What’s skin prick testing for allergies?

A skin prick test can look for common allergens such as house dust mites, certain tree and grass pollens, certain food allergies (the list is long, from particular nuts to fruits and white fish or seafood), milk and egg allergies, animal dander, latex, and bee or wasp venom.

It really helps if you can be specific about what you think you are allergic to, so tests can be tailored to you.

A blood test, known as a RAST IgE test, is used in some cases as an alternative to skin prick testing. But results are much slower - they can take up to 4 weeks to come back.

While skin prick testing is useful for certain allergens in the air or in food and usually causes a near-immediate reaction, another type of allergy testing called patch testing is used for substances that might cause specific skin reactions – either allergic contact dermatitis or eczema. This reaction on patch testing takes a couple of days to emerge, a so-called delayed hypersensitivity reaction, and tests for substances that come in direct contact with the skin.

Skin prick testing involves a meticulous process aimed at identifying allergic sensitivities. Initially, healthcare providers prepare allergen extracts containing measured amounts of suspected allergens like pollen or pet dander. The testing device, equipped with prongs for each allergen, is then employed. A drop of each allergen extract is placed on the patient's skin, and the device, featuring disposable lancets, is pressed through these drops, creating tiny punctures. Through capillary action, allergens enter the skin, triggering an immunological response in allergic individuals.

This manifests as raised bumps, or wheals, surrounded by redness. The site is observed for 15-20 minutes, and healthcare providers measure and interpret the size and characteristics. Quality control measures ensure accuracy. Results inform discussions with patients and guide the development of allergy management plans, potentially involving avoidance strategies, medications, or immunotherapy. Follow-up appointments allow ongoing assessment and adjustment of treatment plans based on the test's findings. Skin prick testing is a crucial diagnostic tool, facilitating personalized allergy management for individuals.

This is considered a safe test, as potential allergens are used at very low concentrations and in small amounts. The worst you can expect is an itchy bit of skin for a couple of hours.

If you’ve had any severe allergic reactions in the past, anaphylaxis, or you have severe asthma, it’s likely you will be given skin prick testing in a clinic with resuscitation facilities and monitored closely, just to be on the safe side.

The only other risk is that the results are difficult to interpret. There’s a medical adage that if you test for something, you should be ready for the answer. Tests don’t always confirm what you think – a substance you think is definitely causing a reaction may not get a positive result. And something you thought you were fine with may actually prove positive in testing. How do you interpret this? That’s for your specialist to discuss, but your own experience usually trumps allergy testing results.

There are clinics that offer skin prick testing – dermatologists or allergists are the medical specialists in this area. Other non-doctor clinics also offer skin prick testing and other types of allergy testing.

Your doctor may consider referring you to an allergy, dermatology, or respiratory clinic if you have symptoms that are not easily controlled with standard medications, or you have had a severe reaction, such as anaphylaxis or severe asthma.

It may be enough to know your triggers and avoid them, but if there is a serious risk, you may be encouraged to wear a Medic-Alert bracelet and to carry an EpiPen containing epinephrine for emergencies.