Skin Allergy Testing: What's Involved and What I Learned

I've been an allergy sufferer for as long as I can remember.   I can't be around cats, dogs, rabbits, horses - any animals, really, without having a major problem.  And I had seasonal allergies.

Since moving to Texas three years ago from the east coast, my allergies have often been atrocious.  This year, my nose has been nothing but a source of agony since February, which is the last time I was actually able to use it to breathe.  Nothing has worked.  Zyrtec, Claritin, Claritin-D, Benadryl, Tylenol Sinus, Sudafed, you name it.  Nothing worked and whatever I took left me feeling groggy.  I'd wake up with a puffy face, stuffy nose and crusty eyes almost every day.  Visine allergy eye drops became part of my daily routine.  Bad bouts turned into sinus infections.  My symptoms became worse whenever I was outside for long spells (an hour or more) but being outside is unavoidable.  I'm a gardener, a parent of energetic children, and a runner.  I can't avoid the outdoors.  So I finally called an allergist to see if I could find some effective relief.

The first thing they did was test my lung capacity, to ensure that the problem didn't include asthma.  No problem with my lungs.  Then they had me blow my nose into a piece of wax paper and hand over the sample.  Then I was examined by the doctor.  He agreed that given my active lifestyle, it would be impractical to avoid going outdoors.  He told me I should have skin testing done to figure out what, specifically, I am allergic to.  This will help me better understand my seasonal challenges and plan for them, rather than being caught off guard.  He gave me a sample of Veramyst nasal mist, scheduled me for skin testing the next week and gave me guidelines on what what medications to avoid until then so they could get clear results.

The following Monday, I arrived at the allergist, prepared to stay there for 1 1/2 to 2 hours.  The first thing the nurse did is give me two "control" pricks - one of histamine and one of saline.

A few minutes later, the histamine welt appeared (see reddish bump toward top) while the saline prick (below it) had no reaction.  We were able to proceed to the skin testing.

That's when I realized they were going to give me 54 pricks, testing a variety of the allergens typically found in north Texas - dust mites, animals, molds, trees, grasses and weeds.  54.  Gulp.

I wore a hospital gown open in the back and lay on my stomach on the exam table.  The nurse swabbed my back, applied tape with numbers on it and then pricked the appropriate allergen next to the numbers taped to my back.  A simple way to organize them.  The pricks were practically painless.  That was the good news.  But seconds later, the allergens that give me a problem started to REALLY itch.  I mean, I was huffing and puffing in that exam room, trying to use Lamaze breathing to help me cope.  I was unsuccessful.  So I pulled out my iPhone and did my best to distract myself.

Here you can see that the following gave me a problem: dust mites (1, 2), all animals (3, 4, 5), some of the trees (21, 22, 32, 33, 35), virtually all grasses (37 - 43), and a few weeds (46, 48).  The nurse measured the diameter of my welts to determine the severity of my sensitivities.  My biggest sensitivities are to animals and grasses. 

The doctor looked at the results and decided to retest a few suspicious results (more pricks to my upper arm) and determined that the original results were correct.

I got dressed and went to another room to consult with the doctor.  He was able to tell me what months of the year each of my sensitivities would be a problem.  He also told me that I am not allergic to the grass in my own backyard, which is well manicured.  Rather, I am allergic to tall grasses - grasses that are allowed to flower and distribute pollen.  I live in the countryside, so there's a lot of tall grass around.  It's also quite windy here in Tornado Alley, so Cedar pollen blows up from the south year-round.  Grass pollen also blows up from the south when it flowers earlier there than it does here - this lengthens the duration of my grass allergies.  So, Fall and Spring are ultimately my worst seasons - but particularly Spring.

He took quite a bit of time with me, which I really appreciated.  I told him I am the product of a highly allergic mother and a father who also has some allergies.  My mother is highly allergic to mold, among other things, so I was surprised to see that this isn't a problem for me.  He informed me that we can inherit an allergic gene from our parents, but what sort of allergies we develop depends on what we are exposed to as children.  Since my mother really suffered from mold, she was very careful with our house while I was young and I was rarely exposed to it.  I did, however, spend a lot of time outdoors as a child and we had many animals.  So there you go!

Then we discussed a plan of action.  I have two alternatives:

1. Continue to treat it with nasal mist, which worked remarkably well for me over the course of one week.  My nose is back to normal and I've noticed a dramatic and steady improvement in my overall itchiness and eyes.  
2. Start shot therapy to desensitize my body to these allergens, permitting me to one day be completely free of them and any medication I'm now taking to control them.  I have to say, despite the inconvenience of weekly (in the beginning) shots, the idea of one day being allergy-free is extremely appealing.  This is typically a 5 year process (weekly shots year 1, every other week year 2, monthly years 3-5) but can be accelerated to 4 years by doing a 1-day "RUSH".  This involves being given multiple allergy shots over the course of one day with an RN staying with you the whole time to ensure nothing goes wrong.  You are given antihistamines, etc, the day before, the day of and the day after the RUSH to control allergic reaction.  It sounds a bit scary but gaining a year on the process is appealing.

I'm not sure what I'll do at this point.  I need to mull it over, though I am leaning toward option #2.

Read my other posts about Allergen Immunotherapy here.


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