What Is Allergic Asthma?

Allergic asthma is a chronic (long-term) breathing condition in which your airways become inflamed and narrow in response to inhaling allergens like pet danderdust mitesand pollen. With allergic asthmaexposure to allergens triggers an overactive immune responseleading to symptoms of an "asthma attack" like coughingwheezingchest tightnessand dyspnea (shortness of breath). 

Allergic asthma is the most common form of asthmaaccounting for about 80% of childhood asthma and 50% of adult asthma cases. It's caused by a combination of genetic and environmental factors. Treatment helps manage symptomsand life modifications can reduce the frequency of asthma attacks.

Allergic Asthma Symptoms 

Allergic asthma symptoms can vary from person to personranging from mild to severe. Most people with allergic asthma experience respiratory (breathing-related) symptoms similar to symptoms of other asthma types. They also experience allergy symptoms.

Respiratory Symptoms 

Inhaling an allergen causes your airways to become inflamed and swollen. This can cause respiratory symptoms such as:

• Wheezing: Whistling sounds when you breathe 
• Coughing: A dry cough (without mucus) 
• Shortness of breath: Feeling like you can't take a deep breath or get enough air in your lungs
• Chest tightness: An uncomfortable sensation of chest pressuretightnessor discomfort

Allergy Symptoms 

People with allergic asthma also typically develop allergy symptoms after exposure to an allergen. These symptoms include:

• Runny or stuffy nose with clear mucus 
• Sneezing
• Redwatery eyes
• Itchiness around the eyesmouthor nose 

What Causes Allergic Asthma? 

With allergic asthmayour airways become overly sensitive to specific inhaled allergens like dust mitespollenor pet dander. These substances are usually harmlessbut if you have allergic asthmayour body sees them as a threat and triggers an overactive immune response.

Your immune system produces immunoglobulin E (IgE) antibodies to fight off the perceived threatwhich causes your body to release chemicals like histaminecytokinesand prostaglandins. These chemicals inflame your airways and lead to asthma symptoms like shortness of breath and wheezing.

Genetic and environmental factors play a role in the development of allergic asthma. 

Genetics 

Researchers have identified over 100 genes associated with an increased risk of developing allergic asthma. These genes influence various aspects of your immune system and lung functionincluding:

• Overactive immune response: Certain genes control your immune system's response to allergens. For exampleinterleukin-4 (IL-4) and interleukin-13 (IL-13) are substances called cytokines that play a role in airway inflammation. Variations in genes responsible for producing these cytokines can make you more susceptible to airway inflammation when you come into contact with allergens.
• Epithelial barrier dysfunction: The epithelial barrier in your airways protects your body from environmental threats like allergens and infectious microbes (e.g.bacteria). Mutations (variations) in genes that regulate how epithelial cells function can disrupt how the barrier functions. This makes it easier for allergens to enter your airways and cause inflammation. 
• Smooth muscle function: Variations in genes that help smooth muscle function in your airways can contribute to airway hyperresponsiveness. This means that your smooth muscles contract more quickly in response to environmental triggerswhich causes your airways to narrow.

Environmental Triggers

People with allergic asthma may develop symptoms in response to indoor or outdoor allergens. Common triggers for allergic asthma attacks or episodes include:

• Pollen from treesgrassesand weeds
• Pet dander 
• Mold
• Dust mites 
• Cockroaches (fecesbody partssaliva) 
  

Risk Factors

Allergic asthma can affect people of all ages. Certain factors can increase your riskincluding:

• Family history: Having a family member with allergies or asthma increases your risk of allergic asthma. 
• Early life exposures: Exposure to allergens and irritants in early childhoodsuch as secondhand smoke or dust mitesis associated with an increased risk of allergic asthma.
• Other allergic conditions: People with other allergic conditions are more likely to develop allergic asthma. This includes eczema (a group of chronic skin conditions that can cause inflammationirritationand swelling of your skin) and allergic rhinitis (seasonal allergies).
• Socioeconomic factors: Lower socioeconomic status is associated with a higher risk of allergic asthma. Factors like living in a more rural areaincreased exposure to allergens and airway irritantsand limited access to healthcare may play a role.
  

How Is Allergic Asthma Diagnosed?  

Diagnosing allergic asthma involves a thorough medical history review and physical exam by a healthcare providersuch as your primary care provider or an allergist. An allergist is a doctor who specializes in diagnosing and treating allergiesasthmaand other conditions related to your immune system.

Your healthcare provider will ask about your symptomsincluding how often they occurhow severe they areand what triggers them. They will examine your eyesearsnosethroatand skin and listen to your lungs for signs of asthma-like wheezing. 

Diagnostic tests can help confirm an allergic asthma diagnosis by ruling out other possible causes of your symptoms. They include: 

• Spirometry: This is a lung function test that involves breathing into a mouthpiece connected to a machine (spirometer) to measure how much and how quickly you can forcibly exhale air from your lungs. 
• Indirect bronchoprovocation: Your healthcare provider exposes you to specific allergic asthma triggers (e.g.pollen) and observes how your airways react. This helps determine which allergens trigger symptoms. This form of bronchoprovocation isn't performed outside of research institutions.
• Direct bronchoprovocation: You inhale a specific concentration of a substance like methacholinewhich causes bronchospasm (airway tightening). At a certain concentration of methacholinethis can be diagnostic of asthma.
• Fractional exhaled nitric oxide (FeNO) test: This measures the amount of nitric oxide in your breath when you breathe into a handheld device. It measures airway inflammation. The FeNO test is more often used to diagnose eosinophilic asthma—asthma caused by overactive white blood cells in your lungs.
• Skin prick test: Your healthcare provider scratches a tiny amount of a possible allergen into the surface of your skin to see if an allergic reaction (e.g.rednessswellingbumps) develops in response to the substance.
• Blood tests: Immunoglobulin E (IgE) is a common blood test. IgE is an antibody produced by your immune system in response to an allergen. People with allergic asthma typically have a high level of IgE in their bloodstream.

Treatments for Allergic Asthma  

There is no cure for allergic asthmabut treatments can help manage symptoms. They can also keep your airways open to prevent future symptom flares (asthma attacks). Your healthcare provider will work with you to develop a personalized treatment plansometimes called an asthma action plan.

Medications

Many medications reduce allergic asthma symptoms. Your healthcare provider may prescribe:

• Quick-relief medications: Bronchodilator medicationssuch as short-acting inhaled beta2-agonists and anticholinergicswork quickly to relieve allergic asthma symptoms when they develop. These drugs relax and open your airways to make breathing easier. You breathe them in through an inhaler or nebulizer to quickly relieve symptoms when they develop. 
• Controller medicines: Daily medications can reduce inflammation and keep your airways open. Your healthcare provider may prescribe inhaled corticosteroids such as Flovent (fluticasone) or Pulmicort Flexhaler (budesonide). Oral anti-leukotriene medicines taken by mouthsuch as Singulair (montelukast sodium)can block the action of immune chemicals that cause inflammation. In a 2025 studyan Airsupra (albuterol/budesonide) inhaler significantly reduced the risk of severe asthma attacks in people with mild asthma by 47% compared to using an albuterol inhaler as needed.
• Biologics: Biologics are therapies that contain a living substance. Some biologics target specific cellsproteinsand pathways that inflame airways. For exampleXolair (omalizumab) blocks IgE antibodies that cause airway inflammation in people with allergic asthma. 
• Antihistamines: Antihistamines block histamine—the chemical that causes allergy symptoms like runny noseitchinessand watery eyes. They're available over-the-counter (OTC) and by prescription. Your healthcare provider may recommend using an antihistamine like Claritin (loratadine)Allegra (fexofenadine)or Zyrtec (cetirizine) when needed. They may recommend taking it daily to prevent allergy symptoms when your allergies are most severe (e.g.seasons with higher pollen levels).

Immunotherapy

Allergen immunotherapy helps build your tolerance to allergens. It reduces or eliminates your symptoms. Immunotherapy decreases your sensitivity and response to allergens like pollenanimal danderdust mitescockroachesand mold over time.

Most allergen immunotherapy treatments involve getting injectionsor allergy shotsregularly—for exampleonce a week to once a month. A course of immunotherapy is for 3-5 years total. The buildup phase typically lasts 3-6 months (weekly shots)until the target dose is reached. You'll then enter the maintenance phasewhich is shots every 2-4 weeks for a total of 3-5 years.

How To Prevent Allergic Asthma 

There is no guaranteed way to prevent allergic asthmabut you can reduce the risk of attacks. Your healthcare provider will discuss these strategies with you as part of your asthma action plan:

• Identify and avoid triggers: This is one of the most effective ways to prevent allergic asthma attacks. It may involve using allergy-proof bedding to reduce dust mite exposureinstalling air purifiers in your homeor checking local pollen forecasts and staying indoors during peak pollen times.
• Follow your treatment plan: Take your medications as prescribedeven when you are symptom-freeto help control inflammation and keep your airways open.
• Use a peak flow monitor: Blowing into a small device called a peak flow monitor can help detect narrowing in your airwayssometimes before symptoms develop. It works similarly to how a thermometer measures body temperature. Your healthcare provider will tell you what your readings mean to help identify when to take quick-relief medicinehow much to takeand when you should call your healthcare provider or go to an emergency room visit for immediate medical care. 

Related Conditions 

Having allergic asthma may increase your risk of developing various conditions. These include:

• Atopic dermatitis (eczema): This is a chronic inflammatory skin condition that causes itchyinflamed skin. It often develops before allergic asthma. The two conditions share many linksincluding allergen sensitivityimmune system dysfunctionraised IgE levelsand genetic factors.
• Sinusitis: Allergic asthma can cause acute (short-term) or chronic sinusitis. Sinusitis is inflammation of your sinuses—air-filled cavities near your noseeyescheeksand forehead. It leads to mucus build-up in your nasal passages and makes asthma symptoms worse.
• Gastroesophageal reflux disease (GERD): GERD is a condition in which stomach acid backs up into your esophagus (a muscular tube that helps move food and liquid from your throat to your stomach). It causes symptoms like heartburn. Asthma can trigger the development of GERD and vice versa. GERD can also worsen asthma symptoms such as cough and breathing difficulty. 
• Obesity: Obesity is associated with chronic inflammationwhich research suggests may cause airway inflammation and contribute to asthma. Excess body fat can reduce also the effectiveness of certain allergic asthma medications (e.g.corticosteroids) and increase the risk of severe symptoms.
  

Living With Allergic Asthma

Living with allergic asthma can be a frustrating and sometimes frightening experience. It's a chronic condition that requires ongoing managementbut it doesn't have to limit your quality of life. It's a controllable condition if you have an effective treatment plan. 

Well-controlled asthma allows you to engage in daily activitiessleep through the nightand exercise without symptoms or requiring quick-acting medication. In shortyou can live an active and fulfilling life by working closely with your healthcare provideractively managing your triggers and symptomsand following your treatment plan.

Talk to your healthcare provider if you think that your treatment plan isn't working as well as you'd like or if you notice a change in your symptoms.