What Is an Allergist?

These doctors treat food allergies, hay fever, asthma, and more

In This Article

If your seasonal allergies are mild enough that you only occasionally use an over-the-counter antihistamine, you know that some allergies may not need treatment or can be handled by your primary care physician. But sometimes allergies can interfere with your day-to-day routine, decrease the quality of your life, or even become life-threatening. In that case, you may be advised to see an allergist, a physician who's specially trained to diagnose, treat, and manage allergies, asthma, and immunologic disorders like immune deficiencies. These conditions range from the common (such as hay fever) to the rare (like angioedema, which causes swelling under the skin), span all ages, and encompass various organ systems.


Allergists often treat the following conditions:

Allergies to food, medication, and animals

Allergists can't always "suss out why" a patient is having a reaction, but they can help diagnose a complaint and offer treatment and or avoidance recommendations.

Hay fever

Also known as allergic rhinitis, hay fever is an allergy that causes sneezing, runny nose, and red, watery, and itchy eyes, often in response to pollen.

Hay fever is one of the most common chronic diseases. In 2018, 7.7 percent of adults and 7.2 percent of children and teens were diagnosed with hay fever in the U.S.


A chronic lung disease that inflames and narrows the airways, asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and/or coughing. Some patients present with only one of these symptoms or even none at all. The exact cause of asthma is unknown, but it's thought that many factors—including allergies—increase the risk of asthma. In fact, allergies and asthma often occur together.


Eczema is the name for a group of conditions that cause the skin to become red, itchy, inflamed, and sometimes blistering and weeping. Atopic dermatitis is a form of eczema that usually develops in early childhood.


Hives (aka urticaria) are red, itchy welts. The welts vary in size and appear and fade repeatedly as the reaction runs its course. Chronic idiopathic urticaria (also referred to as chronic spontaneous urticaria) is a common type of urticaria seen in allergy clinics that is caused by internal factors and is not a reaction to any substance that the skin is exposed to.

Chronic sinusitis

Sinusitis (aka rhinosinusitis) is a common condition in which the sinuses, the passages behind your cheeks and forehead, become inflamed. When, despite treatment attempts, sinusitis hangs around for at least 12 weeks, it's considered chronic. Acute sinusitis usually resolves within three weeks.


Anaphylaxis is a rare, sudden, and severe immune response to an allergen, most commonly a medication, food, or insect sting. While allergies cause local symptoms like itching, a runny nose, or a rash, usually anaphylaxis affects many parts of the body at the same time.

Procedural Expertise

There's a lot of overlap between how an allergist will treat allergies and asthma. Good treatment for both is based on your medical history, the results of your tests, and the severity of your symptoms. It can include three treatment types: avoiding allergens, medication, and/or immunotherapy. Here's a rundown what your visit to an allergist might include:

Allergy testing. The allergist will usually perform tests to determine what allergens are involved. Allergen skin tests, the most common type of testing, is relatively painless. It involves putting very small amounts of certain allergens into your skin via a small indentation or "prick" on the surface of your skin. The worst part of the procedure is usually the itching caused by a reaction to an allergen.

Spirometry. This is a common office test used to assess how well your lungs work. Spirometry, which employs a small instrument (spirometer) that measures that amount of air you can breathe in and out, is used to diagnose asthma and other conditions that affect breathing.

Prevention education. The most effective approach to treating asthma or allergies is to avoid the factors that trigger the condition in the first place. Even when it's not possible to completely avoid allergens, an allergist can help you decrease exposure to allergens.

Medication. There are many prescription and OTC medicines to relieve allergy and asthma symptoms and an allergist can help you figure out which are most appropriate for you. They include steroid nasal sprays to reduce swelling so you can breathe easier, antihistamines to block histamine, the chemical that triggers allergies, mast cell stabilizers to prevent your body from releasing histamine, oral corticosteroids, and epinephrine to give during life-threatening anaphylaxis. People with asthma may be prescribed an inhaler, a portable device that contains steroids to treat inflammation and/or a bronchodilator to open your airways.

Immunotherapy. This is a treatment that trains your body to become less allergic to specific allergens. By giving gradually increasing doses of the allergen, it causes the immune system to become less sensitive to the substance. Immunotherapy can be given as a series of allergy shots or by putting drops of allergen extracts under the tongue (sublingual immunotherapy).

Compared to allergy medicines, which act to simply “cover up” symptoms, immunotherapy is the only treatment that changes the immune response.

Training and Certification

After earning a medical degree, an allergist completes a three-year residency in either internal medicine or pediatrics and passes the exam of either the American Board of Internal Medicine (ABIM) or the American Board of Pediatrics (ABP).
Internists and pediatricians interested in becoming allergists have two or more years of additional study, called a fellowship, in an allergy/immunology training program. Fellows are boarded to see both adults and children regardless of whether they initially trained in internal medicine or pediatrics.

To be a board-certified (or board-eligible) allergist, a physician has undergone specialized training in the field of allergy and immunology in a program recognized by the American Board of Allergy and Immunology (ABAI), the medical specialty board responsible for setting, maintaining, and verifying the education requirements of allergists working in the United States. Allergists listed as ABAI-certified have successfully passed the certifying examination of the ABAI.

To maintain their certification, allergists must meet additional requirements. These requirements include completing 25 continuing medical education credits every year and completing a "recent advances and practice assessment module" every five years. This demonstrates the allergist is up to date when it comes to current medical thinking.

Appointment Tips

If your primary care doctor refers you to an allergist, you'll probably see one your doctor is familiar with. Otherwise, you can find an allergist through one of the two national professional organizations for allergists in the United States: The American Academy of Allergy, Asthma, and Immunology (AAAAI) or the American College of Allergy, Asthma and Immunology (ACAAI).

Once you've identified some prospects, it's important to make sure the one you choose is a good fit for you. Here are some questions to ask:

  1. What ages of patients do you see? While most allergists see adults and children, some only see one or the other groups of patients. It's important to know if your allergist will see children, and if so, does the doctor have a minimum patient age.
  2. What kinds of health insurance do you accept? Before seeing your allergist and having testing done, it’s always important to be sure that the doctor accepts your health insurance. It's ultimately your responsibility to ensure that the allergist is part of your insurance plan and that any testing to be done is covered by your insurance. If the allergist doesn’t contract with your insurance plan, you may be responsible for paying any part of your bill that your insurance doesn’t cover.
  3. What types of allergy testing do you perform? Formally trained allergists usually perform skin testing, although they may also perform blood testing as a way of testing for allergies. There are many types of “allergy tests” that non-traditional allergists may perform; these are considered to be unproven and unhelpful in the diagnosis of allergies. A clue that your allergist wants to perform an unproven test is when that test isn't covered by health insurance.
  4. Do you prescribe allergy shots or allergy drops? Most allergists do prescribe allergy shots and a growing number also prescribed allergy drops, but a good allergist should not prescribe either to every patient. Allergists can make money by prescribing allergy shots and therefore have an incentive to put patients on them. While allergy shots do provide a tremendous benefit for the treatment of allergic rhinitis, allergic conjunctivitis, and allergic asthma, allergy shots aren’t for everyone.
  5. Do you recommend allergy shots to be given in your office, or can I give them to myself at home? This question can be used as a test for your allergist and can even be posed to the allergist’s office staff over the phone before the appointment. Any allergist who would allow a person to receive allergy shots at home should be avoided. While allergy shots are generally safe, they aren’t 100 percent safe, and the AAAAI and ACAAI require waiting periods of up to 30 minutes in a physician’s office after receiving an allergy shot in order to monitor for potentially dangerous side effects.
  6. When is your office open for allergy shots? Since you'll be required to be in the allergist’s office at least weekly for the first few months of allergy shots, convenient office hours are helpful to achieve this requirement. Also, ask if the clinic gives allergy shots during the lunch hour.
  7. How quickly can I be seen if I’m sick? Some allergists are able to see you on the same day for a sick visit if needed. Other allergists don’t provide this service, but rather send you back to your regular doctor for sick visits. If you do see your allergist for a sick visit, make sure it has something to do with the initial reason why you saw the allergist in the first place.
  8. Do you use physician assistants (PAs) or nurse practitioners (NPs)? Many allergists use PAs and NPs to see follow-up and sick patients. While this is generally considered routine in today’s health care environment, you should know if you’re going to see someone other than the allergist for certain visits. You can always insist on seeing the allergist, but you may have to wait longer for appointments, and may not be able to get in for sick visits right away.
  9. Are you available after-hours and weekends by telephone for non-emergency issues? Many allergists offer on-call telephone services for after-hours allergy issues that may arise. However, many will charge for these services. Depending on your health insurance, these after-hours telephone calls to the allergist may not be covered, meaning that you're responsible for the costs.
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Article Sources
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  1. Centers for Disease Control and Prevention. Allergies and Hay Fever. Updated January 20, 2017.

  2. American Academy of Allergy Asthma & Immunology. Allergy shots (immunotherapy).

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