Cochineal extract is a food additive, which may result in allergy symptoms in sensitised individuals.

It should not be confused with or mistaken for the dyes indigo carmine and cochineal red.

Cochineal Extract Allergy Test: Allergen Exposure

Cochineal extract is obtained from the dried female insect Dactylopius coccus Costa and from the insect’s eggs. This insect is principally found as a parasite living in wax-covered colonies on the prickly pear cactus, mostly in South America, especially Peru, as well as the Canary Islands.

It is an expensive colourant and is therefore not in common use: it requires 70,000 insects to make one pound of colour. The final product is a crumbly solid or a powder usually known as carmine.

Trade in cochineal extract declined with the introduction of cheaper synthetic dyes. However, due to findings that synthetic red dyes may induce cancer, there has been an increasing preference for foods with natural dyes during the last decade.

Cochineal provides a bright strawberry-red shade to various food products. It is used in products with a pH above 3.5 and comes in water-soluble and water-insoluble forms.

Carminic acid is water-soluble and provides clear orange colours in acid-based products, such as soft-drinks.

Cochineal may also be used in the dyeing, printing and paint industry and may be found in lipsticks, blushes, eyeshadow, medication coatings and homeopathic medications. This colourant is not permitted in some countries.

As the colourant is of animal origin, it is not acceptable for use in foods for vegetarians or vegans and may not be suitable for individuals keeping strict religious diets.

Cochineal Extract Allergy Test: Allergen Description

No allergens from this substance have yet been fully characterised, but a number have been detected or isolated.

Commercial carmine retains proteinaceous material from the source insects. These insect-derived proteins are responsible for IgE-mediated cochineal extract allergy.

Cochineal Extract Allergy Test: Potential Cross-Reactivity

No cross reactivity between cochineal extract and other allergens has been reported or suspected.

Cochineal Extract Allergy Test: Clinical Experience

In many of the reports of adverse reactions to cochineal, the cause of sensitisation was topical exposure from the use of carmine-containing cosmetics or occupational exposure to carmine, and not ingestion of carmine-containing foods and beverages.

Following sensitisation, affected individuals would be sensitive to carmine, and the amounts present in foods and beverages could elicit allergic reactions.

Some researchers state that reactions to carmine solely because of ingestion are likely to be exceedingly rare due to the low levels of carmine found in foods and beverages.

A number of instances of allergic reactions to cochineal, including anaphylaxis, have been reported.

Three female patients presented with a history of anaphylaxis and/or urticaria/angioedema after ingestion of carmine-containing foods (popsicle, artificial crab, red grapefruit juice).

Two patients experienced an immediate, pruritic, erythematous eruption after applying a blush, coloured with carmine, directly to facial skin, but not when the blush was used over foundation makeup.

Adverse effects from occupational exposure to Cochineal have also been described. Occupational asthma was described in 3 Carmine dye workers and occupational asthma and rhinitis in natural dye and food processors.

Other reactions

Extrinsic allergic alveolitis following exposure to Cochineal has been described.

A batch of contaminated cochineal colourant used in food was involved in an outbreak of salmonellosis.