An immunologist, also called an allergist-immunologist, is a medical doctor specializing in allergies and other immune system disorders. Immunology is a subspecialty of internal medicine (care for adults) or pediatrics (care for infants through teens). 

Immunologists help diagnose, treat, and manage immune system conditions. Your primary healthcare provider might refer you to an immunologist if they suspect you have an allergy or other condition related to the immune system, such as asthma (a condition that inflames, swells, and narrows the airways, making breathing difficult).

This article will take a closer look at what an immunologist does, what specialties they may have, and what to expect from an appointment with an immunologist. 

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Concentrations 

Immunologists are trained to diagnose, treat, and manage conditions involving the immune system.

This includes:

  • Allergic reactions to drugs, food, insect stings or bites, or other things
  • Asthma and other respiratory conditions like sinusitis and allergic rhinitis (hay fever)
  • Eye conditions stemming from allergies
  • Skin conditions like eczema (a type of atopic dermatitis, a condition of red, itchy, inflamed skin), hives (itchy welts that form on the skin), and contact dermatitis (itchy rash that forms from direct contact with an allergen)
  • Immune-related digestive conditions such as eosinophilic esophagitis (allergic condition in which the food tube does not contract properly)
  • Autoimmune conditions (conditions in which the immune system attacks healthy cells by mistake)
  • Stem cell (bone marrow) transplantation or organ transplantion

Not all immunologists work directly with patients. Some work in a lab setting and do research to advance the study of immunology. They may work on vaccine development research or antirejection research for organ transplantation.

Procedural Expertise 

Immunologists diagnose, treat, and help manage conditions involving the immune system. 

Many clinical immunologists who work directly with people seeking care have their own medical practice and work out of an office. They may work with children or adults, depending on their background. For example, an immunologist with a pediatrics background will work with children, while an immunologist with an internal medicine background will work with adults. 

Often, your first interaction with an immunologist will be to help diagnose a condition your primary care provider suspects is an allergy- or immune-related condition. 

An immunologist can order tests to help diagnose allergies and other immune system conditions. These tests may include:

  • Antibody tests: These tests check the levels of antibodies in your blood. When your immune system detects a foreign invader, like a virus, it produces antibodies to help combat the invading pathogen. Sometimes, the immune system produces antibodies in response to specific food products or other allergens. The body may also produce antibodies because of autoimmune disorders, directing them against the body's own cells.
  • Patch tests: A patch test can help pinpoint the cause of skin-related allergic reactions. It involves putting a patch on the skin that contains potential allergens. After about two days, your doctor will examine the area to check for a reaction.
  • T-cell tests. This test measures the levels of T cells, specialized immune cells, in your blood. Your doctor will order this test to check your immune system's health.
  • Skin prick test. Immunologists may recommend this test to help identify potential food or environmental allergens like pollen or mold. A medical professional will scratch the allergen onto the skin of your back or forearm. If you experience symptoms like redness, swelling, or itching, it’s a sign you have an allergy to the particular substance. 

After making a diagnosis, your immunologist will be able to recommend treatment options for your condition. The treatment course will depend on your diagnosis but may involve:

  • Medications, oral or topical, depending on your condition
  • Lifestyle changes 
  • Dietary changes 
  • A prescription for an epinephrine injector, such as EpiPen, for severe allergic reactions 
  • Stem cell or immunoglobulin therapy 
  • Complementary therapies to manage symptoms 

Subspecialties

Immunology is a subspecialty of pediatrics or internal medicine, and some immunologists may choose to further specialize in the following:

  • Organ transplant surgery
  • Specific infectious diseases, like human immunodeficiency virus (HIV)
  • Cancer

Training and Certification

Immunologists are doctors who have gone through medical school. After medical school, residency training for internal medicine or pediatrics takes three to four years.

Before becoming a board-certified physician, they must be certified in internal medicine (American Board of Internal Medicine) or pediatrics (American Board of Pediatrics) and go through two years of training in allergy and immunology.

After a two-year fellowship in allergy and immunology, prospective immunologists need to pass the certification exam with the American Board of Allergy and Immunology.

Appointment Tips

You’ll likely need a referral to make an appointment with an immunologist. While your regular healthcare provider can treat mild allergies, you’ll want to see a specialist for moderate to severe allergies. 

Before your appointment, you may want to consider logging your symptoms. It can be tough to pinpoint the cause of an allergy. If you or your healthcare provider suspects an allergy is causing your symptoms, keeping track of potential triggers may help with your diagnosis.

While an immunologist can order tests to help diagnose allergies, logging your symptoms and situations that may have led up to them may speed up the diagnostic process. 

When making an appointment, you’ll likely be told whether to expect testing that day and whether you need to avoid eating or drinking beforehand. 

Summary

An immunologist or allergist-immunologist is a doctor who specializes in treating immune-related conditions, including allergies. Some immunologists work directly with people seeking care, while others work in a research setting. 

A Word From Verywell 

Diagnosing immune-related conditions (allergies included) can be an arduous process. Working with a qualified allergist-immunologist can help streamline the process. 

Don’t hesitate to ask about treatments and their side effects. Your allergist-immunologist should be able to walk you through the pros and cons of treatment options and provide you with information about what to expect throughout the treatment process. 

Need help finding a qualified immunologist in your area? Use the American Academy of Allergy, Asthma, and Immunology’s (AAAAI) Find an Allergist/Immunologist tool.  

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