Asthma Flare-Ups

What Are Asthma Flare-Ups?

An asthma flare-up is when asthma symptoms get worse, making kids wheeze, cough, or be short of breath. An asthma flare-up can happen even when asthma is controlled.

Asthma flare-ups are also called asthma attacks or exacerbations.

What Happens in an Asthma Flare-Up?

Asthma is a disease of the breathing tubes that deliver air in and out of the lungs. When someone has asthma, these airways (also called bronchial tubes) might be slightly inflamed or swollen, even when the person seems to be breathing fine.

During a flare-up:

• The inflammation gets worse. Sticky mucus clogs the airways and their walls get more swollen.
• The muscles around the airways get tight, further narrowing them (this is called bronchoconstriction).

These problems leave very little room in the airways for air to flow through — think of a straw that's being pinched.

What Causes Asthma Flare-Ups?

People with asthma have airways that are overly sensitive to some things (called triggers). Being around triggers can bring on asthma symptoms.

The most common trigger in kids are viral respiratory infections, such as colds. Other common triggers include:

• viral infections (most common trigger in kids)
• tobacco smoke
• cold air
• exercise
• animal dander
• dust mites
• mold
• cockroaches

Many people with asthma also have allergies, which are another important flare-up trigger.

If not treated, a flare-up can last for several hours or even days. Quick-relief medicines (also called rescue medicines or fast-acting medicines) often stop the symptoms pretty quickly. A person should feel better once the flare-up ends, although this can take several days, especially if a viral infection was the trigger.

What Are the Signs of an Asthma Flare-Up?

Asthma flare-ups can vary in strength and length. They can happen without warning, causing sudden coughing, shortness of breath, and wheezing.

Flare-ups should be treated right away. So it's important to know their early warning signs, including:

• coughing
• throat clearing
• fast or irregular breathing
• being very tired
• trouble doing everyday activities
• restless sleep or coughing that prevents sleep
• mild chest tightness or wheezing
• shortness of breath

If the flare-up is severe, a kid might:

• struggle to breathe or have fast breathing even when sitting still
• be unable to speak more than a few words at a time without pausing
• have retractions (sucking in of muscles in the neck and chest) while breathing in

Because they can be life-threatening, flare-ups demand attention. Your child might need to take quick-relief medicine (which acts quickly to relieve symptoms), visit the doctor, or even go to the hospital.

Following the instructions in your child's asthma action plan can help you know what to do when a flare-up happens.

How Can Parents Help?

To help prevent flare-ups:

• Make sure your child always has quick-relief medicine and the spacer available.
• Teach your child how to avoid asthma triggers.
• Make sure your child takes the long-term control medicine (also called controller medicine or maintenance medicine) as the doctor directed. Even when your child feels well, it's important not to skip it.
• Make sure your child gets a yearly flu vaccine, and washes his or her hands well and often to avoiding germs that lead to colds and other illnesses.
• Work with the doctor on an effective asthma action plan.