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Your provider has recommended allergy puddle skin testing to help identify possible allergens (what you may have an allergic to).

These are specific instructions to prepare for puddle skin testing. Please call your provider ahead of time if you have questions regarding additional testing.


What is allergy puddle skin testing?

Your doctor has suggested you/your child have this test as part of the evaluation at National Jewish Health. Puddle skin tests are done to help identify if you/your child are allergic and what you are allergic to. Puddle testing is a non-commercial test. We make the puddle test from samples you bring us. These are often samples of fresh foods. They may also be samples of hair/dander from a family pet or medication.


How do you get ready for the test?

Please follow these directions when getting ready for this test. If this is not done correctly, we will need to cancel and reschedule the test.

Preparing the items to be tested for puddle skin testing

  • If you are going to be tested to fresh food, please bring the food prepared. Meats need to be cooked. Fruits and vegetables may be raw. If you requested testing to a cooked food (i.e. oatmeal), bring a small amount that is cooked.

  • Place a small amount of each food to be tested in a zip lock type baggie that is labeled with the name of the food (slices of fruit, a leaf of lettuce or two cashews). We will provide you with labels that have your name on them. If you don’t receive a label write your name on the zip lock baggie also.

  • If you are going to be tested to pet dander, brush the animal vigorously to get a sample of the hair and dander. Place the hair/dander in the zip lock type baggie that is labeled with the animal and the patient label or name.

  • Arrive for you appointment at least 30 minutes early if you have 10 or less items for puddle testing. Arrive at least 1 hour early if you have 11 or more items for puddle skin testing. We need the time to prepare the items for testing.



Check with your/your child's doctor before you stop the medicine. All antihistamines will affect the results of these tests and need to be stopped before the testing is completed. If the medicine is not stopped before the test we will not be able to get an accurate result.

  • Stop these antihistamines for the length of time listed before your appointment at National Jewish Health.

  • Stop these oral antihistamines for 5 days before your appointment:

    • Atarax®, Vistaril® (hydroxyzine)

    • Claritin® (Loratadine), Allegra® (fexofenadine) Clarinex® (desloratadine)

    • ChlorTrimeton®  (chlorpheniramine)

    • Dimetapp® (brompheniramine)

    • Phenergan® (promethazine)

    • Tavist®, Antihist®, Dayhist® (clemastine)

    • Xyzal (levocetirizine)

    • Zyrtec® (cetirizine)

    • Combination medicines: Actifed®, Aller-Chlor®, Bromfed®, Drixoral®, Dura-tab®, Novafed-A®, Ornade®, Poly-Histine-D®, Trinalin®

  • Stop this oral antihistamines for 3 days before your appointment:

    • Benadryl®  (diphenhydramine)

  • If you are taking an oral antihistamine that is not listed stop the medicine for 3-4 days before your appointment. If you are not sure if the medicine you are taking is an antihistamine, ask your doctor. Some over-the-counter cold and flu medications contain an antihistamine, so be sure to read labels carefully.

  • Stop this medicine the night before your appointment:

    • Accolate® (zafirlukast)

    • Singulair® (montelukast)

  • Local antihistamines (Examples: azelastine (nose), olopatadine (eye))

  • Stop these medicines the morning of your appointment:

    • Axid® (nizatidine)

    • Pepcid® (famotidine)

    • Tagamet® (cimetadine)

    • Zantac® (ranitidine)

    • Zyflo® (zileuton)

  • Some psychiatric medications, including tricyclic antidepressants, as well as some sleep aides (examples: Tylenol® PM, Advil® PM and Nyquil™) can also affect the results of your skin testing. Let your doctor know if you are on any antidepressants or sleep aides before your test, but do not stop them without consulting the prescribing doctor.

  • Continue to take all your other medicine as you usually do. Inhaled, nasal and oral glucocorticoids (steroids) will not interfere with the results of your skin testing

  • Do not apply lotions or creams to your back the day of your appointment.


What is done during the allergy puddle skin test?

When you have puddle skin test done, a small amount of each item you may be allergic to (allergen) is placed on the skin (usually your back). The skin is then pricked. If you are allergic to an allergen, you will get a bump and redness where the skin is pricked. After a short time, each skin test reaction is measured for swelling and redness. A large enough skin reaction is a positive skin test. This means an allergy may exist to the allergen placed at that site. Your doctor will compare your puddle skin test results with your history of symptoms to make recommendations for treatment.


How long will the test take?

Puddle skin testing often takes 30 to 40 minutes to complete. Remember to arrive early with the items to be tested so we can prepare them.


How do you get to your allergy puddle skin test?

If you are being seen at National Jewish Health:

Adults - On the day of your scheduled test, please check in with admissions, and they will direct you to the skin testing area.

Children – On the day of your scheduled test, report to the skin testing area in the Pediatric Clinic.

If you have questions please call 303.398.1355.