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  • Q&A with Australian Health Practitioners

    Can skin prick tests fail to detect allergies?

    Related Topic
    Allergy
    I have vasomotor rhinitis all year round with symptoms of nasal congestion, excess phlegm, and postnasal drip, been suffering for about 6 years. I use fluticasone furoate nasal spray and saline rinses to manage. Previous ENT's have confirmed I have inferior turbinate hypertrophy but I have not undergone any allergy testing before. I am planning on getting a new referral to an allergist specialist, and have a few questions.

    Is it possible for skin prick tests to not detect any allergies which can only be picked up on a blood test?

    What are the other possible treatments the specialist may recommend?

    What other questions/information should I bring up with the specialist?
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  • Dr Liam Beiglari

    Allergy Specialist & Immunologist

    I am a clinical immunologist and allergist. I am experienced in the diagnosis and treatment of adult patients with allergic diseases, autoimmune conditions, those living … View Profile

    It's possible that skin prick tests could be falsely negative in patients with a high pre-test probability. It is important to understand that no test is perfect. In the case of skin prick tests, the reagents can go bad over time if they're not stored properly, the test may not be good enough at detecting positives such as in the case of crustacean allergy, or sometimes antihistamines (or other medications) have been taken which reduces the reactions from exposure. Blood tests (the specific IgE tests) or direct challenges (supervised ones!) might be better in some circumstances but this is worth discussing with your allergist. For your specific example, I would be very suspicious for dust mite allergy, and if this is not detected by skin prick tests or blood tests, then it may be worthwhile considering an intranasal challenge, which can just be done in the clinic. Please consider discussing with your specialist.

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