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No, the scratch test shouldn't hurt. It feels sort of like when you run the corner of your finger nail down your arm. Usually they test you for the typical allergens such as pollen, molds, mildew, dust, dustmite, cat, dog etc. If you have a positive reaction, the skin where it was scratched will get red and sort of puffy. If there is no reaction, nothing will show up on the skin. I can't remember exactly since it was a long time ago that my son had this done, but they use a scale I believe. If it falls within a certain range, then it shows an allergy. (someone correct me if I'm wrong here)