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How To Test And Treat Allergy

Dr. Sadaf Sarwar

2 min read

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Allergic reactions are very common. In developed world, 20% people suffer from nose allergy, 6% suffers from food allergy and 20% from some sort of skin allergy.

What is Allergy?

Allergy is a condition in which our immune system gets very sensitive to harmless things/chemicals present in the environment resulting in symptoms like red eyes, runny nose, sneezing, itching and breathing difficulty.

What things can cause Allergy?

Common air allergens

Cat hairHouse dust mite
Dog hairMold
Horse hairGrass pollens
RabbitTree pollens
Animal FeathersFlowers

Common food allergens


Common skin allergens

PerfumesHair dyesGlovesTopical medicines
CementSticky plasterCosmetics 

How can we test allergy?

Skin Prick test (SPT) is the most used test for allergy diagnosis. It is quick and results are visible.

IndicationsAllergic rhinitis (Nose allergy) Suspected food allergy Refractory Asthma (asthma not responding to usual treatment) Suspected food or drug allergy
ContraindicationsSevere red and itchy skin (dermatitis) Severe redness and swelling of skin on pressure or trauma (dermatographism) History of severe allergy (anaphylaxis) Age below 2 years Uncontrolled Asthma  

How is Skin Prick test performed?

SPT is usually performed on skin of forearm or back. Skin is cleaned with a sterile alcohol swab, then a drop of suspected allergen is applied on the marked area of the skin in a grid pattern. Then a small prick with a sterile needle is done through the drop to allow allergen to penetrate the skin. Allergy is indicated when a small insect bite size lump appears over the site within 15-20 minutes. Risk of severe reaction is very low because a very small amount of allergen goes into the superficial layer of skin.

How are results interpreted?

Results are assessed size of lump or wheal on prick site.

Wheal diameter 5-10mmMild allergy
Wheal diameter 10-15mmModerate allergy
Wheal size >15mmSevere allergy

What are symptoms of food allergies?

It can be divided into two groups.

  1. Immune/allergic reaction
  2. Non-immune (food intolerance)

What are Immune mediated food allergies?

  • These food allergies are caused by IgE antibodies or non-IgE antibodies.
  • Immediate symptoms of allergy appear from IgE antibodies.
  • Skin prick test is good for IgE mediated reactions.

Delayed symptoms of allergy (>2 hours) appear from non-IgE antibodies. Skin prick test may not give definitive results though patient may still suffer from food allergies. You may consider ALCAT test (Antigen Leukocyte Cellular Antibody test).

What is treatment of food allergies?

Avoid the triggering food. Maintain a food diary.

What is immunotherapy?

Immunotherapy is a treatment in which body is exposed to known allergens in a controlled way to reduce severity of allergic reactions. It is given in form of injections or sublingual drops from accredited labs.

Who can get immunotherapy?

People suffering from allergic rhinitis, allergic asthma, allergic conjunctivitis, insect sting allergy.

Who cannot get immunotherapy?

People who have food allergies, hives or urticaria and eczema cannot receive this treatment.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Sadaf Sarwar
Dr. Sadaf Sarwar - Author Dr. Sadaf Sarwar is a top General Physician with 17 years of experience currently practicing at Australian Polyclinic, Lahore. You can book an in-person appointment or an online video consultation with Dr. Sadaf Sarwar through oladoc.com or by calling at 04238900939.

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