Allergic Asthma: Everything You Need to Know

An allergic reaction occurs when your immune system overreacts to the presence of a harmless substance called an allergen. Allergic asthma is when you develop breathing difficulties from inhaling allergens. It occurs when the airways swell as part of an allergic reaction.

Common allergens that can cause allergic asthma include:

• pollen
• mold
• dust mites
• pet dander (skin flakes)
• cockroach droppings
• rodents

You may notice that your allergy symptoms get worse during certain seasons due to increased pollen from trees, grasses, and weeds.

However, allergic asthma symptoms can occur year-round. This may be due to mold spores, which can grow indoors or outdoors on damp surfaces. Indoor dust mites feed on human skin cells and live in pillows, carpets, and other fabrics. And feces, saliva, dander, and other substances released by cockroaches, rodents, and pets can cause an allergic reaction in some people.

You might be surprised to learn that certain foods can cause an asthmatic reaction in a small number of people. Common food triggers include milk, shellfish, eggs, soy products, peanuts, gluten, tree nuts, and sesame seeds. Histamines and sulphites in alcohol products like beer and wine can also trigger asthma symptoms in some people.

Irritants such as air pollution, aerosol cleaning products, tobacco smoke, wood fires, and strong odors don’t cause an allergic reaction. But they may inflame your airways and make asthma symptoms worse.

An asthma attack that’s due to allergic asthma causes the same symptoms as other types of asthma. The difference is the trigger. Allergic asthma may also cause other symptoms that are linked to the allergy itself.

Symptoms of an asthma attack include:

• wheezing
• coughing
• chest tightness
• rapid breathing
• shortness of breath

If you have hay fever or skin allergies, you might also experience:

• itchy skin
• rash
• flaky skin
• runny nose
• itchy eyes
• watery eyes
• congestion

If you swallowed the allergen, these symptoms might be present as well:

• hives
• swollen face or tongue
• tingly mouth
• swollen mouth, throat, or lips
• anaphylaxis (severe allergic reaction)

A skin prick test is the common way to check for allergies. Your doctor will poke your skin with a needle containing a small amount of an allergen. After 15 minutes, they will check the area for redness or discoloration, swelling, and itching. You might also have a raised, round, red or discolored, hive-like bump known as a wheal. These are signs of an allergic reaction.

Additional lung function tests can determine whether you have asthma along with allergies. Lung function tests check whether your breathing improves after you use an asthma medication called a bronchodilator (if this medication improves your breathing, you probably have asthma).

Specific types of lung function tests include:

• Spirometry. This measures the amount of air you inhale and exhale and how fast you can exhale. You’ll blow into a mouthpiece connected to a device or computer that looks for narrowing in the bronchial tubes of your lungs.
• Peak flow. A simple test of lung function, you’ll breathe into a small handheld device that measures air pressure as you breathe out. The test can’t diagnose asthma, but it can be used in the lab or at home to keep track of your condition.
• FeNO test. Also known as exhaled nitric oxide testing. You’ll blow into a device that measures the amount of nitric oxide in your airways. Your lungs produce this gas when they become inflamed due to asthma.
• Provocation (trigger) test. This test tells doctors how sensitive your lungs are to certain triggers and is used to help confirm an asthma diagnosis. You may get it if you have asthma symptoms that can’t be diagnosed with other tests. Your doctor will ask you to you inhale a potential asthma allergen and then take a breathing test to measure your response.

Treating allergic asthma can involve treating the allergy, the asthma, or both.

Treatment options

To treat your asthma, your doctor may prescribe a number of medications. These may include one or a combination of the following:

• a fast-acting medication (such as short-acting beta agonists or anticholinergics), which treat asthma symptoms when they occur and may be the only medication needed if you have intermittent symptoms
• a control inhaler or nebulizer for daily usage (such as inhaled corticosteroids or long-acting beta agonists), which may be prescribed to prevent and manage mild but persistent asthma symptoms
• oral or injectable medications with anti-inflammatory effects (such as oral corticosteroids, leukotriene modifiers, or biologics), which are used to help prevent and manage more severe asthma symptoms and may also help manage allergy symptoms

Allergy treatment depends on the severity of your symptoms and may include:

• antihistamines, which can help treat classic allergy symptoms like itching
• allergy shots (immunotherapy), which help your body become less sensitive to certain allergens and may be necessary if your symptoms are more severe

How to manage allergic asthma

An essential step to managing allergic asthma is identifying and avoiding triggers when possible. You may need to remove the source of the allergen from your home or other environment.

You can also reduce allergic asthma symptoms by washing out your nasal passages regularly with saline solution using a Neti pot or squeeze bottle.

Allergic asthma can have serious complications. One complication is anaphylaxis. This type of severe allergic reaction may have symptoms such as:

• hives
• mouth or facial swelling
• difficulty swallowing
• anxiety
• confusion
• cough
• diarrhea
• fainting
• nasal congestion
• slurred speech

Untreated anaphylaxis can be life threatening. It may cause health concerns such as an abnormal heart rate, weakness, low blood pressure, cardiac arrest, and pulmonary arrest.

If you’re at risk of a serious allergic reaction, your doctor may prescribe an epinephrine self-injecting device (Epi pen). Carrying this medication with you at all times and using it within the first few minutes of the onset of allergy symptoms can prevent a life threatening allergic reaction.

Allergic asthma attacks aren’t always preventable. However, you may be able to make them less frequent by changing your environment.

The steps you take will depend on the allergen(s) causing your symptoms. They may include:

• washing bedding frequently in hot 130°F (54°C) water
• mopping instead of sweeping
• putting dust covers on pillows and mattresses
• removing rugs from rooms or using a vacuum with a HEPA filter
• keeping windows closed during allergy season
• avoiding being outside as much as possible when pollen counts are high
• changing clothes and showering after spending time outdoors
• keeping pets outdoors
• bathing your pet weekly to remove dander
• cleaning bathrooms, your kitchen, and the basement regularly
• keeping humidity in your home at between 30 to 50 percent
• emptying garbage frequently and avoiding leaving food out, to avoid attracting cockroaches
• setting roach traps

Will I have allergic asthma for my entire life?

There is currently no cure for allergic asthma. You can take steps to manage it with an asthma action plan recommended by your doctor. This usually includes avoiding or minimizing triggers and taking the medications prescribed to you.

Allergic asthma (allergy-induced asthma) is a chronic inflammatory condition where your airways tighten when you inhale an allergen. Exposure to allergens such as pollen, mold, dust mites, or pet dander causes the immune system to produce too much IgE. This causes the airways to swell. You may experience symptoms such as wheezing and shortness of breath.

Diagnosis may involve a skin prick test and lung function testing. Treatment of allergic asthma includes avoiding or limiting known environmental triggers and using medications to manage symptoms. Your doctor may also suggest immunotherapy to increase your tolerance to specific allergens.