Patch Testing Dermatologist2019-11-08T17:46:59+00:00

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Patch testing is a specialised skin test used to determine whether you 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 I will note any initial reactions. I will see you again two days after that, where I’ll take a final “reading” of your back and any noted reactions.

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.

How do you get started?

Investigations consist of three visits. On the first visit, I will conduct a consultation with you. Based on your history, and if we determine that an allergy could be relevant to your skin rash, I may recommend testing you to a minimum of 45 substances and sometimes upwards of 100. By your third visit, we should have an answer to whether an allergy is contributing to your skin problem. 

Treatment enables people of all ages take control of their skin condition and get their life back

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What my patients love about my service

MY PATIENTS ARE MY BEST PROMOTERS

Please pass on my thanks to Dr Pratsou for her assessment on my continued taking of roaccutane.

She was completely right, I didn’t need a new course, I needed to move away from the drug. The creams she gave me and Cetaphil recommendation have meant my skin has been the best it’s ever been (ongoing and since I saw her) ALL SUMMER :))))) I’ve had zero problems…and I’m loving it.

Thank you once again.


Phillip, Acne

“Dear Dr Pratsou,

Following the consultation today I feel it appropriate to say thank you for your help in dealing with my rosacea.

On each occasion, I have visited your department I have noticed the kindness and cheeriness of all the staff I have encountered and particularly wanted to say that you made me feel at ease with your calmness and excellent manner.

All is much appreciated.”


Anne, Rosacea

“Thank you very much!!

You three were (and are) a great team!

I will remember you.

You made me feel comfortable.”


Ellie

“Tania,

Please pass to Dr Pratsou my thanks for her skilled work.

The wound is healing beautifully and now the stitches are out it looks as though it will be almost invisible once fully healed.”


Graham, Skin cancer removal

“Dear Dr Penelope, Rena & the team, (I can’t remember the nurse’s name who helped me during my 2 procedures at the Spire!)

I wanted to thank you for your support and help during a very difficult time. You guys do a wonderful job – and we are eternally grateful for your help.”


Clarissa, Skin cancer

“I would like to put on record how impressed I was with the operation you performed for the removal of the SCC on my neck. I cannot even see where the cut or the stitches were! I am indeed very grateful for the excellent work you do.”


Harry, Squamous Cell Carcinoma

“Dear Dr Pratsou,

I am very grateful to you for your diagnosis, recommended treatment and advice. Your letter to my GP sets out both the course of events, and your own analysis of probable condition and possible cause, clearly summarising our discussion.

I hope there will be no recurrence but I will certainly come back to you if there is.”


Ryan, Skin rash

“Dear Tania,

Please pass on my thanks to Dr Pratsou. I saw her this morning for a mole check. She was so lovely and reassuring. Please also thank the two nurses who assisted her during the mole removal procedure. I was very nervous, but they were very efficient, which meant I did not have too long to think about it, but most of all they were very kind. They kept me distracted and calm, which made a huge difference. Thank you also for your efficiency in both booking me in so quickly.”


James, Mole removal
Dear Ms. Pratsou,

I am writing to thank you for the care you have given me in the past few months. From the moment I walked into your consulting room with a lesion on my cheek, a lesion that I fully expected to be some sort of skin cancer (and it was), you have been thorough, reassuring, respectful and in every way professional.

You recognised that I had some insight into the condition of my skin and the procedures required to treat me. You listened to me. You projected expertise and compassion.

During the procedure to remove the growth you ensured that the atmosphere in the treatment room remained not only calm, but actually pleasant. Had it not been that you were excising a growth and sewing me up, I almost felt as if you, me and the nurse were at some sort of women’s discussion group. The time flew by. I had zero anxieties about the procedure and as we both know now, the wound healed flawlessly.

Thank you for your expertise and your communication skills and all round good nature. I feel very lucky.


Karen Tatom, Skin cancer removal

We have replaced the images and names of real patients who provided these testimonials to protect their privacy.

The first step to feeling in charge of your skin is to book an initial consultation

FIND OUT HOW TO GET THE SKIN YOU WANT

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How it works

FEEL IN CHARGE OF YOUR SKIN IN 3 EASY STEPS

STEP 1 – CALL US
STEP 2 – LET’S MEET
STEP 3 – RESOLUTION
CONTACT MY STAFF

Give us a call on 441183735198 and we’ll help guide you towards a first appointment.

MEET WITH ME

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.

FEEL IN CHARGE OF YOUR SKIN

I’ll guide you down the road towards a resolution of your skin condition so that you can get back to normal life.

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

Investigations consist of three visits. 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 test a minimum of 45 substances and sometimes upwards of 100 on you.

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.

They should remain in place until your next appointment two days later. I then remove the chambers (with the substances within). The ink mark or tape will stay in place for a further two days. I will note any initial reactions on that occasion. I may add new substances to patches.  Sometimes, I undertake a test known as skin prick testing on the same day.

I will see you two days later where I’ll take a final “reading” of your back and any noted reactions. Positive reactions can be red and itchy, but this can also occur due to irritation. I will interpret it accordingly.

I encourage you to bring your personal products with you as I may need a small sample of these for testing.

Patch testing is a complex specialist investigation. If I 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. 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 test a minimum of 45 substances and sometimes upwards of 100 on you.

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.

They should remain in place until your next appointment two days later. I then remove the chambers (with the substances within). The ink mark or tape will stay in place for a further two days. I will note any initial reactions on that occasion. I may add new substances to patches.  Sometimes, I undertake a test known as skin prick testing on the same day.

I will see you two days later where I’ll take a final “reading” of your back and any noted reactions. Positive reactions can be red and itchy, but this can also occur due to irritation. I will interpret it accordingly.

I encourage you to bring your personal products with you as I may need a small sample of these for testing.

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 I apply. 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. I 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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