Dr. Hutto may recommend that you undergo allergy skin testing. Please read the following and if you have any questions don’t hesitate to ask.
Skin testing may be a part of your evaluation to determine if you are allergic to certain things in your environment which can be the underlying cause for many of your symptoms. Our practice skin tests routinely for allergies to grass, weed and tree pollen; mold spores, dust mites, cat and dog dander, cockroach and feathers. Allergies to these substances, referred to as allergens can cause eye, nose, sinus, lung and skin symptoms. It is important to know if you have underlying allergies as the cause of your symptoms because an allergy vaccine can be prescribed to desensitize you to these allergens. For patients taking the following antihistamines, the number of the days the medication must be stopped before skin tests are listed below:
Over the counter and prescription medicines such as Clarinex, Claritin (Loratadine), Claritin-D, Xyzal, Atarax, Vistaril, Hydroxyzine, Meclizine, Antivert
7 full days
Antihistamine nasal sprays Astelin, Astepro 0.15%, Dymista, and Patanase
7 full days
Antihistamine eye drops such as Pataday, Patanol, Bepreve, Zaditor, Pazeo, and Optivar, others available over the counter
3 full days
All over the counter antihistamine medicines such as Allegra, Allegra-D, Zyrtec, Zyrtec-D, Benadryl, Tylenol Allergy and Sinus, etc.
3 full days
Many over the counter medicines that are not for allergy or sinus symptoms contain antihistamines such as Tylenol PM & Pamprin
3 full days
Other medications that can block allergy skin tests include heartburn medications such as Tagamet, Zantac, & Pepcid
3 full days
Antihistamine & steroid creams such as cortisone cream and Benadryl cream
7 full days
It is not possible to list all the over the counter & prescription medications that contain antihistamines. If you are unsure about a medication, you are taking call your pharmacist.
Often patients can’t stop their antihistamines for fear of having severe nasal, skin and eye symptoms. If this is the case, please don’t stop your antihistamines prior to your visit because Dr. Hutto may be able to change you to other medicines that will not interfere with your skin tests and will control your symptoms. Your skin test will be scheduled for another day.
If you are taking antihistamines for hives and swelling DO NOT STOP them prior to your visit. Also DO NOT STOP any other prescription medicine you are taking for other medical problems such as asthma, high blood pressure, heart disease, etc, or antibiotics for infections. This could be dangerous to your health. Please bring all prescription and over the counter medications you are taking with you to the visit or a list that can be read of all medications.
It is important to tell Dr. Hutto if you take BETA BLOCKER medications. These medications are commonly used to treat glaucoma (beta blocker eye drops), high blood pressure, anxiety, migraine headaches and heart disease. DO NOT STOP any beta blocker medication without specifically discussing with Dr. Hutto or the physician who prescribed you the medication. If you have taken Imitrex, you may not be skin tested on the same day. Do not stop heartburn medications or beta blockers prescribed by other physicians because this may cause an illness to flare.
Skin tests are routinely done on the back by a fast, relatively painless plastic device called a multi-test which barely pricks the skin. This will be fully discussed and demonstrated by the nurse before any skin tests are done (if recommended by Dr. Hutto and agreed upon by the parent). This type of skin test hurts less than the finger prick which most pediatricians perform for blood tests. For older children we routinely do 2 sets of skin tests on 2 different days. For younger children, we may pick only selected allergens such as dust mites and animal dander.
Skin testing consists of two parts. The first part consists of a series of pricks on both forearms. It is a relatively painless process that can take 45 to 60 minutes to perform. If the result of any part of this test is negative, you will progress to the second test.
Part two of the test consists of a number of intradermal injections on the upper arms. Each injection is a mixture of allergens that you have been pricked with but did not react to. This test is more accurate and more likely to be positive if you have allergies than the initial prick test. Many patients ask why we can’t do the intradermal test first; the reason for this – it is important to determine first if someone is highly allergic by prick tests. Only if prick skin tests are negative is it safe to proceed to the higher concentration which is injected slightly under the skin.
Intradermal testing progresses slower because we don’t want to overload your immune system with too many allergens. This part of the test can last 2 to 4 hours. However, if you begin to have numerous large skin test reactions the skin tests will need to be stopped for the day. People with large skin test reactions may have to come for 2 to 3 separate skin test appointments on different days only staying for the testing 30 to 45 minutes each time to safely apply the skin tests. These appointments may be on consecutive days at different times to accommodate your schedule. We are open until 6:00 p.m. on Tuesday and Thursday nights to prevent patients from missing work. Patients with mild skin reactivity to the skin tests may have one long skin test session which would allow them to complete the skin test in one visit.
We highly recommend eating before you come. Based on the time involved, you may want to bring a
book or paperwork to work on and a sweater in case you get cold. If you come around lunch time, you
may leave, eat lunch, come back and we will continue your testing. We will do our best to complete your testing as quickly and safely as possible. We hope this information will help you plan accordingly with your time and schedule.
Please let Dr. Hutto and your nurse know if any time in the past you have fainted after having blood drawn, an injection given, blood donated or any other medical procedure. We have many patients who have a fear of needles and medical procedures. If this applies to you, we can allow you to lie down in a comfortable environment for any skin tests or allergy shots.
Patients can not be skin tested on days that their symptoms are severe as this is not safe. Dr. Hutto will examine and decide in each case if it is safe to proceed with skin tests on that day. Many patients come to our office with moderate to severe allergy symptoms and have to be treated for several days to a week before skin test can be done. Do not worry if you have symptoms and are unable to skin test on the first visit. Dr. Hutto will treat you and reschedule your skin tests when convenient for you. For younger children they must have a normal lung exam and no severe lung or nasal symptoms within the last several days.
After you finish skin tests you will be given a detailed list of all the allergens you tested positive for as well as recommended environmental control measures which can be done to your environment to help prevent exposure to some allergens. We will also discuss allergy shots or administration of allergy vaccine with you (if Dr. Hutto has recommended this), as well as billing information for the vaccine and shots. Dr. Hutto will want to see you for a follow-up one to two weeks after the skin testing has been completed to make sure you understand what you are allergic to and see if recommended medications, if any are helping you. If you would like to start your allergy vaccine at the follow-up visit, we can have it ready to do so on that day to save you time (if allowed by your insurance company).