An allergic reaction to pineapple can be triggered by eating a small amount of the fruit or drinking pineapple juice. You may even have an allergic reaction from touching pineapple.

Allergic reactions to fruits, including pineapple, are less common than allergies to other foods, but they can be serious when they occur.

The most common food allergies include:

You may have the symptoms of a pineapple allergy immediately after being exposed to the fruit, or it could take up to several hours for your first symptoms to appear.

Intense itching and hives are often the first symptoms of an allergic reaction. Hives may show up on one or more places on your body.

You may also have digestive symptoms, including stomach pain, vomiting, and diarrhea. These digestive symptoms are your body’s way of trying to rid itself of the allergen.

In addition to digestive symptoms, pineapple allergy symptoms can include:

Anaphylaxis is a medical emergency. Seek immediate medical help if you have difficulty breathing or think you may be going into anaphylactic shock.

In one study from 1993, 20 out of 32 people who tested positive for pineapple allergy went into anaphylactic shock after eating the fruit.

You’re at an increased risk for a pineapple allergy if a close relative is allergic to pineapple. Close relatives include parents, siblings, and grandparents.

This is an especially important consideration when introducing new foods to babies. While it may seem counterintuitive, delaying introduction of familial allergenic foods to babies can actually increase allergy risk according to the American Academy of Allergy, Asthma, and Immunology (AAAAI).

Aim to introduce top allergenic foods to babies by 6 months of age. For babies with existing atopic dermatitis, a peanut allergy sibling, or a previous allergic reaction, speak to your doctor first.

Fruits, such as pineapple, can contain allergens found in other foods or substances. If you’re allergic to pineapple, you may also have an allergy to natural rubber latex. And, you may experience allergic symptoms when you’re exposed to items made from it. Things made from natural rubber latex include:

  • hospital gloves
  • adhesive bandages
  • sanitary napkins
  • crutches
  • blood pressure monitoring cuffs
  • condoms
  • rubber-grip utensils
  • rubber toys
  • toothbrushes

People who are allergic to pineapple may also be allergic to birch tree pollen or bananas, which is known as pollen-allergy syndrome. Ingestion of raw pineapple may result in mouth or throat symptoms known as oral-allergy syndrome, which rarely leads to anaphylaxis.

Cooked pineapple is usually tolerated by oral-allergy or pollen-allergy sufferers. Raw pineapple also contains a protease enzyme called bromelain which may irritate the lips or skin, but is not typically life-threatening either.

The most serious complication from a pineapple allergy is anaphylaxis. Anaphylaxis is a medical emergency and can be life-threatening. You should seek immediate medical help if you think you’re having anaphylaxis. Symptoms include:

If you’ve experienced anaphylaxis before, your doctor has likely prescribed an EpiPen. This is an auto-injected dose of epinephrine, which is a fast-acting type of adrenalin. It’s used to relieve severe immune system reactions to allergens.

You should visit the ER immediately after the use of an EpiPen, even if your symptoms are significantly reduced or eliminated due to the possibility of a second-wave reaction that is not responsive to epinephrine.

If you have a pineapple allergy, you should avoid both canned and fresh pineapple. You also shouldn’t drink pineapple juice if you’re allergic to pineapple.

Pineapple may also lurk in other foods. Some of these products include:

  • canned fruit salad or cocktail
  • pineapple salsa
  • pineapple rum
  • pineapple jam
  • fruitcake
  • banana bread
  • pineapple soda or soft drinks
  • tropical fruit punch
  • tropical alcoholic beverages, such as margaritas and piña coladas
  • fruit candies

Make sure to check the ingredient labels on food before you buy it to make sure it doesn’t contain pineapple. Also, when you eat out at restaurants, let your server know that you have a pineapple allergy. This will help you avoid accidental exposure to the fruit.

Pineapple enzyme may also be an ingredient in skin care products, such as soap and face cream. You should always check the ingredient list and not use the product if you have any doubt about what’s in it.

If you suspect you’re allergic to pineapple, talk to your doctor. They may recommend taking an over-the-counter antihistamine tablet to alleviate your symptoms, such as diphenhydramine (Benadryl).

If you’ve experienced anaphylaxis, your doctor will prescribe an EpiPen that you can use if you have symptoms of an allergic reaction.

If your symptoms don’t improve or if they worsen, treat the situation as a medical emergency. Call your local emergency services or have someone drive you to the nearest hospital.

Food allergies can occur for the first time at any point during a person’s life. In the United States, nearly 8 percent of children and up to 4 percent of adults have a food allergy. You may outgrow your pineapple allergy if you developed it as a child, or it may appear at any time during your life.

Your doctor may confirm a pineapple allergy through a blood or skin test. And it’s important to tell them exactly what happened. Your doctor may recommend that you avoid pineapple completely, and they might also prescribe antihistamines or an EpiPen as a precaution.

Unless your doctor indicates otherwise, avoid pineapple and any product that may contain the fruit. If you eliminate your exposure to the fruit, you won’t experience any symptoms.

Pineapple may be refreshing and high in vitamin C, but so are many other fruits. Delicious substitutes for pineapple include:

  • apples
  • pears
  • grapes
  • bell peppers
  • citrus fruits
  • mangoes

You can also use mango or apple juice instead of pineapple juice in many tropical concoctions. If you want to add sweetness to either baked products or snacks, raisins, dates, and dried cranberries are good substitutes.