What to Expect From an Allergy Evaluation?

There are approximately 50 million Americans that have asthma, hay fever or other allergy-related conditions. Allergic conditions can range from mild to life threatening reactions. Having an allergy evaluation performed by a board certified allergist is the first step to help prevent allergy symptoms and improve your quality of life. Allergy tests can help identify the specific triggers of your allergy symptoms. Avoidance of the specific allergen can help you lead a happy and healthy life.

What are allergists trained to evaluate and treat?

It is important to see a “board certified” allergist. Allergist/immunologists who are listed as ABAI-certified or board-certified have passed the certifying examination of the American Board of Allergy and Immunology (ABAI). An allergist/immunologist, often referred to as an allergist, is a physician specially trained to manage and treat allergies, asthma and immune system disorders. These include hay fever, food allergies, allergic asthma, allergic skin reactions, drug allergies, allergic sinusitis, recurrent infections, insect sting reactions, immunodeficiency and more.

When should you see an allergist?

An allergist should be seen in the following scenarios:

• Allergies are responsible for symptoms such as chronic sinus infections, nasal congestion, snoring or mouth breathing.
• Concern of hay fever or other similar allergy symptoms several months out of the year.
• Reproducible, adverse reactions after eating certain foods.
• Dry and itchy skin (with or without hives).
• Concern or established diagnosis of drug allergy e.g. penicillin.
• Over-the-counter medications or prescription medications from your regular doctor do not control your allergy symptoms.
• Use of over the counter medications for your allergies are causing adverse reactions e.g. drowsiness and fatigue.
• Previous established diagnosis of asthma or serious asthma symptoms like wheezing, coughing, shortness of breath, tightness of chest (especially at night).
• Frequent asthma attacks in spite of being on asthma medication(s).
• Adverse reaction with insect stings.

Most importantly, consult an allergist if your allergy and asthma symptoms prevent you from doing day-to-day activities and impair your quality of life.

What happens during an allergy visit?

Your initial visit could last up to 1-2 hours. Please schedule enough time for the allergist to provide best, complete and personalized care. This visit will include detailed medical history, physical exam, skin prick testing, and breathing test (if needed). The physician will review these findings with you and plan a personalized course of action. The allergy evaluation also includes interview of person’s lifestyle and recent activities to discover any pertinent allergy information. Counseling on allergen avoidance will also be discussed. Sometimes it is impossible to completely avoid specific allergens. An allergist will do the best to recommend tips and give handouts to minimize your exposure. Effective treatment plan with or without medications will be discussed.

What are allergy tests? 

Allergy skin prick testing might be the first step in identifying the correct treatment plan. These are the most reliable and cost-effective test for allergies. Results of skin testing have proven to be more accurate than blood testing in diagnosing allergies. This is a safe, minimally invasive, easily interpreted, simple in-office procedure. These tests could be performed in children as young as 6 months to 1 year of age. Testing can be performed on common allergens such as pollens, molds, dust mites, animal dander, insects, various foods and even medications such as penicillin. Allergy tests are NOT painful and no blood is drawn. Allergy solutions (of a specific allergen or allergens), selected by the allergist, is introduced through an indention or “prick” on the surface of the skin. If you are allergic you will have a small local reaction. This reaction occurs because skin releases histamine forming a bump and redness. After approximately 15- 20 minutes, the reaction will be measured and recorded by the nurse. The physician will then come and review the results with you. The skin tests help physician to recommend a personalized treatment plan for you.

Occasionally physician may recommend a second phase of testing, using a higher concentration of allergen placed under the skin (intradermally). In this test a small amount of the allergen solution is injected with a very fine needle directly under the skin. Allergy patch testing is usually performed specifically for contact allergic dermatitis to identify if a lotion, cosmetic products, metal (e.g., jewelry), hair dye, medication, or preservative is causing a delayed allergic reaction. With this testing, patches containing specific allergens are placed on the patient's back for 72 hours. At 72 hours, the patches are removed and the skin is examined for any signs of rash or irritation at the patch site.

How should you prepare for your allergy visit?

Here are few tips to prepare for your visit:

• Keep a symptom diary.
• If you have previous medical records, bring them to your visit.
• An antihistamine may interfere with allergy testing. You will be asked to hold the antihistamines for 3-7 days prior to certain tests to yield reliable results.