Patch Testing Dermatologist2025-03-14T17:43:18+00:00

Feel in charge of your skin

PERSONALISED DERMATOLOGY TREATMENT PLANS

Patch testing is a specialised skin test used to determine whether you are allergic to a specific substance

FINDINGS FROM A PATCH TEST CAN HELP ME ADVISE YOU ON PARTICULAR ALLERGENS TO AVOID

What is patch testing?

Patch testing is a complex specialist investigation used to determine whether you are suffering from an allergy caused by skin contact to a specific substance. A common example is cosmetics or fragrances resulting in facial or hand eczema. Once a contact allergy which is directly relevant to your symptoms is confirmed, avoidance of the allergen can result in dramatic improvement in your skin condition.

What happens during patch testing?

Based on your history of reactions, you will be tested to a variety of possible allergens. A nurse will place a small amount of each substance in a small chamber, held in place with hypoallergenic tape, on your back. They should remain in place until you are seen two days later, when any initial reactions will be noted. You will be seen again two days after that, when a final “reading” of your back will be undertaken and any reactions will be noted.

patch testing dermatologist berkshire

In what circumstances is patch testing appropriate?

Patch testing may be appropriate if you have new onset eczema, persistent eczema despite appropriate treatments, or a rash that we suspect is allergic in nature.

What if patch testing is negative?

A wholly negative test is also extremely beneficial. In this case, you do not have to worry about avoiding anything specific. It can help guide how we manage your eczema.

patch testing dermatologist berkshire
patch testing dermatologist berkshire

How do you get started?

I will first conduct a consultation with you. Based on your history, and if I suspect that an allergy could be relevant to your skin rash, I may recommend a referral for patch testing. This normally consists of three visits, testing you to a minimum of 50 substances and sometimes upwards of 100. By your third visit, you should have an answer to whether an allergy is contributing to your skin problem. 

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I’ll see you and examine your skin before I recommend treatment. In some cases, I can begin treating your condition on the same day.

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More information about the treatment

FOR THOSE WHO WANT THE DETAILS

Patch testing is a specialised skin test a Dermatologist performs to determine whether you are suffering from an allergy caused by skin contact to a specific substance.

Patch testing is indicated for cases of persistent eczema, even when there is a diagnosis of lifelong eczema, to ensure that there is no superimposed contact allergy.

New cases of sudden onset eczema, especially when present on the face, hands or other sides, can be another indication for this test.

In some cases, you may suspect a contact allergy through occupational exposure. It is, therefore, quite important to either confirm this or rule it out.

If I find that you have a contact allergy, then I can advise you on how avoiding the particular allergen can improve or resolve the skin condition that I believe to relate to your problem.

  • Eczema-like rashes that can result from contact allergy
  • Exacerbations of pre-existing eczema due to an acquired contact allergy
  • Rashes suspected to be allergic in nature by yourself or your GP due to the particular distribution or persistence, despite treatment
  • Rashes that you or your GP suspect may be caused through work

On the first visit, I will conduct a consultation with you. I will further take a thorough history including:

  • The onset and duration of your symptoms
  • The pattern of improvement and worsening of your condition
  • Attempting to identify your contact with any potential allergens at work or through hobbies
  • History of any reactions to previous personal products

Based on your history, I may recommend a referral for patch testing. Testing can involve a minimum of 50 substances and sometimes upwards of 100.

A nurse will place a small amount of each substance in a small chamber held in place with hypoallergenic tape. These substances are usually placed on your back. You will be encouraged to bring your personal products with you as a small sample may be needed for testing.

The patches should remain in place until your next appointment two days later. The patches will be removed and any initial reactions will be noted. The ink mark or tape will stay in place for a further two days. Sometimes, further patches may be added, and a test known as skin prick testing may be undertaken on the same day.

You will then be seen two days later when a final “reading” of your back will be undertaken, and any reactions noted. Positive reactions can be red and itchy, but this can also occur due to irritation.

Patch testing is a complex specialist investigation. If we confirm a contact allergy and think it is relevant to your symptoms, avoiding a specific allergen can result in dramatic improvement.

A wholly negative test is also extremely beneficial. In this case, you do not have to worry about avoiding anything specific. It can help guide how we manage your eczema.

Investigations consist of three visits. It is normally not recommended that you have patch testing if you are pregnant, breastfeeding, have a suntan or are on strong immunosuppressive medication.

If you have extensive eczema on your back, I may need to defer the test to a later date.

Side effects of patch testing are uncommon but include

  • Itching and/or irritation
  • Flare up of your skin problem brought on by positive reactions during the test

Extremely rare reactions:

  • Sensitisation and new allergy
  • Infection
  • Pigmentation change
  • Scarring

Do I need to avoid anything specific during the week I am having patch testing?

You should avoid getting your back wet as this can affect the tests applied. That may mean that you should avoid showering or swimming, though a shallow bath is not a problem.

It is best you avoid sports or heavy physical activity to prevent sweat and excessive movement from dislodging the patches on your back.

Are there any contraindications to patch testing?

I generally avoid using patch testing if you are pregnant. We may need to defer testing to a later date during severe flare-ups of eczema, especially if they involve the back, and in patients with a suntan. Immunosuppressive medication and high doses of oral steroids can result in false negative results.

What if my tests are negative, have I wasted my time?

On the contrary, a negative test can be beneficial as we will then know that there is nothing you should avoid and we can focus on treating your problem differently.

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About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.

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