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Skin testing is usually done at a doctor's office. A nurse generally administers the test and a doctor interprets the results. Typically this test takes about 20 to 40 minutes. Some tests detect immediate allergic reactions, which develop within minutes of exposure to an allergen. Other tests detect delayed allergic reactions, which develop over a period of several days.
Skin prick test
A skin prick test, also called a puncture or scratch test, checks for immediate allergic reactions to as many as 40 different substances at once. This test is usually done to identify allergies to pollen, mold, pet dander, dust mites and foods. In adults, the test is usually done on the forearm. Children may be tested on the upper back.
Allergy skin tests aren't painful. This type of testing uses needles (lancets) that barely penetrate the skin's surface. You won't bleed or feel more than mild, momentary discomfort.
After cleaning the test site with alcohol, the nurse draws small marks on your skin and applies a drop of allergen extract next to each mark. He or she then uses a lancet to prick the extracts into the skin's surface. A new lancet is used for each allergen.
To see if your skin is reacting normally, two additional substances are scratched into your skin's surface:
- Histamine. In most people, this substance causes a skin response. If you don't react to histamine, your allergy skin test may not reveal an allergy even if you have one.
- Glycerin or saline. In most people, these substances don't cause any reaction. If you do react to glycerin or saline, you may have sensitive skin. Test results will need to be interpreted cautiously to avoid a false allergy diagnosis.
About 15 minutes after the skin pricks, the nurse observes your skin for signs of allergic reactions. If you are allergic to one of the substances tested, you'll develop a raised, red, itchy bump (wheal) that may look like a mosquito bite. A nurse will then measure the bump's size.
After the nurse records the results, he or she will clean your skin with alcohol to remove the marks.
Skin injection test
You may need a test that uses a needle to inject a small amount of allergen extract just into the skin on your arm (intradermal test). The injection site is examined after about 15 minutes for signs of an allergic reaction. Your doctor may recommend this test to check for an allergy to insect venom or penicillin.
Patch test
This test doesn't use needles. Instead, an allergen is applied to a patch, which is then placed on your skin. This type of test can detect delayed allergic reactions. It's generally done to see whether a particular substance is causing allergic skin irritation (contact dermatitis). During a patch test, your skin may be exposed to 20 to 30 extracts of substances that can cause contact dermatitis. These can include latex, medications, fragrances, preservatives, hair dyes, metals and resins.
You wear the patches on your arm or back for 48 hours. During this time, you should avoid bathing and activities that cause heavy sweating. The patches are removed when you return to your doctor's office. Irritated skin at the patch site may indicate an allergy.
- Tips to remember: What is allergy testing? American Academy of Allergy, Asthma and Immunology. http://www.aaaai.org/patients/publicedmat/tips/whatisallergytesting.stm. Accessed Jan. 20, 2011.
- Allergy testing. American College of Allergy, Asthma & Immunology. http://www.acaai.org/public/background/testing.htm. Accessed Jan. 20, 2011.
- Nolte HN, et al. Overview of skin testing for allergic disease. http://www.uptodate.com/home/index.html. Accessed Jan. 20, 2011.
- Li JT (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 25, 2011.
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