Wondering If You Have Allergies or Asthma? It Could Be Allergic Asthma

“Do I have allergies or asthma?” Many people ask this question when they have a stubborn cough, a stuffy or runny nose, or noisy breathing. It’s a good question to ask. Allergies and asthma are both very common. In the U.S., up to 30% of adults have allergies, and nearly 8% of adults have asthma.

While you might have either allergies or asthma, it’s also quite common to have both. There’s a specific kind of asthma known as allergic asthma. Knowing the basics about allergies and allergy-induced asthma attacks can help you identify what is causing your symptoms.

What is allergic asthma?

Allergic asthma is a chronic medical condition caused by inhaled allergens and inflammation in the small airways of your lungs. Inhaled allergens cause your immune system to overreact. As a result, the airways and lungs become inflamed and swollen. This can cause symptoms like coughing and difficulty breathing.

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Allergic asthma is linked to the same types of cells that cause allergies — Immunoglobulin E (IgE). When you breathe in something that you’re allergic to, it can set off reactions in the lungs that lead to an asthma attack. In both allergic asthma and allergies, IgE levels are very high.

Some common triggers that cause allergic asthma attacks include:

• Dust mites

• Pet dander

• Pollen

• Mold 

If you’re allergic to these triggers and have a history of asthma, they may cause an asthma attack.

What are the symptoms of allergic asthma?

Common symptoms of allergic asthma are the same as in other types of asthma. These include: 

• Difficulty breathing (shortness of breath)

• Wheezing

• Coughing 

• Tightness in the chest

Allergy symptoms may also be present in allergic asthma. These can include:

• Runny nose

• Red, itchy, or watery eyes

• Sneezing

Quiz: Could I have asthma?

What’s the difference between allergic asthma and nonallergic asthma?

Allergic asthma, or allergy-induced asthma, is the most common type of asthma. It tends to start in childhood, although you can also develop symptoms as an adult. In allergic asthma, the airways in the lungs are also overly sensitive to allergens like pollen or dust mites. These allergens can trigger asthma symptoms in allergic asthma. 

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These aren’t typical triggers for nonallergic asthma. Nonallergic asthma has triggers like:

• Respiratory infections

• Exercise

• Cold air

• Gastroesophageal reflux disease (GERD)

• Stress

• Hormonal changes

What are the treatments for allergic asthma?

The right treatment for allergic asthma depends on many things, including what type of symptoms you have and how severe they are. There are also steps you can take to prevent — or at least minimize — the symptoms.

The first step is identifying what allergens are triggering your asthma. This may require a test by your healthcare professional. Once you know your triggers, try to lower your exposure to them as much as possible. For example, this might mean staying indoors when the pollen count is very high. Or you can make sure that there is no mold growing in your home.

Many people will also need medications to treat their allergic asthma. 

Over-the-counter medications

Up to 90% of people with allergic asthma also have allergy symptoms like stuffy nose and sneezing. For these symptoms, there are several over-the-counter (OTC) medications that can help:

• Antihistamines: Azelastine nasal spray (Astepro) and cetirizine pills (Zyrtec) both block histamines, making your allergy symptoms less severe.

• Decongestants: Oxymetazoline nasal spray (Afrin) decreases inflammation in your nose.

• Nasal steroid sprays: Fluticasone (Flonase) also helps to lower inflammation.

Some of these medications are also available in combination. For instance, azelastine and fluticasone nasal sprays can be prescribed as a combined nasal spray azelastine / fluticasone (Dymista). 

Decongestants combined with antihistamines (like Allegra-D) are also available OTC. It’s important to note that decongestants aren’t the safest choice for everyone. If you have other medical problems, it’s best to ask your healthcare professional before starting them.

Prescription medications

There are also several prescription medications used to treat allergic asthma. Their use depends on how frequent and severe your symptoms are. Some medications work quickly to open the airways and make breathing easier during an asthma attack. Examples include: 

• Short-acting beta agonist (SABA) inhalers like albuterol (ProAir), which relax the airways so they can let more air into the lungs

• Oral steroids like prednisone, which quickly reduce inflammation in the lungs and airways

Many people require regular, long-term treatment to reduce inflammation in the airways and help keep them open. This helps prevent the start of an asthma attack. Examples include:

• Inhaled steroids like fluticasone propionate HFA (Flovent)

• Long-acting beta agonist (LABA) inhalers like Serevent

• Combination therapy like fluticasone / salmeterol (Advair), which combine two medications into one inhaler

• Leukotriene modifiers like montelukast (Singulair), which are medications that come in pills and help treat both allergies and asthma

People with severe allergic disease may benefit from treatment that helps lessen the immune system’s response to allergens. Examples include:

• Allergy shots: This form of immunotherapy regularly exposes your immune system to the allergen, gradually making it less reactive over time.

• Xolair: This medication works to block certain signals from your immune system and helps block allergic asthma symptoms. Similar options include medicines like Dupixent, Nucala, Fasenra, and Tezspire. 

It’s important to work with your healthcare professional to determine the best treatment plan for you.

Do allergies cause asthma?

There’s definitely a link between allergies and allergic asthma. People with nasal allergies are eight times more likely to develop allergic asthma than people without them. But it’s not clear if allergies cause allergic asthma. Around 30% of Americans have allergies that affect their nasal airways. Up to half of these people also have allergic asthma.

With that said, worse allergy symptoms can cause more breathing problems. This may be why controlling allergies can also help control allergic asthma. The upper airways in your nose are connected to the lower airways in your lungs. This is called the “one airway hypothesis,” which explains the ways allergy and breathing symptoms might be linked:

• Post-nasal drip can bother your throat and lead to more coughing. 

• A stuffy nose can force you to breathe through your mouth. This can be irritating to your lungs since your mouth can’t warm and humidify air like your nose does.

• Your immune system works throughout your whole body. Allergens can cause lung irritation in people with allergies, even if they don’t have asthma.

Is allergic asthma curable?

There is no cure for allergic asthma. But there are very effective treatments that can help prevent and control your symptoms in the short and long term.

Allergy shots are the closest thing to a cure, since they gradually decrease your sensitivity to allergens. After allergy shots, you may be able to cut back or even completely stop your allergy medications. But it generally takes 3 to 5 years of allergy shots to get a lasting benefit.

Is asthma an allergy?

Asthma and allergies are very closely linked, and inflammation is a big part of both. But asthma isn’t the same thing as an allergy. Most people with allergies don’t ever have an asthma attack. And some people with asthma don’t experience allergic symptoms. 

For those with allergic asthma, allergic triggers can set off an asthma attack. Allergic asthma is a combination of the two conditions.

Why trust our experts?

Written by:

Fonda Jiang, MD

Dr. Fonda Jiang is a practicing allergist in Long Beach, California. At her current practice, Dr. Jiang is committed to working as a team with her adult and pediatric patients to diagnose and treat a wide range of allergic conditions.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

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