Asthma and Adolescents

Asthma is a chronic airway condition that can cause respiratory symptoms. Managing asthma in adolescents may be challenging due to hormonal changes, increased physical activity and shifting social dynamics. There is increasing exposure to allergens, irritants and stressors from school and social environments. It is especially important for adolescents to have the confidence to manage asthma independently, so they can continue to do all the activities - old and new - that they enjoy.

Why can adolescence be a challenging time for asthma?
●    Hormonal changes: Hormones may affect asthma control especially around puberty.
●    Increased physical activity: Many teens are involved in sports or other physical activities. Exercise is often a trigger for asthma flare-ups.
●    Social pressures: Some teens may feel embarrassed about using an inhaler in front of friends, which can lead to skipping doses or downplaying symptoms.
●    Learning self-management: This is the transition period where adolescents are expected to have more responsibility for their health. Understanding medication schedules and avoiding triggers are essential components of asthma management.

How to recognize an asthma episode?
While many adolescents may have developed asthma during childhood, some may experience their first symptoms during their teenage years. Asthma symptoms can also vary widely from person to person and even day to day. Common presentations include the following:
●    Shortness of breath: a feeling of not being able to get enough air
●    Wheezing: a high-pitched whistling sound when breathing
●    Coughing: coughs are often dry and may happen as coughing fits
●    Chest tightness: a feeling of something squeezing your chest

Managing asthma: Asthma Action Plan
Having a clear plan in place for both control and immediate relief of symptoms is essential. Physicians and other health care providers often follow a step-wise approach to managing asthma. It is important to speak with your doctor before making any modifications to the plan as it is designed to keep your asthma under control. Any abrupt discontinuation of medications may result in flare-ups.  

●    Daily medications: These include inhaled corticosteroids that help prevent asthma attacks by reducing inflammation in the lungs. Of note, inhaled corticosteroids are not the same as anabolic steroids and are much less of a dose compared with systemic corticosteroids (oral or intravenous medications). Hence, inhaled steroids have fewer long term side effects. Sometimes inhaled steroids are combined with other longer acting medications, referred to as long-acting bronchodilators, for more effective asthma control.
●    Biologics: Biologics for the management of severe asthma are used based on the underlying mechanism and other features of the condition. They target specific antibodies, molecules or cells involved in the development of asthma. These are medications that need to be taken regularly unless otherwise directed by your doctor.
●    Fast-acting medications: These fast-acting inhalers (such as albuterol) act quickly to relax the muscles around the airways, allowing you to breathe easier during an asthma attack. Fast-acting inhalers should always be carried with you. Speak to your doctor if there is an increase in frequency of fast-acting medication use as this may signal poor asthma control and the need for changes in the medication plan.
●    Symptom monitoring: Using a peak flow meter, a small device that measures how well air moves out of the lungs may more accurately measure asthma control.
●    What to do during an asthma attack: It is best to stay calm, use the fast-acting inhaler as recommended and follow the asthma action plan. Do not hesitate or delay in seeking help when necessary.

Make sure to talk to your board-certified allergist / immunologist regarding any potential new treatments, and do not change/stop the medications by yourself.

Managing asthma: lifestyle tips
●    Avoiding triggers: Knowing and avoiding triggers is essential. Consider reducing exposure to known allergens such as pollen or pet dander. Cigarette smoke, pollution and strong odors are other common triggers.
●    Exercising smartly: Staying active is important, but sometimes physical activity triggers asthma. Using a fast-acting inhaler prior to high intense activity may help. Warming up and cooling down slowly can also help prevent symptoms. It is best to inform the coach or teacher about the condition so they can guide the player/athlete towards the path to success in sports while also ensuring their safety.
●    Managing stress: School, social life, and extracurriculars can be stressful for adolescents, and stress can worsen asthma. Practicing relaxation techniques like deep breathing, mindfulness or yoga can improve overall well-being.
●    Learning warning signs: Paying attention to specific signs that signal an upcoming asthma attack, such as an increase in coughing or chest tightness, is helpful. Knowing early warning signs can help you take action before symptoms get severe.
●    Taking medications as prescribed: Adolescents may forget or avoid using their inhaler due to social pressures. Setting reminders on the phone, having sticky notes on spots they always come across in a day, pairing medication with another daily habit, like brushing the teeth, may help with consistency. Counselling may help adolescents understand that taking inhalers is a sign of taking responsibility for one’s own health and will reassure them, so they do not shy away from using inhalers in public places.
●    Talking to parents and doctors: Encouraging adolescents to talk to their parents and their health care team about any questions or concerns they may have regarding asthma management helps alleviate some of the doubts and social challenges. Parents can help by fostering open communication, encouraging self-management and providing reminders when needed.

Learn, plan and control!
While having asthma may require some adjustments, it doesn’t have to significantly restrict one’s life. With the right education and support, adolescents with asthma can gain confidence to lead a healthy and active life. By understanding their condition and following a personalized management plan, they can continue to pursue their goals, while taking care of their health.

Controlling asthma helps prevent asthma from controlling you!

The AAAAI's Find an Allergist / Immunologist service is a trusted resource to help you find a specialist close to home.

Find out more about asthma.

Additional Reads:
1.    https://pmc.ncbi.nlm.nih.gov/articles/PMC7529939/
2.    https://www.sciencedirect.com/science/article/abs/pii/S1526054213001073
3.    https://www.sciencedirect.com/science/article/abs/pii/S073839910400285X

12/18/2024