Can Asthma Be Cured? What You Need to Know
Is there a cure for asthma? Experts say not yetโbut treatment approaches are getting better and better. Here's what the experts want you to know.
What is asthma?
Asthma is a chronic respiratory condition where the airways are hypersensitive to certain irritants.
Asthma might not cause problems for everyone on a day-to-day basis, but exposure to a trigger can quickly worsen airway tighteningโand lead to symptoms like coughing, wheezing, and trouble breathing.
But someone could experience asthma symptoms most of the time if the underlying inflammation in the lungs is not well controlled, says Jennifer Monroy, MD, an allergist and immunologist at Barnes-Jewish Hospital in Saint Louis, Missouri.
What triggers asthma symptoms?
Well-managed asthma or not, certain triggers can make breathing difficult (and attacks more likely) for people with the condition. Those include:
- Pollution
- Strong smells
- Allergens like pet hair, mold, cockroaches, and dust mites
- Respiratory infections like colds, the flu, and sinus infections
- Exercise
- Stress
- Sudden changes in temperature
Are some people at greater risk for asthma?
About one in 13 Americans has asthma, according to the Asthma and Allergy Foundation of American (AAFA.) But experts still aren’t sure what causes the disease.
“There’s clear evidence that respiratory and viral infections early in life can drive the development of asthma,” says Mitchell Grayson, MD, chair of AAFA’s Medical Scientific Council and director of the division of allergy and immunology at The Ohio State University. “But there are also people who get asthma who that doesn’t apply to.”
Researchers have been able to identify some risk factors for asthma, however. For example, the American Lung Association (ALA) says having a family history makes you three to six times more likely to develop the disease.
The ALA says other potential risk factors for asthma include:
- Having allergies
- Occupational exposures, like industrial dusts or other irritants in the workplace
- Smoking, including exposure to secondhand smoke
- Obesity
There is also evidence that asthma disproportionately impacts communities of color and low-income communities.
For example, a recent study in Current Allergy and Asthma Reports shows how structural and socioeconomic barriersโfrom housing conditions to lack of treatment access and asthma educationโlead to much greater rates of uncontrolled asthma.
“One in 11 American kids has asthma,” says Katherine Bisset, BSN, RN, a school nurse in West Baltimore who acts as a project manager for BREATHE: Baltimore Realizing Equity in Asthma Treatment Health and Education. “[But] children of color suffer at rates of three times more than their white peers.”
Research from AAFA also shows that Black Americans are five times more likely to need emergency room care due to asthmaโand three times more likely to die from the disease.
Can asthma be cured?
The short answer is no. Because we don’t know why asthma exists in the first place, there’s currently no way to prevent or cure the disease (although it’s highly treatable).
But Dr. Grayson says it’s a question many researchers are working to unravel.
He explains that the overarching goal today is to understand how asthma develops. Only then can scientists start looking at ways to prevent it.
“What we do have are some excellent medicines that can control asthma,” he says.
Asthma medications
The bedrock of asthma treatment is a rescue inhaler. This device generally contains a drug called albuterol that quickly relieves asthma symptoms when they occur.
For many, daily controller medicationsโinhalers, oral meds, and injected drugs that deliver inflammation-dampening corticosteroids or other medicationsโhelp reduce or prevent the need for this rescue inhaler.
Dr. Grayson explains that these medications work to lessen the underlying airway inflammation in people with asthma.
“When you have less inflammation to start with, thanks to the controller medication, you’re less likely to end up with significant asthma exacerbation [in response to a trigger],” he says.
Does asthma ever go away on its own?
Asthma is a chronic condition, which means that in most cases, it requires ongoing management and care to keep symptoms from becoming life threatening.
But sometimes it can seem like someone “outgrows” their asthma. For example, Dr. Grayson says some children may have small airways that cause them to wheeze early in life, but then they breathe normally after they’re about 6 years old.
He explains that for other people, asthma simply becomes less of a burden as they get older.
“We don’t entirely know why,” he says. It might have something to do with how allergies, a common trigger for asthma symptoms, are sometimes less of an issue as people age.
Dr. Monroy says a simple rule is that if asthma symptoms are present, medications are still needed. And there is no definitive way to predict if or when you’ll need to take asthma medication throughout your lifetime.
Are there natural remedies for asthma?
There’s no medical cure for asthma, so there’s no natural remedy either. But there are some things doctors recommend to help manage triggers and reduce flare-ups.
Dr. Monroy says people with asthma can work to control their environmental triggers, for example. This includes strategies like:
- Avoiding strong scents and perfumes
- Controlling humidity in your home to decrease dust mite and mold populations
- Keep your body fat percentage in check to reduce inflammation
She says stress-relieving techniques like meditation and deep breathing can help manage asthma symptoms as well.
“Stress can worsen asthma by heightening the immune response to environmental triggers,” she says. “It lowers your threshold for developing an asthma attack with an exposure such as cigarette smoke or an allergen.”
Check out other MD-approved home remedies that may help manage asthma.
What is ‘well-controlled’ asthma?
Dr. Monroy says asthma is considered under control when a patient:
- Experiences symptoms less than two days per week
- Has no difficulty with normal activity
- Uses an albuterol rescue inhaler less than two days per month
- Awakens overnight with asthma symptoms less than two times per month
A personalized asthma action plan helps individuals reach this point of asthma management.
“Typically, asthma action plans have red, yellow, and green zones,” she says. These zones correlate with the present severity of someone’s symptomsโexacerbated, uncontrolled, and controlledโand clarify measures like medication use and when to seek emergency care.
What are the risks of uncontrolled asthma?
“People tend to think of asthma as just an annoyance,” Dr. Grayson says. “But people still die every day from asthma.”
According to AAFA, asthma attacks lead to more than 3,500 fatalities per year, most of which are preventable with proper treatment.
The risk of an asthma attack isn’t the only danger either. When inflammation in an asthma patient’s airways goes untreated, Dr. Grayson says, it can change the structure of the lungs over time. This decline in function and elasticity is called airway remodeling.
Lorene Alba, director of education for AAFA, adds that uncontrolled asthma can also diminish people’s quality of life. Its affect can vary from one person to the next but may include:
- Anxiety and panic that result from worrying about triggers and attacks
- Social isolation in an attempt to avoid triggers
- Sleep disturbances, which can lead to other health risks, fatigue, and poor moods
Uncontrolled asthma’s impact on kids
Bissett says that for kids, asthma isn’t only a health issue. It’s an academic one as well.
She explains that on average, the illness causes 36,000 kids to miss school every day. This absenteeism can trickle on to effects such as:
- Lower academic achievement
- Decreased college admissions
- Reduced job opportunities
Are we getting closer to a cure?
According to Dr. Grayson, there are many labs today trying to understand why asthma exists in the first place.
His research team, for example, is currently studying the role viral infections might play in the development of asthma and allergic diseases.
Once we understand the disease’s root cause and how it develops, he says, the goal is to develop studies to interveneโpotentially preventing asthma from occurring altogether.
But in the meantime, experts say, asthma treatments are getting smarter.
“The future of asthma treatment is bright,” Dr. Monroy says. While a cure for asthma remains elusive, scientists and doctors have made tremendous strides in better understanding and treating the disease.
Asthma biologics
Biologic drugs are one of these advancements. They are injectable therapies that alleviate asthma symptoms by preventing bodily processes that cause lung inflammation.
“We’re still in the process of trying to understand what patients respond to which biologic,” Dr. Grayson says. “Over the next five to 10 years, we’re going to see significant changes in how we approach the treatment of asthma in terms of these biologics.”
Inhaler improvements
Dr. Monroy says “smart inhalers” are also on the horizon. These will aim to help people manage medication regimens with alerts sent straight to their phones.
The drugs inside of an inhaler are getting more efficient too. Dr. Grayson says there’s a new protocol called single-maintenance and reliever therapy (SMART) that’s recommended by the U.S. National Institutes of Health.
Through this approach, people use a medication that has both short- and long-acting bronchodilator properties, a combination that allows for lower medication doses and more-flexible treatment protocols.
Advancements in access
Programs like BREATHE are working to improve access to asthma treatment as well.
For example, the program provides daily controller medication and personalized education to kids with asthma at school-based health care centers.
Bisset says that through this approachโcalled directly observed therapyโan average of seven in 10 asthma attacks have been prevented at her school.
She explains that expanding a program like this citywide in Baltimore would prevent around 1,000 trips to the ER each year and 25,000 missed school days per year.
“The challenge today isn’t just about seeking a cure for asthma,” Bisset says. “It’s [also] ensuring that people who have it gain access to the treatment they need for full and healthy lives.”
Next, learn how asthma and allergies are linked.
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- Jennifer Monroy, MD, allergist and immunologist at Barnes-Jewish Hospital in Saint Louis, Missouri
- Mitchell Grayson, MD, chair of the Asthma and Allergy Foundation of America's Medical Scientific Council and director of the division of allergy and immunology at The Ohio State University
- Katherine Bisset, BSN, RN, school nurse in West Baltimore and project manager for BREATHE: Baltimore Realizing Equity in Asthma Treatment Health and Education
- Lorene Alba, A-EC, director of education for the Asthma and Allergy Foundation of America
- Asthma and Allergy Foundation of America: "Asthma Facts and Figures"
- Asthma and Allergy Foundation of America: "Asthma Disparities in America"
- American Lung Association: "Asthma Risk Factors"
- Current Allergy and Asthma Reports: "Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019"