WHAT TO EXPECT FROM SKIN TESTING

Skin testing is the most accurate, economical, and quickest way to tell whether or not you have IgE-mediated inhalant allergies. For more information on food allergy testing, please see the webpage on food allergies. The technique is based on allowing a very minute amount of an extract of pollen, mold, dander, dust, food, or drug to come in contact with cells that reside just below the surface of the skin. If you are allergic (that is a specific IgE-dependent hypersensitivity) to any of the extracts, redness, itching, and a small hive will develop within 15 - 20 minutes around the skin test site. This response is caused by histamine and other factors involved in allergies. The reaction usually lasts only a short while before fading away and leaving no trace.

In order to properly interpret the results, your skin tests must be applied under the proper circumstances using the correct technique. Only then can we determine what the results mean for you. In some cases a negative result does not mean that you will not have a reaction if exposed. In other cases, a positive skin test does not mean that a noticeable allergic reaction will definitely occur. Proper technique and our interpretation of skin tests are what make us so successful at managing allergic conditions.

For older children and adults: Skin testing usually requires two visits. The first is for scratch/prick testing, and the second is for intradermal testing. Scratch/prick testing is done on the back (or forearm if only a few tests are being performed). The technique merely involves touching the skin and pulling it ever so slightly so that a small channel is made for the extract to come in contact with immune cells located just beneath the outer layer of skin. If necessary, after the scratch/prick tests are done, intradermal testing is done on the upper arm at a second visit. This involves placing a drop of extract just below the outer layer of skin. Intradermal tests allow testing to a larger dose than the scratch technique. Only those extracts that did not cause a reaction during scratch/prick testing are applied intradermally. Each session (one for the scratch/prick and one for the intradermal) should require no more than 45 minutes from the time the extracts are applied to the time they are interpreted and recorded in your chart. If you have any further reaction after you leave, call the office immediately!

For small children and toddlers, I use a special device called a Multi-Test that allows testing 8 foods, pollens, molds, etc. at a time. The device is not threatening to the child and he/she can move about almost immediately after the tests are applied. There is an additional charge to cover the expense of using each Multi-Test.

Because skin tests rely on histamine release from the cells in your skin, anti-histamines must be avoided so that they do not hide the skin test reactions. In addition to medications used for allergies, certain ulcer medications and antidepressants have anti-histamine activity. Please see the list on the back of this handout to find out what medications to avoid. NOT ALL medications need or should be stopped for skin testing. If you are not sure, call us in advance.

AVOID these medications for 3 full days (read the label for the ingredients!)

• A.R.M.
• Actidil syrup & tablets
• Actifed (all)
• Ah Chew chewables
• Alavert
• Alka Seltzer Plus Cold
• Allent
• Allegra and Allegra-D
• Allerest
• amitriptyline (7 days)
• Antivert
• Atarax (10 days)
• Atrohist
• Axid
• Azatidine
• Benadryl (all)
• Bonine
• Bromfed
• brompheniramine
• Bufferin A.F. Nite Time
• Cheracol
• chlorpheniramine
• Chlor-trimeton
• Cimetidine
• Clarinex (7 days)
• Claritin and Claritin-D (7 days)
• Comhist LA
• Comtrex Multi-Symptom
• Contac
• Coricidin
• cyproheptadine
• Deconamine-SR
• Demazin
• desipramine (10 days)
• dexbrompheniramine
• Dimetane
• Dimetapp
• Diphenhydramine
• Extra Strength Doan's PM
• Dorcol
• Doxepin (10 days)
• Dramamine
• Dristan
• Drixoral
• Dura-Tap PD
• Duravent\A or \DA
• Elavil (10 days)
• Endep (10 days)
• Etrafon (10 days)
• Excedrin P.M.
• Extendryl
• 4-Way
• Fedahist
• Hismanal (4-6 weeks)
• Hycomine Compound hydroxyzine (10 days)
• imipramine
• Isoclor
• Kronofed-A
• Limbitrol (10 days)
• Marax
• meclizine
• Miles Nervine
• Naldecon
• Nolahist
• Nolamine
• Norpramine (10 days)
• nortriptyline (10 days)
• Novahistine
• Nytol
• Omni-hist LA
• Optimine
• Ornade
• PBZ
• PediaCare
• Pepcid
• Periactin
• Phenergan
• Polaramine
• Polyhistine products
• protriptyline (10 days)
• Rhinolar
• Robitussin Night Relief
• Rondec
• RuTuss or R-Tannate
• Ryna
• Rynatan or Tri-tannate
• RynaTuss
• Seldane & Seldane-D
• Semprex-D
• Sinarest
• Sine-Off
• Sinequan (10 days)
• Sinulin
• Sinutab
• Sleep-Eze
• Sleepinal
• Sominex
• Sudafed Plus
• Tacaryl
• Tagamet
• Tavist ands Tavist-D
• Teldrin
• Temaril
• terfenadine
• Tofranil (10 days)
• trepelennamine
• Triaminic
• Triavil (10 days)
• Trinalin
• tripolidine
• Tussafed
• Tussionex
• Tylenol Cold or P.M.
• Extra Strength Tylenol PM
• Ultra-Brom PD
• Unisom
• Vicks NyQuil
• Vicks Formula 44 Cough
• Vistaril (10 days)
• Vitamin C (>500mg)
• Vivactil (10 days)
• Zantac
• Zyrtec (10 days)

 THE FOLLOWING MEDICATIONS CAN BE TAKEN

¨Bronchodilators (inhaled and oral): Accolade, Advair, albuterol, Alupent, atropine, Atrovent, Brethine, Brethaire, Bricanyl, Maxair, Metaprel, metaproterenol, Proventil, Serevent, Singulair, Tornalate, Ventolin

¨Theophylline: Choledyl, SloBid, Theo-24, Theodur, Theolair, theophylline, Theox, Unidur, Uniphyl

¨Inhalers: Advair, Aerobid, Azmacort, Beclovent, Dexacort, Flovent, Intal, Pulmocort, Tilade, Vanceril

¨Any nasal spray: Afrin, Beconase, Flonase, Nasacort, Nasalcrom, Nasonex, Nasarel, Rhinocort, Vancenase, saline, Sinus Rinse

¨Decongestants: Duravent, Entex LA and PSE, Guaifed, Sudafed, Nolex, D-Feda II, Deconsal II, Duratuss-G, Pima, Sinuvent, SSKI, Zephrex

¨Any Antibiotic: Amoxil, Augmentin, Avelox, Biaxin, Ceclor, Cedax, Ceftin, Cefzil, Cipro, doxycyline (Doryx), Duricef, Dynabac, Ery-C, E-Mycin, Erthromycin, Floxin, Levaquin, Lorabid, Minocin, Suprax, Bactrim or Septra, Minocin, Vantin, Vibratabs, Zithromax (Z-Pak)

¨Misc: Accutane, Fenesin, Humibid-LA, Humibid-DM, guaifenensin, Iotuss-DM, Organidin, NAC, Tussi-Organidin, Phrenilin, Esgic-Plus, Tylenol (plain or extra-strength), ibuprofen (advil, Motrin, Nuprin), prednisone, Prelone, Acular, birth control pills, Premarin, Provera, Prempro, Prometrium, DHEA, and other female hormones, all thyroid products, most vitamins, Prilosec, Viagra