If you're exploring whether your child might have allergies, testing at our London clinics can help uncover what’s behind their symptoms. We offer a range of tests that can point to potential triggers, but making sense of the results isn’t always straightforward. That’s where our specialists come in — they don’t just look at the numbers, but take your child’s full medical picture into account. This guide walks you through the different types of allergy tests, what the results can tell you, and why expert interpretation really matters.
Allergy diagnosis typically relies on three key elements
Each component provides valuable information, but none alone can definitively diagnose an allergy. Together, they create a comprehensive picture that guides diagnosis and management.
There are two main methods for detecting IgE antibodies – the proteins your immune system produces in response to allergens that can trigger allergic reactions.
Skin prick testing works by introducing a tiny amount of allergen extract into the skin's surface layer:
Skin testing provides immediate results during your appointment and allows for testing multiple allergens simultaneously.
Blood tests (sometimes referred to as RAST or ImmunoCAP tests) measure allergen-specific IgE antibodies directly in the blood:
Understanding test results requires nuance and expertise. Here's what parents should know:
A positive test result (whether skin or blood) indicates sensitisation to an allergen – meaning your child has developed IgE antibodies to that substance. However, sensitisation alone doesn't necessarily mean your child will experience allergic symptoms when exposed to the allergen.
Some key points about positive results
Negative test results generally suggest a low likelihood of IgE-mediated allergy, but they don't completely rule it out. A 0mm skin test combined with undetectable specific IgE in blood makes IgE-mediated allergy unlikely.
However, false negatives can occur, particularly if testing is done during very early stages of allergy development, when the allergen extract used in testing is of poor quality, or when recent antihistamine use suppresses skin test reactivity. This is why we emphasise the importance of proper preparation before testing and may recommend repeat testing in certain circumstances.
A common misconception is that larger test reactions predict more severe allergic reactions. This is not true.
Test size does not reliably predict the severity of future reactions, nor does it indicate the amount of allergen required to trigger symptoms.
Additionally, test size does not confirm that a reaction will happen with every exposure. Rather, test size primarily reflects the likelihood of allergy, not the intensity of response.
This distinction is crucial for understanding what your test results actually mean for managing your condition.
Each testing method has specific advantages, and they often work well together:
Skin testing may be preferred when:
Blood testing may be more appropriate when:
When skin and blood test results are inconclusive or conflict with the clinical history, controlled challenge testing may be recommended:
Challenge testing is particularly valuable when:
These examples illustrate how different test results might be interpreted in clinical practice:
Example: A child has a 10mm skin test to peanut and a blood test level of 30 IU/mL.
Interpretation: This combination of strongly positive results indicates a very high probability (>95%) of clinical peanut allergy. If this aligns with the clinical history, a diagnosis can usually be made without challenge testing.
Example: A child has a 0mm skin test to milk and an undetectable specific IgE level in blood testing.
Interpretation: These results make IgE-mediated milk allergy highly unlikely. However, if the child has experienced clear reactions after consuming milk, non-IgE mechanisms might be involved.
Example: A child has a 3mm skin test to egg and a blood test level of 0.7 IU/mL.
Interpretation: These borderline results indicate sensitisation but don’t clearly confirm or rule out allergy. Clinical history becomes particularly important, and a supervised food challenge may be recommended.
Not necessarily. This often represents sensitisation without clinical allergy. Your allergist might recommend cautious continued consumption if the child has been eating the food without issues, or suggest a supervised food challenge if exposure has been limited or unclear. In cases where the positive result is very strong, they may advise temporary avoidance and retesting to monitor how the sensitivity evolves over time.
Yes. Many children, especially with egg or milk allergies, develop tolerance over time. Periodic retesting helps track changes, and declining test values may indicate growing tolerance.
No. Avoiding foods based on small positives can lead to unnecessary restrictions. Especially without symptoms, low-level positives may not represent true allergy. Your allergist will help decide what’s safe to continue.
Home test kits are not reliable for allergy diagnosis. They often test for IgG (which is not relevant to allergy), can be misleading, and lack clinical context for accurate interpretation. Always consult a qualified specialist.
The most crucial message about allergy testing is that results require expert interpretation.
Your allergy specialist integrates the specific test results with your child's detailed clinical history, knowledge of the reliability of tests for specific allergens, understanding of cross-reactivity patterns, and awareness of how conditions like eczema impact test interpretation.
Self-interpretation of results can lead to unnecessary anxiety, inappropriate dietary restrictions, or failure to recognise true allergies. This is why we strongly recommend that you discuss your test results with your specialist rather than attempting to interpret them yourself. Your specialist has the expertise to provide accurate, personalised guidance based on your complete clinical picture.
When discussing test results with your allergist, they will typically explain what the tests have shown in the context of your child's symptoms and discuss the likelihood of true allergy versus sensitisation without clinical significance.
They will recommend which allergens should be avoided and which can likely be safely consumed, provide emergency management plans if significant allergies are confirmed, and suggest when retesting might be appropriate.
Throughout the consultation, they will address any questions or concerns you have about the results, ensuring you leave with a clear understanding of your child's allergic status and next steps.
While testing provides valuable information, allergy diagnosis and management consider many other factors. These include the pattern and timing of symptoms, the consistency of reactions, and response to previous treatments. We also consider family history of allergic conditions, impact on quality of life, and nutritional considerations with food allergies, alongside the practical aspects of allergen avoidance.
This holistic approach ensures that recommendations are both medically sound and practically manageable in daily life.
Once your allergy test results have been properly interpreted, they serve as a foundation for creating clear management plans, developing emergency action plans if needed, and making informed decisions about dietary modifications. They also help us understand which environmental measures will be most helpful and enable us to track changes in allergic status over time.
With expert guidance, allergy test results become a powerful tool for managing allergic conditions effectively, avoiding unnecessary restrictions, and improving quality of life. Remember that allergy testing is not a one-time event but part of an ongoing process. As children grow and their immune systems develop, their allergic profile may change, making periodic reassessment valuable in many cases.