An allergist/immunologist is a medical doctor who specializes in treating and managing allergies, asthma, and other immune system disorders.
An allergist/immunologist treats conditions involving the immune system. Common conditions that affect the immune system include the following:
- Seasonal allergies — sometimes called allergic rhinitis — affect 1 in 6 adults in the United States.
- The National Institute of Allergy and Infectious Diseases state that 5% of children and 4% of adults in the U.S. have food allergies.
- The World Health Organization (WHO) estimate that about 235 million people live with asthma worldwide.
In this article, we discuss what allergist/immunologists do, the types of conditions that they treat, and how they differ from rheumatologists.
An allergist/immunologist is a medical doctor who specializes in diagnosing, treating, and managing health conditions that affect the immune system.
People with allergies often work with these healthcare professionals. Allergies occur when the immune system overreacts to a usually harmless substance, such as pet dander, insect stings, or specific proteins in food.
Allergist/immunologists may help treat the following immune-related conditions:
- Allergic rhinitis is an allergic reaction that causes inflammation in the nose and airways.
- Allergic conjunctivitis causes inflammation around the eyes when the person comes into contact with an allergen.
- Anaphylaxis refers to a severe, life threatening allergic reaction that can make breathing difficult or impossible and may cause low blood pressure and vomiting. Injectable epinephrine can help minimize these symptoms, but the person will require immediate medical attention.
- Asthma is a chronic condition that causes inflammation and excess mucus production in the airways, which can make breathing difficult. Other asthma symptoms include wheezing, coughing, and chest tightness.
- Atopic dermatitis is a type of eczema that causes a red, itchy skin rash. It occurs most frequently in individuals who have underlying allergies. In some cases, certain environmental or food triggers may aggravate it.
- Urticaria, or hives, refers to red, itchy welts that develop on areas of the skin following exposure to a food or medication allergen. The welts may also develop after contact with an environmental allergen, such as animal dander, or even as part of an autoimmune-like reaction.
- Eosinophilic esophagitis occurs when a type of white blood cell called an eosinophil accumulates in the esophagus (food pipe), resulting in chronic inflammation and tissue damage.
- Primary immunodeficiency diseases that occur when different types of immune cells or proteins malfunction or are missing.
- Autoinflammatory syndromes, which cause spontaneous inflammation due to an overactive immune response.
Allergist/immunologists in the U.S. complete at least 9 years of graduate-level education and training before they start seeing patients.
Allergy/immunology is an internal medicine or pediatric subspecialty. Clinical allergist/immunologists treat people who have allergies or immunologic diseases. They usually work in private or state-run healthcare facilities.
Academic allergist/immunologists plan and conduct research studies in the field of allergy and immunology. Some academic allergist/immunologists also see patients in a clinical setting.
Allergist/immunologists can choose to focus on treating or researching other medical subspecialties in addition to allergy and immunology. These can include:
- general or transplant surgery
- autoimmune diseases
- infectious diseases
- oncology (cancer)
Allergist/immunologists perform a wide range of tests and procedures to identify and treat immune conditions.
Clinical allergist/immunologists work with patients directly. During the initial visit, an allergist/immunologist will review the person’s medical history. They may ask questions regarding a person’s:
- current symptoms
- current medications
- previous treatments and their effects
- family medical history
- exposure to environmental toxins
After gathering enough background information, an allergist/immunologist might recommend one or more tests to help them diagnose the underlying immune condition. They may use:
- Patch tests, which can help identify specific substances that cause allergic skin reactions.
- Skin prick tests to identify specific immediate allergies to environmental and food triggers.
- Antibody tests to measure the levels of antibodies present in the blood. Allergist/immunologists use these tests when they diagnose immunodeficiency conditions and allergies.
- T cell tests, which measure the number of specialized immune cells, called T cells, in the blood. Allergist/Immunologists also use this test to evaluate a person’s T cell activity.
Once an allergist/immunologist diagnoses an underlying condition, they can plan the best course of action. Treatments for allergic and immune diseases vary and can include:
- antihistamines, topical corticosteroids, and over-the-counter decongestants for minor environmental allergies
- corticosteroid creams and ointments for allergic skin reactions
- epinephrine injections for severe systemic allergic reactions
- immunoglobulin replacement or stem cell transplantation for primary immunodeficiency diseases
- antibiotics to prevent recurring infections
Allergist/immunologists can also educate people about their condition and provide valuable lifestyle and dietary tips to help them manage their symptoms.
People currently receiving treatment for an allergic/immunological condition can expect to see their allergist/immunologist for regular follow-up appointments.
At a follow-up appointment, an allergist/immunologist may run additional tests to evaluate the person’s condition. They will also ask them about any new or worsening symptoms or side effects relating to the medication.
The exact education requirements for allergist/immunologists vary by country. Allergist/immunologists in the U.S. undergo the following education programs before beginning their practice:
- 4 year bachelor’s degree at a college or university
- 4 years at medical school
- 3 year residency in internal medicine or pediatrics
- 2 or 3 year fellowship in allergy and immunology
Most allergist/immunologists take an average of 9 years to complete their graduate education and specialized training. This training ends with the fellowship program, during which they will get experience in treating specific types of allergic and immune conditions.
As with allergy and immunology, rheumatology is a subspecialty within the fields of internal medicine and pediatrics.
Allergist/immunologists and rheumatologists both treat conditions that result from problems with the immune system.
However, allergist/immunologists treat systemic allergic conditions and immunodeficiency, whereas rheumatologists treat autoimmune diseases and other musculoskeletal diseases, such as arthritis, fibromyalgia, and chronic pain.
People should contact an allergist/immunologist if they have an allergic reaction or experience frequent, recurring infections. Rheumatologists can help diagnose and treat people who have autoimmune diseases or chronic muscle or joint pain.
Allergist/immunologists diagnose, treat, and manage various immunologic conditions, including allergies, asthma, and immunodeficiency diseases. Many allergist/immunologists combine their clinical experience with academic research to discover how the immune system functions and test new treatments.
Allergist/immunologists are not the only medical doctors who treat immunologic diseases. Rheumatologists treat and manage musculoskeletal symptoms that result from inflammatory and autoimmune diseases.