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Does childhood asthma come back in adulthood?

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For parents of young children who struggle with asthma, the idea that they may outgrow it is a great relief. While it is true that some asthmatics become asymptomatic around puberty, it’s important to remember that a flare-up is always a risk. Anyone with a history of asthmatic reaction to illness or allergens will always need to be aware.

Monitoring History

A careful review can help to determine the chance of outgrowing asthma. As a general rule, asthma triggered by illness offers the best chance of fading as a child gets bigger, develops a larger lung capacity, and has a bit more space in their breathing passages.

Those who struggle with environmental allergies or seasonal allergies that trigger their asthmatic response are more likely to suffer from lifelong asthmatic reactions. However, managing environmental and seasonal allergies can lessen the risk of triggering a full-blown asthmatic flare-up.

Kathryn Edwards, MD, an allergist located in Princeton, NJ, outlines some useful therapies to reduce the risk of severe allergic response.

Determining the allergen source is critical to proper treatment to reduce allergic response severity and the possible trigger of asthmatic inflammation:

  • Seasonal allergies refer to a trigger in the outdoors, such as pollen
  • Environmental allergies refer to an indoor trigger, such as cigarette smoke, dust or a chemical

When you’re ready to start the process of allergy testing and management, be aware that determining your triggers will take time. Controlling environmental allergies may allow seasonal allergies that previously weren’t obvious to make themselves known. One successful round of allergy shots to calm down your immune system may lead to a flare-up in response to another trigger, which will need a different therapy.

Breathing Issues Become Chronic

While someone who suffered from childhood asthma may be able to avoid full-blown asthmatic reactions later in life, they are likely still at risk for breathing issues in adulthood.

Even for those who don’t suffer from seasonal or environmental allergies, the lung inflammation typical to asthmatics can become inflamed again. If you wheezed when you had a bad cold as a small child, you may start wheezing again or be at risk for pneumonia, with a virus in adulthood.

Additionally, a history of childhood asthmatic reactions to any trigger may need to be considered when choosing a career. If you struggled with childhood asthma, getting a job as a firefighter may still be possible, but you should take precautions and discuss preventative measures with your physician to manage a flare-up caused by smoke exposure.

Male vs. Female

Current research indicates that boys are more likely than girls to outgrow childhood asthma. This is because boys develop a larger chest cavity, particularly during puberty, and this extra room may mean that formerly crowded air passages become more open-air passages. The inflammation doesn’t necessarily decrease, but there’s more space, so there’s less risk of wheezing.

Girls tend to develop asthma after puberty, while boys tend to show signs before.

Skin Issues

There are multiple indicators for those who are unlikely to outgrow their asthma. One is a direct genetic link; if a parent had lifelong asthma, chances are that you will as well. Additionally, if you suffer from food allergies as well as wheezing not tied to an infection in childhood, you will likely deal with asthma as an adult.

The other factor is childhood eczema. The connection between eczema and asthma is, on the surface, simple. Both are inflammatory reactions. Currently, there’s a study of a genetic mutation pairing asthma and eczema.

Asthma and Hormones

As noted above, many boys are seen to outgrow their asthma as they experience the growth spurt around puberty. There are also studies underway to determine whether hormonal changes at this time contribute to girls developing adult asthma while undergoing puberty.

More boys than girls have childhood asthma; more women than men have adult asthma. Additionally, the older the child is when their childhood asthma, the greater their chance of outgrowing it, no matter what the trigger is.

Environmental Change

It’s critically important that environmental changes be considered when looking at asthmatic severity and the chance of outgrowing it. If you grew up in a house in the country where the ground was farmed, you lived with exposure to dust and multiple pollen. As you got older, you may have moved to the city to go to college or look for work, which may have changed your environmental exposure.

Did you outgrow your asthma, or just get rid of an allergy trigger that set your lungs up for an asthmatic reaction? This can also work in the reverse; if your asthma and allergies were under control while growing up in your parent’s house, you may have had a terrible asthmatic flare-up when you moved to the city due to pollution and increased ozone exposure.

You may also engage in different habits as an adolescent. If you spent part of every day with a parent, grandparent, or babysitter that used a particular cleaner or scent that irritated your breathing passages, aging out of needing a sitter may have changed your exposure and thus reduced your allergic response.

Remission, Not Cure

The key to maintaining good respiratory function in adulthood after a childhood impacted by asthma is to stay vigilant. A body that has had a wheezing response to illness or trigger can develop a wheezing response in the future.

If you’re undergoing treatment for allergies, or if you are on medications for them, don’t travel without them. Carefully review the weather conditions and pollen risks on days you plan to be outdoors, especially if you plan to exercise outside.

With these preparations in place, you can manage a flare-up and get help if you need it.

You can lessen the risk of an asthmatic reaction, reduce your health-related anxieties, and breathe freely again by properly assessing your symptoms with an expert. By lessening your allergic responses with the right treatments, you can reduce the risk of a frightening asthmatic crisis.

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