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During allergy skin tests, your skin is exposed to suspected allergy-causing substances (allergens) and is then observed for signs of an allergic reaction.
Along with your medical history, allergy tests may be able to confirm whether a particular substance you touch, breathe or eat is causing symptoms.
Why it’s done
Information from allergy tests may help your doctor develop an allergy treatment plan that includes allergen avoidance, medications or allergy shots (immunotherapy).
Allergy skin tests are widely used to help diagnose allergic conditions, including:
- Hay fever (allergic rhinitis)
- Allergic asthma
- Dermatitis (eczema)
- Food allergies
- Penicillin allergy
- Bee venom allergy
Skin tests are generally safe for adults and children of all ages, including infants. In certain circumstances, though, skin tests aren’t recommended. Your doctor may advise against skin testing if you:
- Have ever had a severe allergic reaction. You may be so sensitive to certain substances that even the tiny amounts used in skin tests could trigger a life-threatening reaction (anaphylaxis).
- Take medications that could interfere with test results. These include antihistamines, many antidepressants and some heartburn medications. Your doctor may determine that it’s better for you to continue taking these medications than to temporarily discontinue them in preparation for a skin test.
- Have certain skin conditions. If severe eczema or psoriasis affects large areas of skin on your arms and back — the usual testing sites — there may not be enough clear, uninvolved skin to do an effective test. Other skin conditions, such as dermatographism, can cause unreliable test results.
Blood tests (in vitro immunoglobulin E antibody tests) can be useful for those who shouldn’t or can’t undergo skin tests. Blood tests aren’t used for penicillin allergy.
In general, allergy skin tests are reliable for diagnosing allergies to airborne substances, such as pollen, pet dander and dust mites. Skin testing may help diagnose food allergies. But because food allergies can be complex, you may need additional tests or procedures.
Skin prick test
A skin prick test, also called a puncture or scratch test, checks for immediate allergic reactions to as many as 50 different substances at once. This test is usually done to identify allergies to pollen, mold, pet dander, dust mites and foods. In adults, the test is usually done on the forearm. Children may be tested on the upper back.
Allergy skin tests aren’t painful. This type of testing uses needles (lancets) that barely penetrate the skin’s surface. You won’t bleed or feel more than mild, momentary discomfort.
After cleaning the test site with alcohol, the nurse draws small marks on your skin and applies a drop of allergen extract next to each mark. He or she then uses a lancet to prick the extracts into the skin’s surface. A new lancet is used for each allergen.
To see if your skin is reacting normally, two additional substances are scratched into your skin’s surface:
- Histamine. In most people, this substance causes a skin response. If you don’t react to histamine, your allergy skin test may not reveal an allergy even if you have one.
- Glycerin or saline. In most people, these substances don’t cause any reaction. If you do react to glycerin or saline, you may have sensitive skin. Test results will need to be interpreted cautiously to avoid a false allergy diagnosis.
About 15 minutes after the skin pricks, the nurse observes your skin for signs of allergic reactions. If you are allergic to one of the substances tested, you’ll develop a raised, red, itchy bump (wheal) that may look like a mosquito bite. The nurse will then measure the bump’s size and record the results. Next, he or she will clean your skin with alcohol to remove the marks.
: Source – Mayo Clinic