Allergy and Clinical Immunology

An allergist is an internal medicine physician who has completed additional years of specialty training to diagnose and treat allergies and related conditions.

Conditions Treated

Allergists are trained in the prevention, diagnosis, and treatment of immune system problems, such as:

  • Allergies
  • Asthma
  • Hay fever
  • Sinus problems
  • Chronic cough
  • Hives and swelling
  • Eczema
  • Food allergies
  • Drug allergies
  • Recurring infections
  • Allergic reactions to
    insect stings

Your First Visit

Your visit begins like most other physician visits. You will provide past and current health information, including the medications you are taking. The allergist will take an additional detailed, problem-focused oral history and perform an appropriate directed examination.

Depending on your symptoms, the allergist may recommend:

  • Allergy testing on your back and/or arms
  • Special blood tests
  • X-ray studies of your lungs or sinuses
  • One or more breathing tests

Some routine x-rays may be performed in the clinic during your visit, while detailed x-rays (such as CT scans or special pulmonary tests) might be scheduled for a future date. Your evaluation and treatment recommendations may be completed in one visit, or you may need to return when additional test results become available. Certain challenging symptoms may require multiple visits.

Frequently Asked Questions

How do I know if I need to see an allergist?How do I know if I need to see an allergist?

Your family doctor will help you decide when an allergy consultation is appropriate. The most common allergic diseases, asthma and allergic rhinitis or "hay fever" frequently can be treated by your family doctor. However, some patients will not respond adequately to common forms of treatment and will benefit by being referred to a specialist. If your symptoms are complicated by sinus, ear or chest infections, a referral is also often appropriate. Often simply knowing whether symptoms are due to true allergy or just an environmental sensitivity is important in choosing the correct treatment.

How old does a child have to be for an allergy evaluation?How old does a child have to be for an allergy evaluation?

Most allergic disease in children under age two years is caused by foods and the common household allergens of dust, mold and animal dander. If your family doctor or pediatrician suspects allergy and is unable to control the problem through environmental means, dietary manipulation or medication then he/she may make a referral to the allergy clinic. Skin testing is rarely positive prior to age six months, but an allergist may be able to assist in treatment of allergic or respiratory problems in young infants less than six months of age.

Learn more about pediatric allergy testing at

Do all patients need allergy shots?Do all patients need allergy shots?

Many of the patients evaluated in the allergy clinic for respiratory allergies will benefit from allergy injection therapy (allergy desensitization). However, some patients may be well controlled with allergen avoidance techniques and appropriate symptomatic medication.

Should I stop my medicines?Should I stop my medicines?

Your provider may recommend stopping antihistamines, allergy, cold, cough and sinus medications for 48 to 72 hours. Consult your provider before making any adjustments to your medications, especially those taken for chronic health issues.

I think I reacted to something I ate. What should I bring?I think I reacted to something I ate. What should I bring?

Please bring a contents label from the food(s) if possible.

Who needs to accompany a minor child (17 years old or younger)?Who needs to accompany a minor child (17 years old or younger)?

A parent and/or legal guardian who can give a complete medical patient history of the minor must accompany the minor to the appointment.

Do you need my old allergy records?Do you need my old allergy records?

Most of the time old records are not necessary and you do not need to delay your appointment to get those.

Will I have skin tests?Will I have skin tests?

When a patient's history and physical exam suggest the possibility of an allergic disease, allergy skin testing may be recommended. This consists of a series of "prick" tests on the upper back usually followed by a series of intradermal or superficial injections into the skin of the upper arms. The tests take approximately 45 minutes, and the results will be available at the end of your allergy visit.

Do you test for contact allergy to makeup, skin products, or metals?Do you test for contact allergy to makeup, skin products, or metals?

No. Those tests are done by dermatology.

Can RAST tests be done in place of skin testing?Can RAST tests be done in place of skin testing?

Many patients ask about RAST testing because it is "new." RAST testing looks for a specific allergic protein in the blood, just as skin testing looks for the same type of protein in the skin. We think that skin testing is preferable because, in our experience, it can be more accurate than RAST testing from a commercial laboratory and because skin test results are available immediately. Many patients find it intriguing to be able to "see with their own eyes" just how allergic they are to each allergen tested.

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Sumit Bose
Karim Dhanani