Allergic Asthma

What is allergic asthma?

Allergic or allergy-induced asthma is a condition where your airways tighten when you breathe in an allergen. Most often, these allergens are in the air — like dust mites, pollen, animal dander or mold spores.

When you have allergies, your body creates a response to something it thinks is a threat — the allergen. Your immune system fires up all of its defenses to try and fight off this danger. Your immune system releases various chemicals that cause inflammation, or swelling, and squeezing of your airways upon exposure to an allergen.

How common is allergic asthma?

Allergic asthma is the most common type of asthma. In the United States, about 25 million people have asthma. Out of that group, approximately 60% have allergies.

What are the symptoms of allergic asthma?

If you have allergic asthma, you may have many of the same symptoms you’d experience with other types of asthma. These symptoms can include:

• Feeling short of breath.
• Coughing frequently, especially at night.
• Wheezing (a whistling noise during breathing).
• Experiencing chest tightness (feeling like something is pressing on your chest).

Allergen exposure can also trigger other symptoms, including:

• A stuffy nose.
• Nasal drainage
• Itchy or watery eyes.
• A rash or hives.

What does allergy-induced asthma feel like?

Allergy-induced asthma symptoms can range from mild respiratory symptoms to severe asthma attacks. During an asthma attack, your airways will tighten, making it difficult to breathe. You may also feel chest pressure, wheeze and cough. The symptoms of an allergic asthma attack are the same as an asthma attack caused by something else. The difference between the two is the cause of the asthma attack.

What allergens trigger allergic asthma?

Allergens can be all around you — in your indoor and outdoor environments. When you have allergic asthma, inhaling these allergens can set off (trigger) your symptoms. It’s important to know what can trigger your asthma so that you can manage your condition.

Possible allergens that can trigger allergic asthma include:

• Pets or animals: Allergies to pets or animals can come from their fur, pee, saliva or from pet dander, which are flakes of skin.
• Pollen: Pollen is a powdery substance from trees, grass, weeds and ragweed. Tree pollen and grass pollen are most abundant in the spring. Weeds and ragweed release their pollen in the fall.
• Mold: Molds are typically found in places that hold moisture (like basements). Outdoors, mold is found during warm or humid days, after mulching or after rainfall. Mold produces spores that get into the air and can trigger your asthma.
• Dust mites: Dust mites are microscopic organisms that feed on human skin. They live on soft surfaces of your home, including carpets, soft furniture, pillows and mattresses. Both the mites themselves and their feces are allergens.
• Cockroaches: You can find these pests in many homes and older buildings. The feces, saliva and other body parts of the cockroaches can trigger asthma.

Food allergies may trigger allergic asthma in some people. Food allergies are rarely the cause of allergic asthma alone.

Who is at risk for allergic asthma?

You’re more at risk of having allergy-induced asthma if you have allergies or a family history of allergies.

How serious is allergic asthma?

Allergy-induced asthma can be serious and cause complications. Some of the most common complications of allergic asthma include:

• Sleep disruptions.
• Missing school and work.
• Inability to exercise.
• Inability to take part in social activities that are outdoors or involve lots of walking.
• Higher rates of hospitalization and illness.

How is allergic asthma diagnosed?

Your healthcare provider will order tests to determine if you have allergic asthma. The two most common tests are spirometry and bronchoprovocation testing:

• Spirometry: This breathing test involves taking a deep breath in and then exhaling into a tube. This tube connects to a computer that’ll collect information about how well the air moves when you breathe in and out. Spirometry can also be done with a bronchodilator (e.g. inhaler medication). Bronchodilator tests look at how well your airways relax before and after taking an inhaler medication.
• Bronchoprovocation testing (methacholine): Methacholine testing is similar to spirometry testing, but in this case, your provider uses a medication called methacholine to see if your airways constrict or tighten after taking it.

If your provider determines you have asthma, they’ll recommend either a blood test or skin test to help determine if environmental allergens are potential triggers for your asthma.

During a skin test, a provider puts small drops of liquid containing various allergens on your skin. Then, they gently scratch your skin to allow allergens to enter the top layer. If you’re allergic to the substance, your skin will react by swelling or you may develop tiny, raised bumps.

In certain cases, a blood test can identify allergic triggers. Allergy blood tests can miss a small percentage of allergies compared to skin testing.

How do I manage allergic asthma?

Your healthcare provider will work with you to treat both your allergies and your asthma. Some treatments work for asthma, while others treat just allergies, and some treatments can help manage both conditions. Treatment can involve avoiding the allergen or making lifestyle changes, and medications.

Avoiding the allergen

Your provider will help you figure out what’s triggering your asthma and find ways to either avoid or manage these allergens. Often, these triggers are in your environment. Once you know what they are, you can manage your interactions with them. This might mean hiring someone to cut your grass if you know that pollen is a trigger for your asthma, or avoiding places with a lot of animals if dander is a trigger for you.

Depending on what triggers your asthma, other steps you can take include:

• Cleaning your house frequently. This could include frequent mopping and dusting and washing your bedding and pillows in hot water every week.
• Using dust and allergen-proof sheets and pillows on your bed.
• Keeping house and car windows closed during peak pollen season. You can also avoid being outside when pollen counts are highest or wear glasses, face masks or other protective equipment when outdoors.
• Using high-quality filters in your home air conditioning units or running an air purifier.
• Developing an action plan. It’s important to have a plan in place that helps you know when to take certain medications, what to do if the medications aren’t working and who to call in those situations. The plan should include what to do during an asthma attack.

Medical treatment

Medications for allergy-induced asthma may include:

• Leukotriene modifiers: This is the name for a group of medications that treat both allergies and asthma. Montelukast (Singulair®) is one of the most common leukotriene modifiers.
• Allergy shots: Also called immunotherapy, allergy shots can reduce how your immune system reacts to an allergen. It involves getting regular injections (shots) of the allergen to build up your tolerance over time.
• Rescue inhalers: These offer fast relief for asthma symptoms by opening up your airways so you can breathe better.
• Antihistamines: This type of medication reduces mild to moderate allergy symptoms like itching skin or watery eyes. Your provider may suggest taking an antihistamine as part of your treatment plan.
• Corticosteroids: Both oral and inhaled corticosteroids can help prevent allergy-induced asthma symptoms by reducing inflammation in your airways.
• Biologics: These are small proteins that your provider injects to help treat the underlying cause of asthma. This treatment is for moderate or severe allergic asthma.

Can allergic asthma be prevented?

While asthma itself can’t be prevented, you can reduce your risk of an allergic asthma attack by understanding and avoiding triggers and ensuring you’re using the best medical treatment to manage your asthma.

Will I have allergic asthma for my entire life?

There isn’t a cure for allergic asthma. However, symptoms can get better or worse depending on your environment and exposures.

When should I see my healthcare provider?

Contact your healthcare provider if you have asthma symptoms due to allergens so they can work on a treatment plan with you. Symptoms may include:

• Coughing or wheezing.
• Shortness of breath or breathing difficulties.
• Allergy symptoms like stuffy nose, itchy and watery eyes or skin rash.

When should I go to the ER?

If you’re having a severe asthma attack and either don’t have an inhaler or your symptoms aren’t improving after using it, go to the nearest emergency department or call 911 (or your local emergency service number). People experiencing an allergy can also go into anaphylaxis, which is a life-threatening allergic reaction.