|  | Conditions & Treatments | Allergies

Allergist/Immunologist: Role, Training, and Conditions Treated

An allergist/immunologist is a physician specialized in diagnosing, treating, and managing allergic diseases, asthma, and immune system disorders.

Scope of Practice

  • Allergic conditions: Allergic rhinitis (hay fever), conjunctivitis, sinusitis, food allergy, drug allergy, insect venom allergy, latex allergy, anaphylaxis.
  • Asthma: Allergic and non-allergic; severe or difficult-to-control asthma; biologic therapy management.
  • Immunodeficiency: Primary (genetic) and secondary (acquired) immune deficiencies; immunoglobulin replacement therapy.
  • Autoinflammatory and autoimmune disorders: e.g., hereditary angioedema, mast cell disorders.
  • Skin conditions: Atopic dermatitis (eczema), contact dermatitis, urticaria (hives), angioedema.

Diagnostic Tools

  • Skin prick testing (immediate hypersensitivity)
  • Intradermal testing
  • Patch testing (delayed/contact allergy)
  • Serum specific IgE (ImmunoCAP)
  • Pulmonary function tests (spirometry, FeNO, bronchoprovocation)
  • Immune workup: immunoglobulins, vaccine titers, lymphocyte subsets, complement, genetic panels.

Treatment Modalities

  • Allergen immunotherapy (AIT): Subcutaneous (SCIT—allergy shots) and sublingual (SLIT—tablets/drops) for environmental allergens and venom.
  • Biologics: Anti-IgE (omalizumab), anti-IL-5/5R (mepolizumab, benralizumab), anti-IL-4Rα (dupilumab), anti-TSLP (tezepelumab) for severe asthma, chronic rhinosinusitis with nasal polyps, atopic dermatitis.
  • Pharmacotherapy: Antihistamines, intranasal corticosteroids, leukotriene modifiers, bronchodilators, topical calcineurin inhibitors.
  • Food allergy management: Avoidance, emergency action plans, epinephrine autoinjectors, oral immunotherapy (OIT) in selected cases.
  • Immunoglobulin replacement: IVIG/SCIG for antibody deficiencies.

Training Pathway (U.S.)

  1. 4-year undergraduate degree
  2. 4-year medical school (MD/DO)
  3. 3-year residency: internal medicine or pediatrics
  4. 2–3 year fellowship in allergy/immunology (ACGME-accredited)
  5. Board certification: American Board of Allergy and Immunology (ABAI)

Collaborative Care

Allergists work with primary care, pulmonology, ENT, dermatology, rheumatology, gastroenterology, and infectious disease for comprehensive management.

See an allergist if you have: recurrent sinus infections, uncontrolled asthma, suspected food, drug, or insect allergy, recurrent anaphylaxis, immunodeficiency signs, or need immunotherapy.

Allergies - Related Articles