Allergy skin tests are used to find out which substances cause a person to have an allergic reaction. These substances are called allergens.
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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:
Before any allergy testing, the provider will ask about:
Allergy medicines can change the results of skin tests. Your provider will tell you which medicines to avoid and when to stop taking them before the test.
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're allergic to the substance in the test.
In rare cases, people can have a whole-body allergic reaction (called anaphylaxis), which can be life threatening. This usually only occurs with intradermal testing. Your provider will be prepared to treat this serious response.
Patch tests may be irritating or itchy. These symptoms will go away when the patch tests are removed.
Allergy tests are done to find out which substances are causing your allergy symptoms.
Your provider may order allergy skin tests if you have:
Allergies to penicillin and 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 skin prick 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.
In rare cases, a person may have a negative allergy test and still be allergic to the substance.
A positive result means you reacted to a substance. Your provider will see a red, raised area called a wheal.
Often, a positive result means the symptoms you're having are due to exposure to that substance. A stronger response means you are likely 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. But, if the dose of allergen is large, even people who are not allergic will have a positive reaction.
Your 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.
Chiriac AM, Bousquet J, Demoly P. In vivo methods for the study and diagnosis of allergy. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 67.
Homburger HA, Hamilton RG. Allergic diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Philadelphia, PA: Elsevier; 2017:chap 55.
Reviewed By: Stuart I. Henochowicz, MD, FACP, Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.