Skin Testing for Allergies
Skin testing is the most reliable form of allergy testing. Because histamine-containing cells are located in high numbers just under the skin, results of skin testing have proven to be more accurate than blood testing in diagnosing allergies. Because we are looking for histamine in the skin, we ask you to stop all antihistamine-type medications for a few days prior to your visit. You will find a list of these medications here.
Skin testing is ideal for diagnosing allergies to airborne allergens that can lead to allergic rhinitis and asthma, and can be helpful in diagnosing food allergy. Skin testing is also commonly used to diagnose insect allergy and occasionally drug allergy (see below).
The allergen extracts used to diagnose respiratory allergens include dust mite, animal dander, molds, cockroach and pollen (trees, grasses, and weeds). The battery of food extracts we use include the common (milk, egg, wheat, soy, wheat, peanuts, tree nuts, fish, shellfish) and not-so-common causes of food-related allergic conditions. In the case of insects, we mostly use venom extracts.
Medications to Avoid Prior to Skin Testing
Medications that contain antihistamines interfere with skin testing results. Therefore, please refer to the list below. They are often used to treat cold and allergy symptoms.
In general, we ask that you try to avoid these medications for 5 days prior to your appointment. If you are very sick and can’t avoid these medications, you should keep your appointment anyway – we may be able to replace your medications with ones that don’t affect the skin testing results.
As a rule, asthma medications do not affect skin testing results (e.g. singular, inhalers) and should be continued. Also, single-ingredient decongestant preparations (e.g. Sudafed, phenylephrine, pseudoephedrine) can be taken. All Nasal sprays can be used except Azelastine, Astepro, Dymista, and Patanase If there are any questions about a certain medication, please speak to your pharmacist or our nursing staff.
PRESCRIPTION DRUGS WITH ANTIHISTAMINES
||EYE DROPS||NASAL SPRAYS|
OVER THE COUNTER ANTIHISTAMINES
- ALLEGRA (FEXOFENADINE)
- ZYRTEC (CETIRIZINE)
- CLARITIN (LORATADINE)
- BENADRYL (DIPHENHYDRAMINE)
- ALAVERT (LORATADINE)
- ACTIFED (TRIPROLIDINE)
- SUDAFED SINUS/ALLERGY
- TYLENOL PM
- TYLENOL COLD
The Skin Test Procedure
The surface of your skin is “scratched” with tiny amounts of a number of specific allergens. If the results are positive, a small reaction on the skin occurs, usually within 20 minutes. This reaction usually causes some itchiness and is very similar to a mosquito bite. This indicates that you are very allergic to that specific trigger. If no bump appears, we normally do a follow up test to that specific allergen with another small injection of extract. Depending on the results of your skin test, your allergist will determine the best way to treat your allergy symptoms.
Sublingual Immunotherapy: Allergy Shots Without the Needles?
Allergic conditions account for many sick, nonproductive days for millions of adults and children. While many adults are able to “deal” with their allergies, children in particular are very vulnerable to their symptoms. Often, their allergic conditions are misdiagnosed as colds or other respiratory tract infections. Because allergies usually present in childhood, it is important that the underlying condition is identified and appropriately treated. By getting the allergy under better control, you or your child can halt the progression of the allergy, lessen the risk of developing secondary complications such as asthma and sinusitis, and most importantly, feel better.
In recent years, sublingual immunotherapy/allergy drops (SLT) has gained popularity in the United States for the treatment of allergies. This treatment is widely utilized in Europe, and the World Health Organization has endorsed sublingual immunotherapy as a viable alternative to injection immunotherapy or allergy shots. Many of our patients, both adults and children, have noticed a significant improvement in their allergy symptoms with this treatment. There have been numerous medical studies on SLT and this treatment is now a “headliner” at the major allergy conferences.
What is sublingual immunotherapy or “allergy drops?”
Immunotherapy, as opposed to allergy medication, “treats” the underlying allergies and builds immunity, rather than just blocking the symptoms. In SLT, the vaccine is administered orally, under the tongue, rather than by injection. During the “build-up” phase, the doses are gradually increased but once “maintenance” dose is reached, you or your child will typically take the same dose for the duration of the treatment. The same allergy extract that is FDA approved for allergy shots is used in SLT. A major advantage of allergy drops is that it is administered in the convenience of your home, instead of at the doctor’s office.
How effective are allergy drops?
Allergy drops are very effective in relieving allergy and asthma symptoms, making them worth considering as an alternative to allergy injections for many patients, particularly children. As with allergy injections, numerous medical studies have proven that allergy drops can help prevent the onset of asthma in children with allergic rhinitis (hayfever). There have also been many studies showing that allergy drops have resulted in a significant reduction in the need for allergy and asthma medications.