Allergy Consultation

The Tonbridge ClinicDo you need to see an allergy specialist?

An allergy specialist can help you identify whether allergy is contributing to your health problems in a number of conditions:
• Asthma
• Hayfever / Rhinitis
• Itchy Eyes
• Food reactions
• Anaphylaxis
• Drug reactions
• Insect sting reactions
• Skin conditions

Skin prick tests
are used by most medically trained allergy specialists to confirm allergies. The tests are usually carried out using standardised extracts of common allergens. Small drops of extract are placed on the skin (usually the inner forearm). A metal lancet is used to prick the skin lightly through the drop. The tests are read after 15-20 minutes.

If there is a reaction, the skin itches and a weal (similar to a nettle sting bump) appears within a few minutes. This will normally be between 1-6mm size and last for 1-2 hours. Mostly, the itch settles quickly. As only a tiny amount of allergen is pricked into the skin, the tests are safe. Results are available immediately.

Patch Tests - If you suspect a skin reaction to skin preparations, chemicals or metals in direct skin contact then patch testing is more useful than skin prick tests or blood tests. These tests require dermatological expertise and it is essential to see a dermatologist rather than an allergy specialist. If you suspect food or dust mite allergy as a cause of skin rashes, then seeing an allergy specialist may help you.

Challenge Tests -
Very occasionally it is necessary to have a challenge test with a suspect food or drug. These tests are performed using very cautious dosing regimes under close supervision in a hospital laboratory.

Unconventional allergy tests - A report of the Royal College of Physicians has ruled that neutralisation-provocation tests, leucocytotoxic tests, hair analysis, Vega testing, applied kinesiology and the auricular cardiac reflex method have no place in the diagnosis of allergy. IgG blood tests also have no validity in the diagnosis of allergy.

The Consultation

Allergy tests cannot be interpreted properly in isolation. A detailed medical history and examination is essential to finding the correct diagnosis. This usually takes an hour, including your skin tests. Breathing tests (Spirometry) may be necessary if you have a chest problem. If you have an allergy, you will receive advice and information leaflets on allergen avoidance and recommendations on medication / emergency kits if indicated.

Immunotherapy (“desensitisation”)
Allergen Immunotherapy is an effective treatment for hayfever. A course of 4-6 injections per year of allergen extract can control the symptoms and reduce medication requirements. Dr. Trigg can advise whether this treatment is likely to help you. Dr. Trigg practices immunotherapy at a hospital in Tunbridge Wells.

Blood tests - Sometimes the skin tests may be inconclusive and blood tests may be needed for further investigation of allergies or other suspected conditions. In the majority of cases, the consultation and skin tests will be enough to confirm the diagnosis.

REGISTERED BODIES:
British Society for Allergy and Clinical Immunology and Royal College of Physicians

Dr Cecilia Trigg MD FRCP

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