Allergy testing

Diagnosing allergies involves a comprehensive history, physical exam, and allergy testing. This process is essential to understand any and all allergens contributing to symptoms.  

Understanding the full picture of your health history and full physical assessment is the first step.

Health history

An extensive survey documents your specific health concerns and exposures to common allergens. A complete list of medications is required to determine which, if any, may interfere with testings.

Physical exam

A comprehensive physical examination is essential to an accurate diagnosis and includes an assessment of the following:

• Eyes – Are they swollen, teary, or red?
• Nose – Are there swollen nasal mucous membranes or structural defects?
• Ears – Is there fluid in the middle ear or any damage to the eardrum?
• Sinuses – Is there any tenderness or indications of infection?
• Mouth – Are there any changes from breathing only through the mouth?
• Throat – Are there any indications of postnasal drip or infection?
• Chest and lungs – Are there any signs of infection or asthma?
• Skin – Are there any signs of allergy such as hives or eczema?

Testing options

Allergy testing involves a skin or blood test to determine what substance, or allergen, may trigger an allergic response.  These skin tests have been found to be both fast and reliable.

• Skin Prick Testing (SPT)
  This test involves placing several drops of a solution containing possible allergens on the skin, typically on the forearm. A series of small needle pricks enables those drops to penetrate the skin’s surface. If the skin reacts with a raised itchy area, that indicates a positive reaction and probable allergy.

• Intradermal Testing (IDT)
  This test involves injecting a small amount of the allergen solution into the skin, typically the upper arm. IDT, a more sensitive test than skin prick testing, is typically used when a substance does not cause a reaction in the skin prick test but is still suspected as an allergen.

• Modified Quantitative Testing
  A combination SPT and IDT with a controlled testing approach is referred to as modified quantitative testing. Careful positive and negative controls ensure maximum accuracy. Skin testing normally takes 1 to 1.5 hours. For patients whose medications may interfere with skin testing, or for those with existing severe skin conditions, blood testing is recommended.