any necessary medication.

An emergency epinephrine auto-injector — EpiPen is one common brand name — should always be on hand in case of accidental exposure to peanuts or other allergens. Your doctor can show you how to use an emergency epinephrine auto-injector.

“​​I recently bought my daughter her own medical bag, which carries her EpiPen and cetirizine,” One MyFoodAllergyTeam member shared. “It has all her information and my contact number. I also bought her a peanut allergy bracelet, which she loves! I’ve found that the bag helps reduce her anxiety, as she always has her medicine with her just in case she comes into contact with peanuts.”

9. Is Accidental Exposure to Peanuts a Serious Risk?

Many children experience an allergic reaction due to cross-contact, which happens when peanut products such as peanut butter, peanut flour, or another allergen are accidentally transferred to another food. Cross-contact can occur even with tiny amounts of peanut protein or another food allergen.

To prevent any chance of cross-contact, it’s essential to clean all kitchen items thoroughly, including cutting boards, countertops, cookware, and dishes. Wash them with warm, soapy water, rinse well with clean water, and let them air dry. Always wash your hands with soap before preparing food.

Trace amounts of peanut protein can end up in foods that don’t contain peanuts. The U.S. Food and Drug Administration (FDA) requires food labels to list major food allergens, such as peanuts, or to warn if there is a risk that the food has come in contact with an allergen during manufacturing.

Foods that have a high risk of containing peanuts or cross-contact with peanuts include:

• Candy and ice cream
• Certain dishes in African, Mexican, or Asian cuisines, such as groundnut stews, mole, or peanut sauces
• Baked goods, such as cookies
• Certain sauces, glazes, and marinades

One MyFoodAllergyTeam member shared, “My oldest has been having issues with hives, and the foods she’s been eating are the same. So now we think it was a new cookie. We’re reading the labels again.”

Be sure to discuss cross-contact with restaurants and schools. While the term “cross-contamination” is sometimes used for allergens, it’s important to know that in the restaurant business, cross-contamination implies that the contaminant can be killed by heat. This is not the case with an allergen.

10. Do Some Children Outgrow Peanut Allergies?

Although many people have lifelong peanut allergies, studies from the American College of Allergy, Asthma, & Immunology show that about 20 percent of children with peanut allergies will eventually outgrow them. However, it’s important to work carefully with your doctor for supervised allergy testing to determine if an allergy has been outgrown, rather than trying to test this yourself.

One MyFoodAllergyTeam member wrote, “Heading to the allergist tomorrow to have my son tested for peanut/tree nut allergies. Praying he has outgrown the peanut allergy.”

Although many people have lifelong peanut allergies, about 20 percent of children with peanut allergies will eventually outgrow them.

11. Can Peanut Allergies Be Effectively Managed?

The key to managing a peanut allergy is prevention. This means avoiding contact with peanuts by:

• Always reading ingredient lists
• Consistently being careful when preparing food
• Having a good emergency plan in case of a severe allergic reaction

Treatment options for mild allergy reactions to peanuts include antihistamines and corticosteroids.

You may want to discuss newer treatments with your allergist, who can help you learn about the latest options available for managing peanut allergies. Staying updated with your allergist and health care team is important, as they can tell you when new treatments become available that may help your child.

One newer option is immunotherapy, which slowly exposes children to peanut proteins in order to train the immune system not to overreact. Peanut oral immunotherapy (OIT) is not a cure for peanut allergies and is not designed to introduce peanut products into a child’s diet. However, OIT can help some children avoid serious reactions if they are accidentally exposed to peanut protein. Palforzia is the first oral immunotherapy treatment approved by the FDA.

Newer therapies are being developed to treat peanut allergies, and promising drugs are in the works. One example is omalizumab (Xolair), an injected biologic drug. This medication is a human-made version of a protein in the immune system and works by targeting immunoglobulin E (IgE). IgE is a protein responsible for setting off allergic reactions. By binding with IgE and neutralizing it, biologic drugs like omalizumab could help prevent the processes that lead to allergic reactions and life-threatening anaphylaxis. Omalizumab has been shown in clinical immunology research to quickly reduce a person’s sensitivity to peanuts, offering hope for better allergy management in the future.

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