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Peanut, tree nut, and seed allergy: Management

Julie Wang, MD
Section Editor
Scott H Sicherer, MD, FAAAAI
Deputy Editor
Elizabeth TePas, MD, MS


Peanut, tree nut, and seed allergies are some of most common food allergies in both children and adults. These allergies tend to cause severe reactions and usually persist over time.

This topic reviews various aspects of management of peanut, tree nut, and seed allergy, including instructions about avoidance of these allergens, education in the proper management of accidental exposures, and monitoring for resolution of the allergy. The epidemiology, pathogenesis, clinical features, and diagnosis of peanut, tree nut, and seed allergy are discussed separately. General discussions of food allergy are presented separately in appropriate topic reviews. (See "Peanut, tree nut, and seed allergy: Clinical features" and "Peanut, tree nut, and seed allergy: Diagnosis".)

The management of food allergy in the specific settings of schools and camps is discussed in detail separately. (See "Food allergy in schools and camps".)


Management of peanut, tree nut, and seed allergies begins with instructions about avoidance of products containing these foods.

Avoidance — The most straightforward approach in managing any food allergy is complete avoidance of the culprit food (Food Allergy Research and Education [FARE] and Consortium of Food Allergy Research [CoFAR] sheets on peanut, tree nut, and sesame). Foods that are at higher risk of containing peanut, tree nuts, or seeds include African, Asian, and Mexican dishes; baked goods (eg, pastries, cookies, crackers, bread); and candy. (See "Management of food allergy: Avoidance" and "Food allergy in children: Prevalence, natural history, and monitoring for resolution", section on 'Role of avoidance'.)

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Literature review current through: Nov 2017. | This topic last updated: Jun 12, 2017.
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