Please read this form to familiarize yourself with our procedures in advance of your appointment.
Allergy Skin Testing Procedure
You are not required to fast for this testing, so please make sure to eat something and be well hydrated before your appointment.
Skin prick testing is not painful, but if you have a young child, you may wish to bring a favorite toy or book to help decrease any temporary anxiety.
Prick Technique: involves introducing a small amount of allergen (eg. cat dander or peanut) in liquid form (ie. extract) into the top layer of skin by making a small puncture with plastic device which looks similar to a toothpick. If you have an allergy, the antibodies (IgE) will cause a reaction similar to a mosquito bite within 15 minutes.
The vast majority of patients don’t have any other symptoms besides the slightly swollen, small hives where the test was done; this goes away within 30-60 minutes. However, there is a remote possibility that you may experience congestion, sneezing, coughing, or itchy eyes during or shortly after testing. If this occurs, you will be treated and monitored until your symptoms resolve
Intradermal Technique: involves injecting a small amount of allergen under the skin with a syringe similar to a TB test. This form of testing is more sensitive than the prick skin test method. This form of allergy testing may be used for a select few allergens if the prick skin tests are negative. Numbing patches are used in children in the event this type of testing is required.
Skin Test Interpretation
After you allergy skin test has “developed”, the physician will examine the testing area and determine which allergens you are sensitive to based on the amount of swelling and redness at the test site. Your physician will then discuss with you options for controlling your symptoms, such as environmental control, medications, and/or immunotherapy.
Medications to Hold Prior to Testing
In order for your allergy skin testing to be as accurate as possible, we ask that you please hold those medications most likely to interfere with testing prior to your appointment. The partial list below is representative, but not comprehensive. If you have concerns about temporarily discontinuing your medications or have questions about a particular drug, please call us for clarification.
Hold for 7 days:
Second-generation antihistamines: cetirizine (Zyrtec), desloratadine (Clarinex), fexofenadine (Allegra), levocetirizine (Xyzal), loratadine (Claritin, Alavert)
Other antihistamines: hydroxyzine (Atarax)
Hold for 3 days:
First generation antihistamines: brompheneramine (Dimetapp), chlorpheneramine (Chlor-Trimeton) , cyproheptadine (Periactin), diphenhydramine (Benadryl), promethazine (Phenergan), triplodidine (Actifed), most over-the-counter and prescription combination cough and cold medicines (Tylenol Cold & Sinus, NyQuil, etc… – check the label and call us if you are confused!)
If you take Beta blockers, Tricyclic antidepressants (TCAs) or MAO inhibitors; do not stop them. Keep your appointment, your doctor will discuss testing options with you.
Beta blockers may need to be held for 24 hours in some allergy testing situations.
Beta-blockers (please check with your primary care physician to ensure that it is safe for you to briefly hold this medication): Acebutolol (Sectral), Atenolol (Tenormin), Bisoprolol (Zebeta), Carvedilol (Coreg), Metoprolol (Lopressor, Toprol XL), Nadolol (Corgard), Nebivolol (Bystolic), Propranolol (Inderal LA)
Tricyclic antidepressants have a potent suppressive effect on allergy skin testing for up to 14 days after the last dose. Amitriptyline (Elavil), Amoxapine, Desipramine (Norpramin), Doxepin (Sinequan), Imipramine (Tofranil, Tofranil-PM) Nortriptyline (Pamelor) Protriptyline (Vivactil) Trimipramine (Surmontil)
Monoamine oxidase inhibitors should be held at least 5-7 days before skin testing, due to a potentially dangerous increase in blood pressure which may occur if you require epinephrine for an allergic reaction. Azilect, Eldepryl, Emsam, Marplan, Nardil Parnate Zelapar
However, due to the risk of discontinuation syndrome, you should NOT abruptly discontinue these medicines. If indicated, a plan for safely tapering these medications can be developed by the prescribing physician. If you are taking one of these medications, please inform our staff to facilitate the most appropriate allergy evaluation.
Not all allergy medications need to be held prior to testing.
You may continue your asthma inhalers or nebulizer treatments (controller and rescue), montelukast (Singulair), zileuton (Zyflo), theophylline, and oral or topical corticosteroids.