Allergy testing - skin
Allergy skin tests are tests used to find out which substances cause a person to have an allergic reaction.
Patch tests - allergy; Scratch tests - allergy; Skin tests - allergy; RAST test
How the Test is Performed
There are three common methods of allergy skin testing.
The skin prick test involves:
The intradermal skin test involves:
Patch testing is a method to diagnose the cause of skin reactions that occur after the substance touches the skin.
How to Prepare for the Test
Before any allergy testing, the health care provider will ask questions about:
Allergy medicines can change the results of skin tests. Your doctor will tell you which medicines to avoid and when to stop taking them before the test.
How the Test Will Feel
Skin tests may cause very mild discomfort when the skin is pricked.
You may have symptoms such as itching, a stuffy nose, red watery eyes, or a skin rash if you allergic to the substance in the test.
Rarely, people can have a whole-body allergic reaction (called anaphylaxis), which can be life threatening. This usually only occurs with intradermal testing. Your health care provider will be prepared to treat this serious response.
Why the Test is Performed
Allergy tests are done to determine what substances are causing your allergy symptoms.
Your doctor may order allergy skin tests if you have:
*NOTE: Allergies to penicillin and closely related medicines are the only drug allergies that can be tested using skin tests. Skin tests for allergies to other drugs can be dangerous.
The prick skin test may also be used to diagnose food allergies. Intradermal tests are not used to test for food allergies because of high false-positive results and the danger of causing a severe allergic reaction.
A negative test result means there were no skin changes in response to the allergen. This negative reaction most often means that you are not allergic to the substance.
Rarely, a person may have a negative allergy test and still be allergic to the substance.
What Abnormal Results Mean
A positive result means you reacted to a substance. Your health care provider will see a red, raised area called a wheal.
Often, a positive result means the symptoms you are having are due to exposure to that substance. In general, a stronger response means you are more sensitive to the substance.
People can have a positive response to a substance with allergy skin testing, but not have any problems with that substance in everyday life.
Skin tests are usually accurate. However, if the dose of allergen is large, even people who are not allergic will have a positive reaction.
Your health care provider will consider your symptoms and the results of your skin test to suggest lifestyle changes you can make to avoid substances that may be causing your symptoms.
Bernstein IL, Li JT, Bernstein DI, Hamilton R, et al. American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008 Mar;100(3 Suppl 3):S1-148.
Demoly P, Bousquet J, Romano A. In vivo methods for the study of allergy. In: Adkinson NF Jr, ed. Middleton’s Allergy: Principles and Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 71.
Gober MD, DeCapite TJ, Gaspari AA. Contact dermatitis. In: Adkinson NF Jr, ed. Middleton’s Allergy: Principles and Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 63.
Review Date: 6/17/2012
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc., and Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School.
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