For some, an allergy and asthma attack can be one and the same. In this case, the immune system overreacts to an allergen and launches a full-on immune response, causing the airway to swell.
The condition, known as allergic asthma, affects as many as 10 million in the United States, according to the American Academy of Allergy, Asthma and Immunology. And for these people, identifying what’s causing these attacks can go a long way toward controlling their condition.
As many of you know, we have twin girls with asthma that’s often triggered by allergies. We follow their Asthma Action Plan and arm them with controller medications, rescue medications and allergy medications. Still, their asthma has been out of control.
This allergy season has been particularly hard on them. There’s been instances where we’ve even had to use oral steroids to decrease their lung inflammation. Frequent use of oral steroids can cause numerous side effects and so we needed a way to eliminate the need for them as soon as possible. At this point, the girls’ pediatrician decided that the next step in their asthma care would be to see an allergist to find out what allergens are triggering these asthma control issues.
How allergy testing works
One of the major advantages of allergy testing is that it can identify those who may be benefit from immunotherapy. The therapy works by desensitizing the child to things they are allergic to and helping to eliminate the severe allergic reactions. Children as young as five can receive immunotherapy in the form of allergy shots.
In their case, we opted for allergy blood testing, which is often done in younger children who may not sit for the multiple pricks required for the skin tests or aren’t able to come off of allergy medications as required for skin tests.
The basic blood test for common allergies, performed on both girls, found that they have allergies to numerous things. Unfortunately, the blood tests can be less sensitive than skin testing so in the coming month we will be doing the skin testing to get a clearer picture of what each girl is allergic to.
Things to consider before the test
Several medications can interfere with skin testing for allergies. These include anti-histamines such as Benadryl, Claritin and Zyrtec as well as H2 blockers, leukotriene blocking medications, high doses of oral steroids and some antidepressants. Talk with your physician about your current medications to determine which ones need to be discontinued and for how long before testing.
It’s also important to consider the time of year in which you’re doing the skin testing. Levels of allergens in the environment can differ depending on the period. For instance, we attempted to do skin testing this Spring when our daughter Ella developed a severe allergic reaction, including hives, when she discontinued her allergy medication. We will attempt the testing again this summer since the environmental allergens tend to be lower in our area during that time.
Talking to your child about allergy testing
When the doctor told Ella that she needed to do skin testing for her allergies she started crying. Sitting in the doctor’s office, she lamented “I don’t want to be a pin cushion.” In hindsight, we would have been better off sitting her down and explaining the test beforehand. So don’t make our mistake. Let them know that it’s a small poke and that the most annoying thing about the testing is that it may itch.
If your child has been suffering from allergies and nothing you have tried seems to be working or if they also have other conditions like asthma or eczema, you should ask your pediatrician to refer the child to an allergist. An allergist can determine which tests would be beneficial moving forward.
Stay tuned as we will be posting our skin testing experience soon.
Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition.She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years.Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER)