Asthma and allergy assessment
A specialist assessment of how allergies and asthma affect each other, using your history, breathing tests and selective allergy testing to find triggers and improve control.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- The assessment looks at how allergies trigger or worsen your asthma, using your history, breathing tests and targeted allergy testing.
- A positive allergy test only matters if it fits your symptoms — it does not by itself prove the cause of your asthma.
- Treating linked allergic rhinitis (hay fever) and reducing trigger exposure can improve asthma control.
- It does not cure asthma; good inhaler technique, a written action plan and review remain essential.
- Asthma treatment is built around a preventer inhaler containing a low dose of steroid (an inhaled corticosteroid); a blue reliever inhaler on its own is not adequate long-term control, and the right inhalers depend on your age.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
A clearer picture of which allergens trigger or worsen your asthma
Broad, untargeted allergy panels are the wrong approach and produce misleading positives.
Skin-test results are often available immediately, and you usually leave with an explanation, treatment changes and a written asthma action plan.
A written, personalised asthma action plan.
Skin-test results are often available immediately, and you usually leave with an explanation, treatment changes...
Any blood-test results return and the plan may be fine-tuned. You start any new or adjusted inhalers and avoidance...
You judge how your symptoms and reliever use respond. Peak-flow monitoring may be used to track control.
Asthma control, inhaler technique and the plan are reviewed; immunotherapy may be considered in selected cases...
What is an asthma and allergy assessment?
Asthma is a condition where the airways narrow and become inflamed, causing wheeze, cough, breathlessness and chest tightness. For many people, allergies are an important trigger, and hay fever or allergic rhinitis can make asthma harder to control. This assessment looks at how the two are linked in you.
The appointment usually combines a careful history, breathing tests to confirm and measure asthma, and selective allergy testing for airborne (aero)allergens such as house dust mite, pollens, pets and moulds. The aim is to identify which triggers matter for you and to improve your overall control.
Allergy testing here is targeted, not a fishing expedition. A positive test only matters if it fits your symptoms — many people test positive to things that do not actually trigger their asthma. The point is to guide avoidance and treatment, not to label every positive result as a problem.
This assessment does not 'cure' asthma. It helps you understand your triggers, get the right inhalers and treatment, and reduce flare-ups. Modern asthma care is built around a preventer inhaler that contains a low dose of steroid (an inhaled corticosteroid) to calm the underlying inflammation. Relying on a blue reliever inhaler on its own is no longer recommended as ongoing treatment, because it eases symptoms for a short time without treating the cause and is linked to poorer control. The exact inhalers, doses and devices differ by age, so use only the written plan your clinician gives you.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Clinical history and asthma control review
A structured look at your symptoms, triggers, flare-ups, current inhalers and how well controlled your asthma is, including any hay fever or eczema.
Breathing (lung function) tests
Tests such as spirometry and FeNO (a marker of airway inflammation), and sometimes peak-flow monitoring, to confirm asthma and measure how well your airways are working.
Aeroallergen skin-prick testing
Targeted skin testing for airborne triggers such as house dust mite, grass and tree pollens, cats, dogs and moulds, interpreted alongside your symptoms.
Specific IgE blood testing
Blood tests for the same airborne allergens, used when skin testing is not suitable, for example if you cannot stop antihistamines or have widespread skin disease.
Preparing for your test
- Keep a diary of your symptoms, flare-ups and what seems to trigger them, including seasons and environments.
- Note your current inhalers and how often you use a reliever inhaler, which reflects control.
- Ask whether antihistamines need to be stopped before skin testing, as they can affect the results.
- Avoid a heavy meal, vigorous exercise and smoking just before breathing tests, and follow any inhaler instructions you are given.
- Bring details of previous asthma attacks, hospital visits or steroid courses.
- Note any hay fever, eczema or food allergy, as these often travel with allergic asthma.
- Mention pets, damp or mould at home, and your work environment, which can all be relevant.
What happens
The specialist takes a detailed history of your breathing symptoms, triggers, current treatment and any allergies. They assess how well controlled your asthma is and check your inhaler technique.
Breathing tests, such as spirometry and FeNO, are often done to confirm asthma and measure airway inflammation. You may be asked to breathe into devices and, for some tests, before and after a reliever inhaler.
Targeted allergy testing — skin-prick tests and/or specific IgE blood tests for airborne allergens — is interpreted together with your symptoms. You usually leave with an explanation of your triggers, an optimised treatment plan, advice on reducing exposure, and a written asthma action plan.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Broad, untargeted allergy panels are the wrong approach and produce misleading positives.
- Allergy testing alone cannot diagnose asthma — breathing tests and history are needed.
- Skin testing may be unsuitable if you cannot stop antihistamines or have widespread skin disease.
- Unproven 'food intolerance' tests have no role in assessing asthma triggers.
Delay or rearrange if…
- You are having an asthma attack or your asthma is acutely unstable — seek urgent care first.
- You have a current chest infection, which can affect breathing-test results.
- You are taking antihistamines that would mask skin tests and cannot yet stop them.
- You have recently used certain inhalers that should be withheld before some breathing tests, as instructed.
Alternatives to discuss
- GP or asthma-nurse-led review, which manages many people well.
- Specific IgE blood testing instead of skin testing where skin tests are unsuitable.
- Trigger avoidance and treating rhinitis without extensive testing where the triggers are already clear.
- Allergen immunotherapy for selected single-allergen-driven cases.
- Watchful waiting with an action plan for mild, well-controlled asthma.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- A clearer picture of which allergens trigger or worsen your asthma
- Confirmation and measurement of asthma with objective breathing tests
- A chance to optimise inhalers, technique and your overall treatment
- Advice on practical trigger avoidance for the allergens that matter to you
- Treatment of linked allergic rhinitis, which can improve asthma control
- A written asthma action plan for staying well and handling flare-ups
Risks & complications
- Mild itchy bumps where skin testing is done, settling within hours
- Positive allergy tests to things that are not actually triggering your asthma, which can cause confusion
- Temporary cough or lightheadedness during some breathing tests
- A larger local skin-test reaction that settles with treatment
- Needing repeat or further tests if results and symptoms do not match
- Discovering poorly controlled asthma that needs a treatment step-up
- A more significant allergic reaction during skin testing — clinics are equipped to treat this
- A breathing test triggering significant wheeze, managed promptly in clinic
The main pitfall is over-interpreting positive allergy tests and chasing triggers that do not matter, sometimes leading to unnecessary avoidance or pet rehoming. Make sure results are tied to your actual symptoms. Tell the specialist about any recent attacks, frequent reliever use, or night-time symptoms, which suggest your asthma needs better control.
Published figures to discuss
Allergy tests measure sensitisation, not whether an allergen actually causes your symptoms, so false-positive interpretation is the main accuracy issue. Breathing tests can be normal between flare-ups because asthma varies over time. Results are read alongside your history rather than as a single yes/no.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Positive aeroallergen test without relevant symptoms | Common | Sensitisation is frequent in the population; only positives that fit your symptoms are clinically meaningful. | Guide sourcesClinical context |
| Systemic reaction to skin-prick testing | Rare | Clinics are equipped to treat reactions immediately, which is why testing is done in a suitable setting. | Guide sourcesClinical context |
| Poor asthma control increasing risk from food allergy or immunotherapy | Clinically important; uncontrolled asthma is a recognised risk factor for severe reactions | Spirometry, inhaler technique and preventer adherence should be reviewed before high-risk allergy plans. | NICE NG245 — Asthma: diagnosis, monitoring and management (BTS/NICE/SIGN)nice.org.ukSource-linked context |
| False reassurance from negative allergy tests | Possible, depending on trigger, timing and test quality | A convincing history may still need specialist review, repeat testing or supervised challenge. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from the appointment. 'Afterwards' is about acting on the plan — adjusting treatment, reducing relevant triggers, and reviewing control.
- Small itchy bumps from skin testing that fade within hours
- Taking a few weeks to feel the benefit of treatment or avoidance changes
- Needing to learn or relearn correct inhaler technique
- Symptoms that vary with seasons or exposure
Aftercare
- Use your inhalers as prescribed and check your technique with a clinician or pharmacist.
- Follow your written asthma action plan, including what to do if symptoms worsen.
- Reduce exposure to the specific triggers that matter to you, rather than all positives.
- Treat linked hay fever or allergic rhinitis, as this can improve asthma control.
- Monitor your reliever use — needing it often is a sign your asthma is not controlled.
- Keep follow-up appointments to review control and adjust treatment.
- Know the warning signs of an asthma attack and when to seek urgent help.
- Symptom and trigger diary started
- Inhaler technique checked
- Written asthma action plan obtained
- Relevant trigger-avoidance steps planned
- Hay fever or rhinitis treatment in place if needed
- Reliever-inhaler use being monitored
- Follow-up appointment booked
⚠ Get urgent help if…
- Your reliever inhaler is not helping, or you need it more than usual
- Getting breathless walking, talking or at rest
- Wheeze, cough or chest tightness keeping you awake at night
- Peak-flow readings dropping below your personal best
- A severe attack: struggling to breathe, lips turning blue, unable to speak in full sentences — call 999
- Symptoms not settling after following your action plan
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result is a clear understanding of which allergens matter for your asthma, confirmation of your diagnosis with breathing tests, and a treatment plan that improves control. For people with strong allergic triggers, targeted avoidance and treating linked rhinitis can make a real difference.
The assessment cannot cure asthma, and a positive allergy test does not on its own prove the cause of your symptoms. Normal breathing tests on one day do not always rule out asthma, because it varies over time, so results are interpreted alongside your history.
Asthma is usually a long-term condition that needs ongoing management, though it can vary over the years and sometimes improves. Allergy test results remain broadly useful but your triggers and control can change, so review is important. Any treatment plan, including inhalers and avoidance, may need adjusting as your symptoms and circumstances change.
Related tests, treatments or support
An asthma and allergy assessment is often combined with assessment of allergic rhinitis (hay fever) and eczema, which frequently occur together. Where a single allergen, such as house dust mite or grass pollen, is a major driver, allergen immunotherapy (desensitisation) may be discussed alongside standard treatment.
Follow-up & long-term care
You should leave with a written asthma action plan and have any blood results back within a couple of weeks. Asthma needs regular review of control and inhaler technique, at least yearly and after any attack. Ask who to contact if your control worsens before your next appointment.
- Continue inhalers as prescribed and review technique regularly
- Keep reducing exposure to your relevant triggers
- Treat seasonal hay fever before and during the season
- Monitor peak flow if advised, and act on falling readings
- Attend at least annual asthma review and after any attack
Repeat, follow-on and what comes next
- Tests may be repeated or extended if results and symptoms do not match.
- Asthma treatment is often stepped up or down over time based on control.
- Trigger lists and plans are revised as exposures and symptoms change.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A written, personalised asthma action plan.
- Confirmed correct inhaler technique and the right treatment step.
- Trigger advice tied to your actual symptoms, not just test positives.
- A named route to seek review if control worsens.
- Regular asthma review, at least yearly and after any attack.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Length and complexity of the consultation
- Which breathing tests are done, such as spirometry and FeNO
- Number and type of allergy tests (skin-prick versus blood tests)
- Whether a written asthma action plan is provided
- Follow-up appointments to review control
- Whether allergen immunotherapy is later recommended, which is a longer course
- The specialist's consultation fee
- Which breathing and allergy tests are included and the cost of extras
- Whether a written asthma action plan is provided
- Cost of follow-up appointments
- Whether inhaler prescriptions are included or charged separately
- What happens, and what it costs, if results are inconclusive
- Cancellation policy
On the NHS? Asthma is mainly managed on the NHS, with allergy assessment available when clinically indicated; private clinics may be used for speed or a combined appointment.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Treating any positive allergy test as proof of an asthma trigger.
- Advising drastic avoidance (such as rehoming a pet) on a test result alone.
- Not checking inhaler technique or asthma control as part of the assessment.
- Selling unproven tests as asthma 'trigger' panels.
- No written asthma action plan or safety-net advice for attacks.
Marketing red flags
- Clinics offering large 'allergy screens' as the key to asthma.
- Claims that allergy testing can cure or eliminate asthma.
- Promising that avoidance alone will replace inhalers.
- Selling IgG 'food intolerance' tests for breathing symptoms.
- Over-stating the benefit of immunotherapy for everyone.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Which of my allergic triggers actually matter for my asthma symptoms?
- Is my asthma well controlled, and is my inhaler technique correct?
- Should I change my inhalers or step treatment up or down?
- Would treating my hay fever improve my asthma control?
- Which avoidance measures are genuinely worth doing for me?
- Could allergen immunotherapy be appropriate in my case?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Does an allergy test show what is causing my asthma?
Will treating my hay fever help my asthma?
Do I have to get rid of my pet if I test positive?
Can I have this on the NHS?
What is FeNO testing?
Could immunotherapy help?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NICE NG245 — Asthma: diagnosis, monitoring and management (BTS/NICE/SIGN) NHS — Asthma BSACI — allergic rhinitis and asthma resources Allergy UK — diagnostic tests for healthcare professionals
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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