Allergy Skin Testing

At UPMC Children’s Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this test and invite you to participate. Please read the following information to learn about the test and how you can help.

Fast Facts About  Allergy Skin Testing

• Allergy skin testing is used to tell if your child is allergic to a wide variety of different allergens (AL-er-jenz). An allergen is anything that causes an allergy.
• The test is done by using a tiny sterilized amount of each allergen on a sterile, plastic pin called a lancet.
• The lancet is used to make a series of light pricks on your child’s forearm.
• The lancet will barely break the skin and usually does not hurt or bleed.
• Your child may resume a normal diet and activities afterwards, although he or she may experience some itchiness for a few hours.
• If your child is allergic to any of the common allergens, an itchy red bump or “wheal” will appear on the skin.
• Allergy skin testing takes about 2 to 3 minutes to apply the allergens, and the results are read 15 to 20 minutes later.

Home Preparation

Before scheduling a skin test, your doctor will ask for a list of all your child’s prescription and over-the-counter medications. Some medications can hide allergic reactions so that the skin testing can’t be performed. Other medications may increase the risk of developing a severe allergic reaction during a test.

Because medications clear out of your child’s system at different rates, your doctor may ask that your child stop taking certain medications a few days before skin testing. Medications that can interfere with skin tests include: 

• Prescription antihistamines (an-tee-HIST-a-meens), such as fexofenadine (Allegra).
• Over-the-counter antihistamines, such as Loratadine, Alavert, Claritin, Benadryl, Chlor-Trimeton or cetirizine (Zyrtec).
• Tricyclic antidepressants, such as amitriptyline and doxepin (Sinequan).
• Heart and blood pressure medications called Beta-blockers, such as Tenormin, Lopressor, Toprol XL or Inderal.

Before the Allergy Skin Test

Allergy skin tests are done through the Division of Pulmonary Medicine, Allergy, and Immunology of Children’s Hospital or one of the Children’s satellite locations. After you have registered your child at the desk, you will be asked to sit in the waiting area.  

• Parents or guardians may stay with the child during the test. 
• Your child will be called to the examining room and asked some screening questions by one of the doctor’s assistants. 
• The assistant will take your child’s vital signs, weight and medical history. 
• Your child may wear normal clothes to the test.
• Your wait time will vary, depending on how many children are being seen that day and the type of test that has been ordered for your child. Since every child is different, the length of time needed to do each test will vary.  Please be patient with the medical staff.
• You will meet with the doctor in the examining room before testing to review your child’s history and discuss the allergy skin testing.

The Allergy Skin Test

After you’ve met with the doctor, a nurse or medical technician will bring the allergens to the examining room.  He or she will perform the actual tests. The results will be reviewed by the doctor.

• Your child will be asked to roll up both sleeves. 
•  The nurse will make two rows of marks on your child’s arms with a pen.
• The nurse will then rub your child’s forearms with an alcohol swab to clean the area to be tested. The alcohol may feel cold.
• The nurse will press a lancet with a different allergen next to each mark. The nurse will use a new lancet for each allergen.
• This test may cause some mild discomfort and itching. Your child should not touch the testing area. You or your child may blow on the area lightly to help relieve any itchiness.
• You and your child will be asked to wait about 20 minutes to see if any reaction takes place at the spots where the pinpricks were made.
• If an allergen causes an allergic reaction during the skin test, your child will develop a raised, red, itchy bump called a “wheal.” The doctor or nurse will then measure the bump’s size.
• Then you’ll meet with the doctor again to discuss the results and possible treatment options.
• The accuracy of skin tests can vary. Children may react differently to the same test performed at different times, or they may react positively to a substance during a test but not react to it in everyday life.
• In general, skin tests are most reliable for diagnosing allergies to airborne substances, such as pollen, pet dander and dust mites. Because diagnosing food allergies can be complex, your child may need additional tests or procedures.
   

A Parent’s/Guardian’s Role During the Allergy Skin Test 

The most important role of a parent or guardian during the test is to help your child stay calm and relaxed.  The best way to help your child stay calm is for you to stay calm and assure him or her that any minor discomfort will pass within a few hours.

• You may stay near your child or hold his or her hand for comfort during the test. 
• Feel free to ask any questions during the test.

After the Allergy Skin Test

Your child may resume normal activities immediately, unless otherwise directed by the doctor.

The most common side effect of skin testing is itching and redness. This may be most noticeable during the test, when your child isn’t allowed to scratch. It usually goes away within 30 minutes but can last a couple of hours. A mild cortisone cream can be applied to relieve the itching and redness.

Special Needs

If your child has any special needs or health issues you feel the doctor or nurse performing the test needs to know about, please call the Division of Pulmonary Medicine, Allergy and Immunology at Children’s Hospital of Pittsburgh before the test and ask to speak with a nurse. It is important to notify us in advance about any special needs.