Asthma Control in Adolescents
Teenagers are at higher risk of poor asthma control and asthma-related emergencies, for several reasons:
- Poor adherence to daily preventer medication
- Under-recognition of symptoms
- Lack of regular asthma reviews or follow-up
- Mental health challenges (anxiety, low mood)
- Vaping or smoking, which worsens asthma
- Lack of ownership or understanding of their condition
Asthma care in this age group must include support with self-management and transition to adult care.
Self-Management and Health Literacy
Teenagers benefit from education and empowerment to manage their asthma effectively. This includes:
- Understanding their asthma – including what it is, what triggers it, and how to manage it
- Using inhalers correctly – including the use of a spacer where appropriate
- Following a written Asthma Action Plan – personalised to them, regularly updated, and shared with their school or college
- Recognising worsening symptoms early
- Knowing when and how to seek help
Healthcare professionals should support young people to take increasing responsibility for their asthma, while still involving parents or carers as needed.
Triggers in Adolescents
In addition to typical asthma triggers like infections, allergens, and exercise, young people may also encounter:
- Vaping and smoking – which can worsen symptoms and increase risk of severe attacks
- Air pollution and urban commuting
- Perfumes or aerosols – in shared spaces like changing rooms or gyms
- Emotional stress – linked to school, exams, or relationships
- Menstrual cycles – asthma can worsen pre-menstrually in some young people assigned female at birth
Avoiding known triggers and reviewing symptom patterns regularly can help optimise asthma control.
School, Exams, and Sport
Asthma should not prevent young people from achieving academically or participating in sport. With appropriate care:
- Ensure the school/college has an up-to-date asthma plan
- Provide access to the reliever inhaler at all times
- Encourage safe participation in PE and sports (with pre-treatment if needed)
- Discuss exam support if asthma impacts performance (e.g. due to fatigue or frequent absence)
When to Review or Refer
All young people with asthma should have at least one asthma review each year, including:
- Symptom control and triggers
- Inhaler technique and medication adherence
- Action plan update
- Review of preventer dose or escalation if needed
Referral to a paediatric respiratory specialist may be needed if:
- Symptoms are not well controlled on regular treatment
- There are frequent hospital admissions or oral steroid courses
- There is uncertainty about diagnosis or possible severe asthma
- The young person is struggling with adherence or mental health issues impacting asthma care
When to Seek Urgent Help
Emergency care is needed if the young person:
- Struggles to speak in full sentences
- Has blue lips or nails
- Needs their reliever inhaler more often than every 3–4 hours
- Is using chest or abdominal muscles to breathe
- Shows signs of fatigue or confusion during an attack
Summary
Asthma in adolescents can be complex to manage due to developmental, social, and emotional changes – but it is also a key opportunity to build lifelong self-management skills. With personalised care, a structured transition plan, and regular reviews, most young people with asthma can thrive in school, sport, and beyond.
Located in London | Infants to young adults seen
Request a referral or book an appointment with Professor Gupta today.
