Board-certified allergists are specialists who are highly trained to understand the ins and outs of allergy testing and to oversee what happens during and after test sample analysis. These skills are important because there are many variables that affect allergy test results. If these nuances are missed or wrongly interpreted by physicians who do not specialize in allergies and asthma, you may not get the best treatment to relieve your symptoms.
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Skin tests for allergic disorders have been used successfully for more than 100 years. Today, prick or puncture tests are commonly used by allergists as diagnostic aids. These tests are not very invasive and, for most allergens, they tend to produce quick results. If the results of prick or puncture tests are negative, they may be followed by intradermal tests, which give allergists more details about what’s causing the underlying symptoms.
Here is how both types of tests are given:
- Prick/puncture: A diluted allergen is applied using a small, disposable plastic device to prick the surface of your skin.
- Intradermal: Using a small and very thin needle, a diluted allergen is injected just below the skin surface.
After either type of test, the area of the skin is observed for about 15 minutes to see if a reaction develops. The “wheal”—a raised, red, itchy bump and surrounding “flare”—indicates the presence of the allergy antibody. The larger the wheal and flare, the greater the sensitivity.
Although skin testing may seem simple, it must be carried out by trained practitioners with an understanding of the variables and risks of the testing procedure.
Steps should include:
- After reviewing the patient’s medical history and performing a physical exam, the allergist determines that allergy skin testing is both appropriate and safe to perform on you that day.
- A trained staff member performs the skin testing under the supervision of the allergist.
- The skin test is read and graded for the level of response.
These factors include:
- Proper evaluation and selection of which patient may benefit from skin testing
- Condition and reactivity of the skin
- Proper selection of where the skin tests are placed
- Type of skin test placed
- Device used for skin testing
- Proper technique in applying the tests
- Quality and selection of the allergen extracts used
- Medications that could alter the validity of the results
Potential risks of non-specialist care include:
- Misinterpretation of test results
- Overprescription of medications and treatments
- Costly and unnecessary allergen avoidance