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Allergic rhinitis (also known as hay fever) causes nasal congestion and other symptoms that develop when the body’s immune system becomes sensitized and overreacts to airborne allergens. This condition affects 10% to 40% of people worldwide and 20% to 25% of Canadians.

There are two types of skin tests – skin-prick testing and intradermal testing – that are used to find out what substances (allergens) people are allergic to. Both tests involve inserting a drop of an allergen under the skin, either by scratching it or using a needle to inject the allergen between layers of the skin, to see if it creates a small rash-like reaction.

Each year in Ontario, about two million skin tests for allergic rhinitis are funded through the Ontario Health Insurance Plan. A patient may get many skin tests at the same time, since each test is for a different allergen.

Although these tests are common, there are questions about how accurate they are. The Ontario Ministry of Health and Long-Term Care asked Ontario Health to assess the accuracy and cost-effectiveness of skin tests for allergic rhinitis and to make a recommendation about whether they should continue to be publicly funded or not.

Based on the evidence, skin-prick testing is reasonably accurate in identifying patients with allergic rhinitis. Although the diagnosis of allergic rhinitis can often be made without skin testing, the tests are very useful in some patients.