Treatments and services
We offer the following treatments for adults:
A one-stop clinic
The patient is assessed by a consultant, receives allergy testing and is given a self-management plan with input from our specialist dietitian and nurse specialist. This can include an exclusion diet or advice on avoidance of allergens (allergic substances), such as reducing dust mites in the home. Our aim is to see and diagnose most patients in just one visit, with further follow-up readily available if necessary.
This may be indicated in certain patients with severe rhinitis or venom allergy, after assessment by the consultant. It involves a course of injections, using the allergen that the patient is sensitive to, over three years. Weekly visits lasting an hour are required for the first three months and then monthly visits over three years. The clinic is run by specially trained nurses alongside the adult allergy clinic at The London Chest Hospital in Bethnal Green and patients are closely monitored after each injection in case of side effects.
The aim is to induce tolerance in the immune system to the provoking allergen, thereby reducing symptoms and medication usage long-term. It is useful in patients who have failed to respond to conventional treatment.
Adrenaline auto-injector pen training
Our nurse specialist gives advice on how and when to use an adrenaline auto-injector pen, including a demonstration with a “dummy” pen.
Adrenaline is the immediate treatment for anaphylaxis - a severe allergic reaction with airway obstruction (difficulty in swallowing or breathing) or a drop in blood pressure (feeling faint or collapse). If you are at risk of anaphylaxis, you will be prescribed an adrenaline auto-injector pen. There are two widely-used types, the EpiPen and the Anapen. They contain a single dose of adrenaline which can be injected into the body; adrenaline helps open the airways so you can breathe and reverse any fall in blood pressure.
After an extreme allergic reaction, you should always be seen in an Accident and Emergency (A&E) department and referred on to an allergy clinic.
Allergy testing
- Skin prick tests: A small needle is used to prick the skin gently through a droplet of fluid containing a known allergen. If the skin around the needle prick becomes itchy, red and develops a swelling, then, in combination with a suggestive history, we are likely to be able to confirm your allergy. You will need to stop taking antihistamines, for at least 48 hours before the test.
- Blood tests: These are an alternative way of testing for allergy and involve measurement of an allergic antibody (chemical) in the bloodstream, after taking a blood sample. They are a suitable test for patients unable to have skin prick tests, for example, those who cannot stop taking antihistamines or who have severe skin conditions, or where further information is needed after skin prick testing.
- Prick-Prick test: The food which the patient thinks he/she is allergic to is brought in by the patient to be used for testing. A lancet is used to prick the food and the same lancet is then used to prick the patient’s skin. After 15 minutes, the site is inspected to check for any reactions (swelling). The reaction size is measured.
- Challenge testing: These tests involve introducing a suspected allergen such as a particular food or drug to the patient. Increasing amounts of an allergen are administered to the patient, often starting with injection under the skin and then orally, to see if an allergic reaction is provoked. If this occurs at any stage, the test is stopped. The test is performed by a consultant in complex selected cases, where other tests have not been able to confirm the diagnosis and the outcome is of clinical importance. Challenge testing can only be performed at centres such as Barts and The London Allergy Centre that have full medical observation facilities including resuscitation equipment with medical and nursing cover.
- Patch testing: All referrals for patch testing should be made to Barts and The London Skin Centre. In a few selected cases, we also undertake this test in our patients. This identifies allergens causing contact dermatitis (delayed allergic reaction on the skin). Strips already prepared with the allergens are placed on the patient’s skin. The normal site used is the back. The strips remain on the skin for 48 hours and read after 72 hours. The area is examined for evidence of hypersensitive reactions.
We offer the following treatments for children:
Adrenaline auto-injector pen training, food challenges and dietary exclusion advice are available with our children’s services. For more information about our Children’s Hospital, please click here.