Allergy to black pepper is not one of the more common allergies. In fact, the first time I started sneezing after exposure to black pepper, my friend laughed and said that black pepper makes everyone sneeze. It wasn't so funny when my lips swelled to ten times their normal size and raised hives developed around my mouth and nose. I suffered for a week, both from the intense itching and from embarrassment, before the skin on my face finally peeled away. An allergy to black pepper is nothing to sneeze at.
Not wanting a repeat experience, I learned everything I could about black pepper allergy. Black pepper comes from the berries or seeds of the plant Piper nigrum, belonging to the botanical family Piperaceae. Black pepper is from the hull of the berry or peppercorn, while white pepper comes from the same fruit but with the hull removed. Green, pink, and red pepper also comes from the same Piper nigrum plant in various stages of ripening. I don't know if I am allergic to the different colors of pepper; I avoid them all. There are peppers that I can eat. Pepper that come from the family Solanacea and includes sweet green bells, cayenne, and chili pepper don't give me a problem.
The usual responses to pepper allergy can be a runny nose, itching watery eyes, red and itching skin, swelling of the mouth, tongue, and throat, hives, pompholyx (very itchy vesicles containing clear fluid), or gastro-intestinal symptoms (pain, nausea, vomiting, diarrhea). If the pepper is inhaled, it can cause difficulty breathing, which is cause to call for emergency medical assistance.
Black pepper allergy can also be due to a cross-allergy in people who are already allergic to celery or pollen. I happen to suffer from hay fever from March to November. Cross-allergies occur when a person who has developed sensitivity to one allergen is exposed to a similar allergen from a different food. The allergen, in my case, black pepper, is capable of eliciting allergy symptoms even though the person has never been sensitized to that particular food. 33% of those with a celery or pollen allergy are also allergic to white pepper, 20% to black pepper.
Combination allergies occur in people who are mildly allergic to one food and not at all to another, but when the two foods are taken together, an allergic reaction occurs. With black pepper allergies, this is seen when black pepper is combined with pork. In one case I read, a young man was aware that eating pork chops with pepper seasoning caused a runny nose and sneezing. He assumed he was allergic to the pork, since he ate pepper at other times without a problem. It wasn't until he put his nose into a dish of pepper seasoning to inhale the aroma, that he discovered he had an allergy to black pepper.
It's important to see your doctor if you suspect you have a food allergy. The reaction may not be bad the first time, but each time you are exposed, your body reacts more strongly. Your doctor can test and find exactly what you are allergic to, and give you medications to have on hand in case of an accidental exposure. For example, your doctor may give you a prescription for an Epi-Pen, so that you or someone with you can give you a shot of adrenaline in case of a serious anaphylactic reaction. Anaphylaxis is the whole body reaction to an allergen, the airways start to close and blood pressure drops. Unless treated immediately, anaphylaxis can be fatal. Your doctor can also give you plenty of information on cross-reactions and related foods to avoid.
Allergies to black pepper are not very common, but the symptoms are no less incapacitating than other food allergies. Treat it as any other food allergy; by avoiding the food, visiting the doctor for a definite diagnosis, educating yourself about sources of the allergen, and by being armed with the appropriate medications in case of the inevitable accidental exposure.