What to Expect From an Allergy Evaluation

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By Julie Kuriakose, M.D.

The number of Americans with allergies has grown in all racial, sex, and age groups since the 1980s. According to a survey from the CDC, in 2010 alone there were 11.1 million visits to physician offices with the primary diagnosis of allergic rhinitis, also commonly known as hay fever or seasonal allergies. Moreover there are approximately 50 million Americans that have asthma, hay fever or other allergy-related conditions.

Some allergic conditions are mild, whereas others can be life threatening. There are no cures for allergies, but they can be managed through regular treatments. Having an allergy evaluation performed by an allergist can help identify the specific triggers of your allergy symptoms, and avoidance of the specific allergen can augment healthy living.

What are allergists trained to evaluate and treat?

An allergist is a physician who specializes in the diagnosis and treatment of hay fever, food allergies, allergic asthma, allergic skin reactions, drug allergies, allergic sinusitis, recurrent infections and insect sting reactions.

So when should you see an allergist?

You should see an allergist if:

  • Your allergies are causing symptoms such as chronic sinus infections, nasal congestion or difficulty breathing.
  • You experience hay fever or other allergy symptoms several months out of the year.
  • You are consistently having reactions after eating specific foods.
  • Your skin is itchy and dry.
  • You have been diagnosed with a medication allergy, i.e., Penicillin.
  • Antihistamines and over-the-counter medications do not control your allergy symptoms or create unacceptable side effects, such as drowsiness.
  • You are experiencing warning signs of serious asthma such as:
  • You sometimes have to struggle to catch your breath.
  • You often wheeze or cough, especially at night or after exercise.
  • You are frequently short of breath or feel tightness in your chest.
  • You have previously been diagnosed with asthma, and you have frequent asthma attacks even though you are taking asthma medication.

At the very least, it may be beneficial to see an allergist if your symptoms start to affect your day-to-day activities and affect your quality of life.

What happens during an allergy visit?

An allergist will examine the patient’s lifestyle and recent activities to discover any pertinent allergy information, and a detailed history and physical exam will be taken. Education and counseling on prevention and allergen avoidance will also be discussed. While it may be impossible to completely avoid specific allergens, an allergist may be able to recommend specific tips to minimize your exposure.

If appropriate, specific allergy tests will be performed to determine allergen triggers or new and effective treatments and medications may be prescribed.

Allergy Skin Testing

Allergy skin prick testing may be the first step in designing the right treatment plan for you. These tests are highly sensitive and can quickly identify specific allergens that may be causing your symptoms. Testing can be performed on common allergens such as pollens, molds, dust mites, animal dander, insects, various foods and even medications such as Penicillin.

While the “skin prick test” sounds like a scary prospect, the test is relatively painless and no blood is drawn. It is the most common test used to identify IgE antibody mediated allergies. During the test, the allergist will place diluted amounts of suspected allergens on the skin. A series of small pricks or scratches allow the solution to enter the skin. In an allergic person, a raised bump or wheal will develop at the test location on the skin. A positive reaction will generally take around 15-20 minutes to develop.

If the skin prick test is inconclusive, an intradermal test may be performed. In this test a small amount of the allergen solution is injected with a very fine needle directly into the skin.

Allergy patch testing may be performed to identify if a lotion, cosmetic, 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 48 hours. At 48 hours the patches are removed and the skin is examined for any signs of rash or irritation at the patch site. A final skin exam may also take place at 72-96 hours.

How should you prepare for your allergy visit?

If you have decided that you’ve suffered long enough with your allergy symptoms and you make the choice to see an allergy specialist, here are few tips to prepare for your visit:

  • Keep a symptom diary.
  • If you have previous medical records, bring them to your visit.
  • Call ahead to find out if there are any special instructions for preparing for your visit.
  • If you are taking an antihistamine, it may interfere with allergy testing. It may be required for antihistamines to be held for 3-7 days prior to testing to yield accurate results.

Being aware of your allergies is the best defense against potential life-threatening reactions. If you suspect you have an allergy, make an appointment with an allergist and get tested.

Read more here:: Huffintonpost


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