Douglas sits down with Dr. Marc Serota, board certified in allergy/immunology, pediatrics, and dermatology, to discuss contact dermatitis trends and practical patch-testing strategies following his lecture.
In this video
Dr. Serota says the T.R.U.E. Test is "totally fine" for clinicians who aren't contact allergy specialists, as long as the patient is set up properly: "we're not patch testing you for everything in the world," just the common allergens that skin typically reacts to. He advises knowing who in your area does expanded testing so you have somewhere to refer, and counseling patients that a negative result doesn't rule out an allergy, while a positive result flags things to avoid.
On trends, he stresses that contact allergy "frequently is not mutually exclusive" — evaluate for irritant and non-allergic triggers at the same time, since identifying an allergen but missing the Purell hand sanitizer used 50 times a day won't repair the skin barrier. He also flags the iatrogenic rebound cycle from systemic steroids, where patients spiral through flare and remission. His favorite strategy is use testing: have patients bring in their own products, tape a bit under a tab during patch testing, and correlate the ingredients with what they're actually putting on their skin.
- The T.R.U.E. Test is a fine, practical option for non-specialists — just counsel patients that it's an abbreviated panel and know who does expanded testing for referrals.
- A negative patch test doesn't rule out allergy; a positive result gives actionable avoidance information.
- Contact allergy and irritant triggers often coexist — evaluate for both, or you won't repair the skin barrier.
- Watch for the iatrogenic rebound cycle: systemic steroids can drive repeated flare-and-remission.
- Do use testing — have patients bring their own products and apply them during patch testing to correlate results with real-world exposures.
