What is Skin Prick Testing?

Skin Prick Testing (also known as scratch or puncture testing) involves introducing a small amount of a potential allergen into the skin using a small plastic device. The plastic device is coated with a drop of the specific food or environmental allergen, and is applied to the surface of the skin, usually on the back or forearm. The skin is lightly pricked to allow the allergen to penetrate the outer layer.

If you’re allergic to a particular substance, your skin will react with a small, raised bump (hive) within 15-20 minutes. This response is the result of the body releasing histamine, which causes inflammation and swelling.

Skin prick testing can help identify allergens such as:

• Food allergens (peanuts, milk, eggs, shellfish)
• Pollen (trees, grasses, weeds)
• Dust mites
• Mold
• Pet dander
• Insect stings (bees, wasps)‍

How Does Skin Prick Testing Work?

Skin Prick Testing is a relatively quick and effective procedure. Here’s how it works for your child:

1. Preparation:
   • Your child will have to stop antihistamines 5-7 days prior to the test. If your child cannot tolerate stopping antihistamines, you can still come to the appointment and discuss other methods of allergy testing such as a blood test or oral food challenge.
2. Consultation:
   • During the initial consultation, your allergist will review your child’s medical history and allergy symptoms. This step ensures the test is tailored to your child's specific needs and helps determine which allergens to test for.
3. Allergen Application:
   • A small plastic device is used to place a drop of each allergen on the surface of the skin, usually on the forearm or back. 
4. Reaction Monitoring:
   • The test takes about 15-20 minutes. During this time, the skin will be monitored for any reactions. If your child is allergic to a substance, a small raised bump (hive) will form at the test site.
5. Interpretation of Results:
   • After the test, your allergist will interpret the results based on the size of the raised bumps. A positive reaction (a hive) may indicate an allergy to that substance, while no reaction suggests no allergy.
6. Personalized Treatment Plan:
   • Based on the results, your allergist will create a customized allergy management plan. This could include strategies to avoid allergens, optimize medications, or other treatments like immunotherapy (OIT, SLIT, or allergy shots).

Who Should Consider Skin Prick Testing?

Skin Prick Testing is recommended for children and adults with the following symptoms or conditions:

• Suspected food allergy after an allergic reaction.
• Infants or children who have reacted to one food can often safely introduce other related foods into the diet to reduce the risk of developing an allergy to them. 
• Persistent or severe allergy symptoms like sneezing, itching, or wheezing.
• Asthma, chronic cough, or wheezing can be triggered by environmental allergies.
• Uncertainty about which allergens are causing the symptoms.

Key Benefits of Skin Prick Testing

Skin Prick Testing offers numerous benefits for diagnosing food and environmental allergies in children:

• Quick and Non-Invasive:
  The test is simple, takes only 15-20 minutes, and does not involve needles or injections, making it ideal for children.
• Performed in the Allergist’s office:
  Results will be available immediately after the test so you can discuss them with the doctor and get a personalized treatment plan before leaving the office.
• Useful Results:
  It provides useful results and can help identify a wide range of allergens, from food to environmental triggers like pollen and pet dander so that you can immediately learn avoidance strategies.
• Comprehensive Allergy Profiling:
  Skin Prick Testing can help determine multiple allergies at once, giving you a better understanding of your child’s allergy profile.

The Risks of Skin Prick Testing

Though Skin Prick Testing is safe, there are some potential risks:

1. Localized Reactions:
   Some children may experience mild redness, swelling, or itching at the test sites. These reactions are temporary and typically subside within an hour.
2. Severe Reactions (Rare):
   In rare cases, a child may experience a severe allergic reaction, such as anaphylaxis. This is why the test is always performed under medical supervision.
3. Skin Sensitivity:
   Children with eczema or other skin conditions may experience a flare of their eczema at the test sites, but this can be managed by your allergist.

Is Skin Prick Testing Right for Your Child?

Skin Prick Testing is suitable for most children, but there are a few exceptions. For example, children with severe eczema or those currently taking certain medications (like antihistamines or steroids) may not be ideal candidates for this test. Your allergist will evaluate your child’s health history to determine if Skin Prick Testing is the right choice.

If you’re unsure about the allergens causing your child’s symptoms or if previous tests have been inconclusive, Skin Prick Testing can provide the answers you need.

Important Instructions for Skin Prick Testing

Please STOP all oral allergy medications 5-7 days prior to the appointment because antihistamine medications interfere with skin tests. If your child has significant allergy symptoms that require treatment with an antihistamine, it is okay to give the medication - you can still keep the appointment and discuss with Dr. Laubach alternative strategies for testing. Antihistamines include the following medications: 

• cetirizine/Zyrtec
• loratadine/Claritin
• diphenhydramine/Benadryl
• fexofenadine/Allegra
• levocetirizine/Xyzal
• hydroxyzine/Atarax
• Many over-the-counter medications that cause drowsiness contain antihistamines

CONTINUE (or start) giving nose sprays and asthma medications to help manage allergy symptoms.

Conclusion

Skin Prick Testing is an essential tool for diagnosing food allergies and environmental sensitivities in children. It is a safe, quick, and accurate method for identifying allergens, which allows you to create a targeted treatment plan and manage your child’s allergies effectively.

If your child is struggling with unexplained allergic symptoms or if blood tests haven’t been conclusive, Skin Prick Testing could offer clarity. Contact Empower Allergy Treatment today to schedule a consultation and take the first step toward helping your child live a more comfortable life.