Allergy Testing in Lebanon: Pollen, Dust, Food & Asthma

Allergy clinics in Lebanon see seasonal peaks: olive pollen in spring, cypress in autumn-winter, dust-mite year-round, and a steady stream of food-allergy and drug-allergy referrals. Getting the right test for the right question matters.

Match the test to the symptom

• Skin-prick test (SPT). Gold standard for inhalant allergies (pollen, dust mite, mould, animal dander). Read at 15–20 minutes. Avoid antihistamines 5–7 days before.
• Specific IgE blood test. Useful when SPT cannot be done (eczema covering test sites, antihistamine cannot be stopped, anaphylaxis history).
• Component-resolved diagnostics. Distinguish, for example, true peanut allergy from cross-reactive pollen sensitization.
• Patch testing. For contact dermatitis (cosmetics, hair dye, metals).
• Drug provocation testing. Done only in equipped centres with emergency capability.

Common Lebanese inhalant culprits

• Olive pollen — April to June, especially in olive-growing areas.
• Cypress pollen — January to March, mountain regions especially.
• Parietaria (pellitory of the wall) — coastal, almost year-round.
• Dust mite (Dermatophagoides) — humid coast.
• Cockroach allergen — older urban buildings.

Treatment ladder

1. Avoidance and environmental control.
2. Second-generation oral antihistamines, intranasal steroids.
3. Asthma controllers if airways are involved.
4. Allergen immunotherapy (sublingual tablets or subcutaneous injections) — disease-modifying, typically 3–5 years.
5. Biologics (omalizumab, dupilumab) for severe asthma or chronic urticaria.

For food allergy

An oral food challenge in a controlled clinic is the only way to confirm or rule out a clinically relevant food allergy. Avoid eliminating foods from a child's diet based on IgE alone — the diagnostic specificity is low.