Allergy Consultation and Testing Procedures
Allergy skin testing identifies specific airborne and food allergy triggers. Patients are taught how to properly use medication to prevent or treat allergic diseases, monitor the efficacy of their treatment regimen, and are instructed in appropriate environmental control measures for indoor and outdoor allergens.
Specific allergen vaccine immunotherapy (allergy shot) may be recommended for those patients suffering from seasonal or perennial allergy, and asthma symptoms caused by allergens that they cannot avoid or that are not completely controlled by medication. Allergy vaccine therapy modifies the body's immune responses to offending inhaled allergens, resulting in decreased allergic inflammation. The decreasing allergic inflammation ultimately leads to less nasal, sinus, and bronchial congestion, less secondary infections, less need for medication, and an improved quality of life in the home, at school, at work, and out of doors.
Because of the nature of allergy consultation and testing, there is a great deal of information that is covered during the initial visit. You should make arrangements to be in our office for approximately one hour. Please do not bring other young children, but if you must, bring another adult to provide proper supervision so that you may give your full attention to the doctor and the information given. If for any reason you are unable to keep your appointment please contact our office as soon as possible, at least 48 hours in advance, so that appointment time may be given to another patient. Please do not plan on making or receiving cell phone calls during your appointment.
Medications Prior to Skin Testing
Please do not take any antihistamines prior to allergy skin testing. These include any medications you may be taking for allergic nasal, eye, or skin symptoms. Certain anti-depressant, tranquilizer, and stomach medications can also interfere with skin testing. Please report ALL medications you or your child are taking prior to skin testing. Benadryl, diphenhydramine, hydroxyzine, Atarax, Chlortrimeton, Dimetapp, Tavist, and other similar antihistamines must be stopped two (2) days before skin testing. Other antihistamines such as Clarinex, Xyzal, levocetirizine, Allegra, fexofenadine, Zyrtec, cetirizine, Claritin, loratadine, DAllergy, Astelin, azelastine, and Astepro must be stopped four (4) days prior to testing. ASTHMA MEDICATIONS SHOULD NOT BE DISCONTINUED. Please review these medications with us as well.
No Beta-Blocker medications are permitted for 24 hours prior to skin testing. These medications are commonly used for heart disease, glaucoma, hypertension, arrhythmia, and migraine headaches. If you are on a Beta-Blocker, please take the last dose 24 hours prior to your appointment. On the day of the testing, bring your Beta-Blocker medication with you so that you may take that day's dose immediately after the testing. Make sure our office knows you are on a Beta-Blocker when scheduling.
The initial allergy consultation will include a detailed history, physical examination, and if scheduled, airborne and/or food allergy skin testing. Very young children may receive a lesser number of tests. Skin testing is performed by gently pricking the surface of the skin on the back with a Derma-Pick. The Derma-Pick is a small plastic rod with tiny tines that contain a droplet of allergen that is brought into contact with allergically reactive cells called mast cells in the superficial layer of the skin. If one is allergic to that allergen, the mast cells release histamine which causes an itchy hive to form at the pricked site. The test is read 20 minutes after the application and indicates those allergens to which one is allergic and to what degree. Derma-Pick is the most technologically advanced method of testing and is very minimally and briefly discomforting. Small children are tested in the parents lap. Once the tests are applied (usually in less than 1-2 minutes), children usually relax and are free to move around and play with toys provided. Intradermal testing, similar to a TB test, may be required to check for those important allergens that did not show up on Derma-Pick testing. These tests are read 10 minutes after application. The discomfort level with intradermal testing is usually less than or equal to Derma-Pick testing. Skin testing is the most accurate and appropriate method that is commonly used to determine specific allergic sensitivities to pollen, dust/dust mite, mold, animal, food, drug, and stinging insect allergens.
If there are local reactions from the skin testing, they usually fade away within minutes to few hours. If stronger reactions occur, an antihistamine may be given after the testing to relieve the itching.
Computerized pulmonary function testing will be performed on all school-age children and adults with known or suspected asthma.