Allergy FAQ: Dr. Stelzle

According to the Asthma and Allergy Foundation of America, allergies affect more than 50 million Americans each year. So, we talked to Dr. Robert Stelzle to answer a few questions about the country’s most common disease.

Robert Stelzle, MD, FACAAI
Allergy & Asthma of the Black Hills




What is an allergist?

An allergist is a physician who specializes in the diagnosis and treatment of allergic diseases.  Allergist are trained internists or pediatricians who go on to completes two or three more years of training in the field of allergy and immunology. Allergists are specially trained to identifying factors that trigger allergies and treat patients with allergic conditions.


What do allergists do?

Allergists manage many allergy related disorders including allergic rhinitis (hay fever), asthma, chronic hives, swelling disorders (angioedema), atopic dermatitis (eczema), allergic contact dermatitis, food and drug allergies, bee sting allergy, anaphylaxis, and several immune related disorders.


Does allergy testing hurt?

Allergy testing is safe and usually causes minimal pain.  Allergens are transferred to the back or forearm by small plastic picks that lightly scratch the skin. Within minutes, a small itchy red spot will form to the positive allergens. Once recorded, these allergens are wiped off and the reaction quickly resolves.


Why bother with allergy testing?

Allergy testing can help in identifying one’s major allergen triggers and allergen avoidance measures be tremendously helpful.  Allergy testing also helps in formulating allergy shots (immunotherapy), which can greatly benefit many allergy patients.


What allergens can be skin tested?

Airborne allergens cause the allergic rhinitis and the majority of asthma.  Pollens (from trees, grasses, and weeds) and outdoor molds predominate outside especially on dry windy days.  Animals and dust mite allergens cause indoor allergies that persist all year, even in the winter months.

Allergists also use skin test to help diagnose other types of allergies such as to foods, medications, and bee stings.


Are allergy shots FDA approved?

Yes.  Allergy shots are FDA approved. Therefore, they almost always covered by insurance.  The FDA has also recently approved three types of under-the-tongue allergens tablets (grass, ragweed, dust mite) as an alternative form of immunotherapy.  However, “allergy drops” are not FDA approved and therefore are often not covered by insurance.


How do allergy shots work? 

Positive skin testing helps identify which allergens are causing the patient’s symptoms.  These positive allergens are used to make custom allergen extract mixes for allergy shots.  Allergy shots are first given at very low doses, increasing slowly over several weeks until a 2-4 week maintenance booster level is reached.  In this way, allergic reactions are minimized and long term tolerance is often achieved.


Do allergy shots really work?

Allergy shots have been proven effective at reducing allergies in numerous studies.  They clearly help patients while they are receiving shots, but in contrast to medications, allergy shots have the potential to provide a long lasting vaccine-like benefit even after stopping shots.


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