Which Allergy Skin Test is Best?

In today’s world, there are endless options for the same or similar services – even when it comes to healthcare. We understand that it can be difficult to decide which allergy skin test option is best for you, or to know who or what to trust when it comes to diagnosing your allergies.

Dr. Mary Morris, author of The La Crosse Method™ Protocol and Allergychoices’ Medical Advisor, provides a little insight on the different allergy skin tests. She always suggests being tested by a licensed allergy provider, and stresses that exam and history are equally as important as the actual allergy test.

Critical Role of History and Exam

Before any allergy skin test, providers should conduct a thorough history and exam to determine which allergens should be tested. Testing should not be a one-size-fits-all panel for every patient. In Dr. Morris’ practice, she says, “We spend a lot of time narrowing down how many tests to do, based on patient medical history.”

Questions in the medical history may include, among many others:

  • What time of year do you feel the most sick?
  • When was your last sinus, ear, or respiratory infection?
  • Where do you work, and what could you be exposed to at work?

Analyzing many questions like this can help narrow down what may be causing your symptoms and can give providers a roadmap for which allergens to test. Dr. Morris recommends testing allergens based on these identified needs, rather than using the same, standard panel for every single patient.


Titrated Intradermal Testing

How it’s conducted: Providers inject individual antigens into the top layer of the skin
Best for: Environmental allergies
Weakness: Can take up to one hour for patients and can be difficult to do on children

Some allergists, and many Ear Nose and Throat (ENT) providers typically use Titrated Intradermal Testing, and this method is often known as the “gold standard” for skin testing for environmental allergens. It looks like an injection, but it’s placed in only the top layer of the skin, so it feels like a bug bite. After all tests are placed, patients wait about 15 minutes, and then reactions are measured to determine allergic sensitivity. The larger the reaction, the higher the sensitivity.

This testing method also allows patients to monitor delayed reactions – reactions that happen hours or days after being exposed. Delayed reactions are common with molds, and can be missed with other testing methods.


Skin Prick Testing (SPT)

How it’s conducted: Providers place devices that have many prongs into the skin
Best for: Environmental allergies and identifying potential food allergies
Weakness: Can have false positives for food allergies and doesn’t account for delayed reactions

Traditionally, many allergists use Skin Prick Testing (SPT). It’s a quick, mostly pain-free way to determine environmental allergies, as well as to screen for food allergies. Like intradermal testing, there is a waiting period after testing (usually 20 minutes), and reactions are then measured. What makes SPT unique? It can also be used to rule out food allergies. “If a SPT is completely negative, it would be rare for the person to be truly allergic,” Dr. Morris says, “However, most studies say that SPTs for foods are falsely positive about half the time.”

When SPTs are used for food allergy, she recommends that they are done for screening purposes to determine when a blood test is needed. This previous blog dives deep into blood testing for allergies, so we invite you to read that for more information.


The Benefit of Allergy Skin Testing

An allergy skin test can tell you what you’re allergic to, but more importantly, those results can be used to guide a treatment path to make you feel better for the long-run. Immunotherapy is the only disease-modifying allergy treatment, and allergy drop immunotherapy can be used safely to treat both food and environmental allergies identified through various allergy tests.

Treat the cause

Interested in learning how personalized allergy drop immunotherapy can be used to treat the cause of your allergies? Find a provider near you who has received training and currently reports following the La Crosse Method Protocol for allergy drop immunotherapy.