Pred and skin prick testing

I'm having allergy testing repeated for various reasons, but one thing I'm confused about: does being on pred long-term-ish (about 4 months now, 15-40mg at variois times) affect the results of skin prick testing for allergies?

I've looked it up and found conflicting answers. I've also rung the AUK nurses who said it was a really good question and they didn't know. The nurse when I booked the tests said I just needed to stop antihistamines, but consultant said pred *might* affect allergy blood test results so I was wondering re skin prick tests as well and no-one seems quite sure; search online (including academic sites) is also inconclusive: everything says short term courses won't affect it but there's not that much either way on longer term, might have to look again though).

Cons just said 'oh well you shouldn't be on pred anyway' - yes thank you very helpful, especially when the allergy testing is related to finding an alternative to pred!

I can't realistically come off it in a time frame that makes sense for the allergy testing (the nurse said tree pollen season starts soon and as I strongly suspect I'm allergic to that I don't want to spend 3 days without fexofenadine when it's started!), but had wondered if it's worth trying to get down as low as I can? I will be on 20mg next week when it's currently booked, so wasn't sure if a) waiting till the next week when I'll still be on 20 but willl have been on the lower dose for longer (current plan is to drop 5mg every 2 weeks) would make any sense, or trying to wait till I'm down to 15 - except that before, trying to drop to 15 didn't really work so well and I ended up on a higher dose!

This can't be an uncommon problem though so wondered if anyone else had had the same issue and what you found/what you were told? AUK nurses said to check with hosp re protocol which I could do but feels like I""ve already had some confusing answers from them? So thought I'd ask here as well and see what other people's nurses/cons etc have said, if anything.

Thanks! I would really like these tests to be useful - I don't want allergies but as I am really sure that I'm allergic to at least some trees and possibly something else as still having probs in the winter, I would like the tests to reflect that as it makes life easier...

7 Replies

  • We were told Thomas needs to be off pred for at least 2 weeks before his skin test can be done. His are just emergency courses so don't know if this is different to long term pred use.

  • Hi

    I had skin prick testing last week along with blood test aswel and my immunologist didn't seem bothered that I was on pred so it must be ok.iam extremely allergic to pollen so they have started me on a desentiziation programme called Grazax for 3years to try and reduce my symptoms.i was on fexofenadine 180mg three times daily still had no affect on my allergies :-(

  • Thanks for replies! Hmm confusing - everything I've read says that short courses like what Thomas has should be fine! I did see a leaflet for allergy testing in children at the Royal Free which says that children must come off pred and steroid inhalers which I think i a bit silly - they're probably on them for a reason and they can't necessarily just be stopped like that for days! Particularly since everything else I've seen says that it shouldn't affect the tests in short bursts/in inhalers, but everyone seems to have diff protocols.

    Irishboy - so what does this involve? Has it helped? My allergies aren't that bad but would be interesting to hear more, maybe in your other post as you've started one?

  • Yea sure we can chat on ther and il tell u more :-)

  • Hi

    I was at the difficult Asthma Clinic a couple of weeks ago and the asthma nurse did allergy testing on me. She asked about any allergy meds I was taking but not about steroids.

    I was on about 15mgs then. The allergy tests still worked. I am allergic to a few things like grass pollen and animal hair particularly dogs and cats.

    So not sure if this helps your situation.



  • I have had allergy tests when on maintenance pred (over ten year ago though). If it is a problem, they could also consider blood tests as these don't require you to stop meds (including antihistamines). This is how I have been tested recently (although they did do a skin test to investigate a false negative).

  • Thanks Kayla. Weirdly though I know the blood tests are meant to be more accurate I get the impression pred actually affects them more than it does the blood tests? So skin prick while uncomfortable with no anti-h is more manageable in terms of coming off things...

    I would really like to have a positive result as am fed up with the no answers thing and I am pretty sure I'm allergic to SOMETHING esp given how I usually feel if I forget to take allergy stuff. Plus the symptoms aren't always that well controlled even on the stuff...

    Mind you I will be v annoyed if it's dust mites (lazy lol) or cats (love them). No pleasing some ppl is there... :p

    I had negative blood tests last year (when I was having allergy symptoms), may have been affected by pred? But last time I had skin prick I wasn't really getting any allergy symptoms at all and didn't have hayfever. Which was nice and would rather not have them but kind of hoping this means this time, if I don't have the antihistamine and I AM having symptoms it will actually show something!

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