TOPLINE:

The use of virtual reality (VR) during skin prick testing (SPT) significantly reduced procedural anxiety, fear, and pain in children while achieving 100% compliance compared with standard care. 

METHODOLOGY:

• Researchers conducted an interventional study involving 108 children (median age, 92 months; 67.6% boys) with suspected or confirmed allergies to environmental or food allergens, recruited from the Pediatric Allergy Clinic of the University of Naples Federico II in Naples, Italy.
• All participants were randomly assigned to either the VR intervention group or the standard-of-care group; after a 6-month washout period, they crossed over to the alternate intervention.
• The primary objective was to determine the effectiveness of VR in reducing procedural anxiety in children undergoing SPT; secondary outcomes were the analysis of pain, fear, and procedural compliance before, during, and 1 minute after the procedure.
• Anxiety, pain, and fear were measured with standard scales, and scores were reported as mean values on visual analog scales, whereas compliance was measured using a checklist score.

TAKEAWAY:

• Anxiety scores were significantly lower in the VR group than in the standard-of-care group before SPT (mean difference [MD], -1.5; 95% CI, -1.8 to -1.2) and during SPT (MD, -1.0; 95% CI, -1.3 to -0.7; P < .001 for both).
• Pain scores were significantly lower in the VR group than in the standard-of-care group during SPT (MD, -1.7; 95% CI, -2.0 to -1.5; P < .001) and 1 minute after it (MD, -0.2; 95% CI, -0.4 to -0.1; P = .004).
• The VR group had significantly lower fear scores than the standard-of-care group before SPT (MD, -0.8; 95% CI, -1.0 to -0.6) and during SPT (MD, -0.5; 95% CI, -0.7 to -0.3; P < .001 for both).
• Full compliance rate was 100% in the VR group vs 0% in the standard-of-care group (MD, 0.7; 95% CI, 0.5-1.0 vs 3.6; 95% CI, 3.4-3.9; P < .001).

IN PRACTICE:

“[Our study] findings support the integration of VR as a standard adjunctive tool in pediatric allergy diagnostics,” the authors wrote. “Broader implementation, alongside further research into long-term outcomes, economic impact, and personalization strategies, could transform pediatric procedural care by fostering a more cooperative, efficient, and child-friendly clinical environment,” they added.

SOURCE:

Rita Nocerino, with the University of Naples Federico II, was the corresponding author of the study, which was published online on November 1, 2025, in Pediatric Allergy and Immunology.

LIMITATIONS:

The single-center design and relatively small sample size may have limited the generalizability of the study. The open‑label design may have introduced reporting bias, and novelty effects and varying levels of individual engagement with VR content may also have influenced the results.

DISCLOSURES:

One author reported receiving research grants from and serving as a speaker for various pharmaceutical and other companies as part of publicly funded research projects supported by the Italian Ministry of Health, Italian Ministry of Universities and Research, and EU.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.