Treatment and prevention for chocolate allergies focus on the ingredient to which the person is sensitive. For allergies to cocoa, this will mean the complete avoidance of chocolate products. However, people allergic to other chocolate ingredients may be able to safely enjoy some chocolate products. For instance, a person with a milk allergy may avoid milk chocolate and yet still eat premium dark chocolate.

Carob, a cocoa substitute derived from the seeds of the carob tree, is thought to be nonallergenic and may be tolerated by those allergic to chocolate. This alternative should be discussed with a physician before being added to the diet.

Avoiding only certain ingredients in chocolate will involve careful inspection of food labels and possibly the purchasing of only pure, premium chocolates. People with allergies to soy, nuts and other common chocolate ingredients should avoid all mass produced chocolates, which commonly use these ingredients.

People with chocolate or other food allergies need to pay close attention to the ingredients of the foods they consume and even how the food is prepared. Food allergies can be triggered by even the tiniest quantities of a problem food.

For instance, people with nut allergies may experience a reaction from eating chocolate that was produced in a factory that also processes nuts – even if the chocolate product itself does not list nuts as an ingredient. This is because trace amounts of the nuts can be transferred to the chocolate during processing. Manufacturers must list on their packaging whether a chocolate product is processed in a factory that also processes nuts, as required by the U.S. Food and Drug Administration (FDA). People with questions about a specific product are encouraged to contact the manufacturer.

Complete avoidance of foods or ingredients is not always possible. Therefore a number of medications may be used to relieve the symptoms associated with chocolate allergies. These may include:  

• Antihistamines. Medications that provide relief for more basic allergy reactions such as hives, sneezing, runny nose and gastrointestinal symptoms. Antihistamines directly counteract the effects of histamines, which are chemicals responsible for many food allergy symptoms. With mild symptoms, these drugs are usually administered orally. For more severe allergic reactions, a physician may recommend an injected form of antihistamine.
  
  

  

• Topical creams. Some creams may be prescribed for people that develop hives or contact dermatitis from allergies to chocolate or chocolate ingredients.
  
  
• Bronchodilators. Medications that open the airways of the lungs, relieving symptoms such as shortness of breath or wheezing. They may be recommended for people whose food allergies trigger asthma attacks or asthma-like symptoms. They are usually breathed directly into the lungs using an inhaler.
  
  
• Epinephrine injection. A synthetic form of adrenaline that, when injected, is a powerful bronchodilator, opening breathing tubes and restoring normal respiration quickly. It is usually reserved for the most severe allergic reactions that involve anaphylaxis. Most physicians recommend that patients susceptible to severe food reactions carry an injection of epinephrine with them at all times and understand how to self–administer the drug. A medical alert bracelet or necklace is also a good idea for these individuals.
  
  
• Corticosteroids. Medications that reduce inflammation. These drugs are often taken regularly to prevent an allergic attack or reduce the severity of symptoms.

A number of non-allergy related symptoms may occur in some people after eating chocolate. For these people, other medications may be useful in relieving symptoms. These may include:

• Antacids. Medications that lower the amount of acid in the refluxed material. Some people with gastroesophageal reflux disease (GERD) should avoid chocolate. Chocolate or chocolate ingredients may weaken the lower esophageal sphincter. Other foods that should be avoided with this condition include caffeine, fats, peppermint and citrus juice. GERD is not an allergic condition.
  
  
• Antidiarrheals. Some of the additives in chocolate may cause gastrointestinal symptoms in sensitive people. Antidiarrheal medications may help relieve these symptoms.