Skin Prick Tests (SPTs)

When symptoms such as persistent sneezing, nasal congestion (a blocked nose), coughing, or irritated eyes affect your daily life, visiting a specialist allergist is the first step towards obtaining an accurate diagnosis. However, the idea of diagnostic testing often causes hesitation, as the word “test” is mistakenly associated with painful injections, needles, or concerns about possible side effects. In reality, **Skin Prick Tests (SPTs)** are internationally regarded as the **gold standard** in the diagnostic evaluation of respiratory allergies. They are an extremely quick, virtually painless, and safe procedure that enables the precise identification of allergy triggers in patients of any age.

The procedure is performed in the doctor’s office within just a few minutes and involves a series of specialised, standardised, high-purity allergen extracts. The allergist places small drops of these extracts on the inner surface of the forearm and then uses a special, microscopic metal lancet to apply gentle pressure to the surface of the skin through each drop. This pressure is barely noticeable, does not penetrate deeply, and does not pierce the skin in the same way as an injection. Instead, it feels more like a brief, mild prick.

The safety of skin prick testing is well established. The test accurately reproduces the body’s allergic response on a much smaller, localised scale in the skin. The amount of allergen introduced into the superficial layer of the skin is minimal and acts locally, without entering the bloodstream. This means that the risk of a systemic or severe allergic reaction is practically negligible, while any itching and swelling usually subside spontaneously within a few hours.

Furthermore, the examination is always carried out under the direct supervision of a specialist allergist in a fully equipped and safe medical environment. To ensure maximum reliability of the results and to rule out false-positive or false-negative findings, the doctor simultaneously uses **control substances**: histamine as a positive control (to confirm that the skin is responding normally) and saline solution as a negative control.

The range of allergens tested is comprehensive and covers a broad spectrum of environmental factors responsible for respiratory allergies. Specifically, the categories of allergens examined include **tree pollens** (such as olive, cypress, plane tree, etc.), **grass pollens and weed pollens** (such as *Parietaria*), **house dust mites**, **moulds** (both indoor and outdoor), as well as **pet dander and epithelial allergens** (including cat and dog). In the case of a positive result, a **wheal** (mild swelling) develops at the site of the skin prick, often surrounded by redness and mild itching similar to a mosquito bite, helping to identify the responsible allergen.

It is important to note that a positive skin test indicates **sensitisation** of the immune system to a specific allergen; however, this does not automatically mean that the patient has a clinically relevant allergy. For this reason, skin prick tests are always performed in conjunction with a detailed medical history. The final interpretation of the results is made exclusively by the allergist, who evaluates the test findings together with the patient’s medical history and symptoms.

An important requirement before the examination is the discontinuation of **oral antihistamines for 5 to 7 days**, as these medications suppress the skin’s normal response and may affect the test results. Other treatments, such as **corticosteroids (topical preparations), certain antidepressant or sedative medications, topical calcineurin inhibitors, or monoclonal antibodies such as omalizumab**, may also influence the results and may require appropriate planning before testing, according to the allergist’s instructions. Common medications used to treat asthma or rhinitis, such as **inhaled medications or nasal sprays, generally do not affect the test**.

In conclusion, skin prick tests provide a rapid, safe, and virtually painless method for identifying the allergens responsible for a patient’s symptoms. When interpreted together with the patient’s medical history, the results help guide the selection of an appropriate and targeted treatment plan.

*Do you have symptoms that may be related to a respiratory allergy? Contact our clinic to schedule your allergy assessment.*