Home Allergy Tests vs. Doctor's Office Tests: Accuracy, Cost, and Testing Method

Fact checked by Nick Blackmer

Key Takeaways

• At-home allergy testing is available from many companies and typically relies on blood from a finger prick.

• Allergy tests look for increased levels of a protein called immunoglobulin E (IgE) in response to allergens.

• Allergy scratch tests offered in doctors’ offices are more sensitive and yield better results, but may be harder to get an appointment.
  

When the pollen count is through the roof and the mold spores are flying, it’s easy to surmise that allergies are the culprit behind your itchy eyes and runny nose. But finding out exactly what’s causing your seasonal or food-related distress can be a bit harder. With the growing popularity of at-home testing kits, there are more ways than ever to get to the bottom of your allergy mystery—but are they accurate?

All allergy tests are looking for the same thing—increased levels of immunoglobulin E (IgE) in response to an allergen. IgE is a protein created by mast cells when they come into contact with an allergen. When those cells react, the body responds with symptoms like itchiness, congestion or inflammation.

While both at home tests and in office tests aim to detect the same protein, they do so in different ways and with different levels of information available.

We asked two allergists to weigh in on at home testing kits versus getting tested in a doctor’s office. Neeta Odgen, MD, medical advisor for Curex, and Shuba Iyengar, MD, co-founder and chief medical officer of Allermi, weighed in on the pros and cons of in-person testing versus at-home test kits.

The verdict: At-home testing is a good starting place, but nothing is as accurate and sensitive as the testing provided in a physician’s office.

Some allergy tests look for another protein, immunoglobulin G (IgG). These tests are unable to properly diagnose true allergies and should be avoided, according to the American Academy of Allergy, Asthma, and Immunology.

At-Home Allergy Testing

Companies like Test My Allergy, Everlywell, and Nectar offer testing that’s accessible to anyone, although most tests stipulate that they should be used by people over 18. Tests can be ordered online and range in price from $60–$500, depending on the number of allergens that they test for. Many kits test for both environmental and food allergies.

The method is simple: A simple finger prick yields enough blood to place on a card that is then mailed to a lab for analysis. A few days or weeks later, users should receive results, generally via email or a patient portal, that tell what allergens they react to the most based on their immunoglobulin E (IgE) levels.

At-home tests are typically not covered by insurance, although they may be eligible for HSA/FSA spending. Many companies will also offer a superbill that patients can use to submit to their physicians for approval and reimbursement.

Are At-Home Tests Accurate?

Serum IgE tests are considered generally accurate, although without the added benefit of a full medical history, they may be more useful as a way to rule out allergens rather than positively identify them, according to a 2021 study.

At-home tests offer easy access and fairly expedient results, but they may only be a first step to getting treatment. Some tests offer access to virtual care with a physician who can prescribe medications to help deal with the symptoms. Others offer only data with little analysis.

Iyengar said that if a patient brought in test results from an at-home test, she would use that information as a starting point but would likely order further sensitive testing to pinpoint allergens more specifically.

For some patients, though, at-home serum IgE testing is ideal. Iyengar said that patients with extreme eczema may benefit, since a clear patch of skin for testing may be hard to come by. Patients who are taking allergy medication to deal with severe symptoms like hives are also good candidates, because the medications don’t interfere with serum tests. In-office scratch testing requires patients to be medication free for a certain period of time before testing.

Related: Best At-Home Allergy Tests

In-Office Scratch Testing

Scratch testing is the most common form of allergy testing, and the most reliable and specific, according to Ogden. This method is also available to anyone, but may be less accessible due to the availability of appointments.

“The scratch test is taking FDA-approved solutions, touching your skin slightly, and abrading it to assess for a reactive response that we call wheal and flare,” Ogden said. “The big difference is that in a doctor’s office, you get the results immediately. Within 15 minutes of the test, it’s being read and we can find out what you’re allergic to. A blood test takes longer.”

Allergy testing in a doctor’s office can range in price depending on your insurance, and sometimes appointments can be tough to come by. In some situations, it’s worth exploring a third option, known as concierge testing. In this situation, a testing company, such as Curex, will send a phlebotomist to your home if you’re in an eligible area. The phlebotomist will draw blood and have it tested using the same serum IgE testing. Once results are in, the patient will have a consultation with a provider about which treatment plan is right for them.

Related: The Difference Between Blood Tests and Skin Tests for Allergies

How Accurate Is Scratch Testing for Allergies?

Not only is scratch testing faster, Iyengar says that it reveals more information than mail-in blood tests.

“When we look at these tests, we look at two parameters. One is sensitivity and the other is specificity. And specificity is the ability for a test to be able to pick up on an allergy if you’re truly allergic to it,” Iyengar said. “Specificity is the ability of a test to be able to confidently say this person is not allergic to something. And when you look at the sensitivity of skin testing, it is much higher than the sensitivity of a blood test.”

Iyengar said that a thorough medical history can also add helpful context when it comes to diagnosing and prescribing the right medicines to help relieve allergies quickly. And a big plus for scratch tests: You’re already seeing an allergist, so a treatment plan can be formulated quickly.

What This Means For You

Allergy testing can be pricey, but finding your sensitivities can help you finally find relief. If you have access to an allergist, you will likely get fast, accurate results with the option to have medicine prescribed immediately. While this is the ideal situation, there are circumstances where a mail-in test makes more sense. Just make sure that whatever test you choose uses an accepted testing method and certified lab for the best results.