Cilantro allergy is rare but real. Cilantro is a leafy herb that’s common in foods from around the world, from Mediterranean to Asian cuisines. It can be added and eaten fresh or cooked, or boiled in dishes.

Symptoms of a cilantro allergy are similar to those of other food allergies. According to the American College of Allergy, Asthma, and Immunology, 4 to 6 percent of children and 4 percent of adults have a food allergy. Most food allergies develop during childhood, but they can also crop up later in life. You can become allergic to cilantro even if you’ve had no problem eating it for years.

If you’re allergic to cilantro, you may find that raw cilantro causes symptoms, but cooked cilantro doesn’t. Cilantro refers to the leafy stems of the Coriandrum sativum plant, which is also sometimes known as Chinese parsley or coriander. In the United States, coriander usually refers to the seeds of the plant, which can also be ground into a spice. It’s possible to be allergic to the plant’s coriander seeds, or to the coriander spice made from ground seeds.

Symptoms of a cilantro allergy may resemble those of other food allergies. These include:

  • hives
  • swollen, itchy lips or tongue
  • coughing
  • stomach pain, including vomiting and cramps
  • diarrhea

A severe cilantro allergy could lead to anaphylaxis, a severe and potentially life-threatening allergic reaction. Symptoms of anaphylaxis from a cilantro allergy include:

  • difficulty breathing, including shortness of breath and wheezing
  • dizziness (vertigo)
  • weak pulse
  • shock
  • difficulty swallowing
  • swollen tongue
  • facial swelling
  • hives

While anaphylaxis is not common with a cilantro allergy, it’s important to seek emergency medical attention if you’re experiencing the above symptoms.

Seek emergency medical attention if you’re experiencing severe symptoms. Anaphylaxis can be life-threatening and can occur very suddenly after you are exposed to an allergen. If you develop a rash, are weak, have a high pulse, feel nauseous, or start vomiting seek out medical care immediately.

If you’re with someone who is experiencing anaphylaxis, you should:

  • Call 911 immediately.
  • See if they have an epinephrine (adrenaline) auto injector (Epi-Pen) and help them, if needed.
  • Try to keep the person calm.
  • Help the person lie on their back.
  • Raise their feet about 12 inches and cover them with a blanket.
  • Turn them on their side if they are vomiting or bleeding.
  • Make sure their clothing is loose so they can breathe.
  • Avoid giving oral medications, anything to drink, or lifting their head, especially if they’re having trouble breathing.
  • If they’re having trouble breathing, you may need to perform CPR.

If you have had anaphylaxis after eating or coming into contact with cilantro, your doctor may prescribe an Epi-Pen for you to keep with you in case of emergency.

If it’s a less serious case, you may be able to use an antihistamine such as Benadryl to calm the reaction and reduce your symptoms.

First aid you need to know: How to treat allergic reaction »

Many people find that cilantro has an unpleasant soapy taste. This isn’t usually because of a cilantro allergy. Studies show that this intense unpleasant flavor of cilantro may be genetic.

A 2012 study looked at the genomes of thousands of participants who answered whether they thought cilantro tasted like soap or not. They found a strong association between those who think that cilantro tastes like soap and those who have a genetic variation that impacts a particular olfactory receptor gene, called OR6A2. Olfactory receptor genes affect your sense of smell.

The olfactory receptor that gene OR6A2 affects is sensitive to aldehyde chemicals, which are a major part of what gives cilantro its smell. This study suggests that dislike of cilantro is probably driven by its smell and is due to how your genes code your nose to respond to the chemicals that give cilantro its smell.

If you’re just developing an allergy to cilantro, it’s important to work with your doctor to confirm that cilantro is the trigger and to immediately remove it from your diet.

The best way to avoid triggering this, like with any allergy, is to avoid it entirely and to know what you need to do if you accidentally ingest it.

There are quite a few cuisines across the globe that incorporate this herb in dishes. Cilantro is common in many central and South American, Mediterranean, Asian, and Portuguese meals. If you’re eating these foods, whether in a restaurant or at home, make sure to double-check the ingredient list.

Remember to be careful when picking up or ordering pre-made dishes such as guacamole or salsas at the grocery as these may also contain cilantro.

In the long-term, you may want find some ingredient replacements, especially if you’re used to eating a lot of cilantro:

Parsley: Parsley is similar to cilantro in color and is a good fresh alternative. The taste isn’t exactly the same, but it offers some similar color, texture, and an added herb flavor to dishes. The flavor tends to be a bit more bitter. It has the same visual effect as cilantro if used as a garnish.

Vietnamese mint: Vietnamese mint, also known as rau ram, is another option. It isn’t from the same family as cilantro, so people with a cilantro allergy may be able to eat it. It has some spice, so it adds flavor. It’s also usually served raw.