What is seasonal asthma?

Seasonal asthma is a type of asthma that gets worse in a certain season due to the conditions around you. More than one season may affect you too and trigger your asthma symptoms. Seasonal asthma is a long term condition, but you may have months where you have little or no symptoms.

What causes seasonal asthma?

Each season comes with its own allergens and irritants that could cause your seasonal asthma to flare up. 

When you are allergic to pollen, you may find that your seasonal asthma is worse over the spring and summer months. The winter can also cause seasonal asthma symptoms, as the cold air can irritate your airways. 

What can trigger seasonal asthma?

There are lots of triggers for seasonal asthma and this is different for every person. You may only notice your symptoms for a few months, or there may be different times in the year when your seasonal asthma is triggered. If you have asthma all year round, this is not seasonal asthma. 

There are several common triggers for seasonal asthma including:

• pollen, a common allergen in the UK during the spring and summer seasons
• cold weather in the winter season, which can dry out or irritate the airways
• mould, which may get worse in the summer or winter months depending on where you live
• hot weather, as the heat and humidity can cause allergies and make it more difficult to open your airways
• indoor allergens such as dust and pets, which may trigger your asthma at certain times of the year, especially in the warmer seasons
• thunderstorms, which can cause high levels of humidity and an increase of allergens in the air

What are the symptoms of seasonal asthma?

The common symptoms of asthma can include:

• chronic coughing, which may be worse at night
• shortness of breath
• a feeling of tightness in your chest
• wheezing, which sounds like a whistling noise while you breathe

When you have seasonal asthma, you may only notice these symptoms at certain times of the year. These symptoms happen because your airways become more narrow, making it harder for air to go in and out of your lungs.

Seasonal asthma is often caused by allergens in the air, such as dust, mould, or pollen. This means you may notice allergy symptoms too, such as:

• a stuffed or runny nose
• sneezing
• red, watery, or itchy eyes

When you have an allergy, your body produces a histamine response because it believes the allergen is dangerous. This causes your immune system to react to the allergen, which causes these symptoms. 

How is seasonal asthma diagnosed?

Any type of asthma can be diagnosed by speaking to a doctor about your symptoms and doing some tests. A GP can diagnose seasonal asthma, but you may be sent to a specialist. 

A GP may ask you about:

• any triggers you have noticed, such as seasonal changes to your asthma symptoms
• your symptoms
• when your symptoms occur including how often and how severe they are 
• any existing medical conditions 
• your family’s medical history

What tests would a doctor perform?

If your GP thinks you have asthma, they may perform some tests. The main tests to diagnose seasonal asthma include:

• a spirometry test, which measures how much air you can hold in your lungs and how fast you can breathe
• a FeNo test, which checks your nitric oxide levels to indicate if your lungs are inflamed 
• a peak flow test, which measures how fast you breathe out

Once you have been diagnosed with seasonal asthma, your GP may send you for additional tests, such as an allergy test, to see if your seasonal asthma is caused by an allergy

How do I know if I have seasonal asthma?

You may have seasonal asthma if you get asthma symptoms at certain points in the year. You should never self diagnose asthma as it can be dangerous and you may need an inhaler to avoid having an asthma attack. The only way to know if you have seasonal asthma is by speaking to your GP and getting a diagnosis from them. They will ask questions and examine you and may in some circumstances order tests to rule out other underlying conditions. 

How is seasonal asthma treated?

Seasonal asthma does not have a cure, but there are asthma treatments available to control your symptoms. If you have seasonal asthma and your symptoms only bother you at a certain time in the year, you may be prescribed an inhaler or medication to use during the season your asthma symptoms are triggered only. 

Inhalers

There are 2 types of inhalers that you can be prescribed to treat seasonal asthma: a reliever inhaler and a preventer inhaler. Both types have different options available. Your doctor will help you find the right inhaler for you based on your symptoms and medical history. 

Reliever inhalers

A reliever inhaler is prescribed to most people with seasonal asthma and helps relieve symptoms when they occur. It is usually effective within a few minutes. The bronchodilator medicines in a reliever inhaler relax the muscles in your lungs, making it easier to breathe. Relieve inhalers are normally blue. 

Preventer inhalers

A preventer inhaler can stop symptoms from happening by reducing the sensitivity and inflammation in your airways. You should use it every day, even when you have no symptoms. You may notice your symptoms improve within a few minutes of using it although you should use it for a long period of time to get the full effects.

There are different preventer and reliever inhalers available depending on your suitability and symptoms. You may also be given a combination inhaler such as Seretide, which acts as both a preventer and reliever inhaler. 

Medications

There are several different medications that can be taken for seasonal asthma. You may be prescribed these in addition to your inhaler if you are still getting symptoms. 

Medications to treat seasonal asthma  include:

• theophylline, which opens your airways and is taken every day
• leukotriene receptor antagonists (LTRAs), which reduce inflammation in your airways, such as montelukast
• steroid tablets, which can be taken as short courses when your asthma symptoms flare up
• antihistamines, which relieve allergy symptoms if your seasonal asthma is caused or made worse by an allergy

For those with severe asthma, injections every few weeks can control symptoms though this is rarely prescribed.

How effective are seasonal asthma treatments?

Seasonal asthma treatments are very effective when taken correctly. If you have a preventer inhaler, you must take it every day as prescribed to get the best effect. Your doctor, nurse or pharmacist can show you how to take your inhaler properly to ensure the medication reaches your lungs.

If your seasonal asthma treatments are not working, you should follow your asthma action plan and speak to your doctor. They can look at your asthma treatment plan which sets out when and how to take your inhalers and/or medication. Your doctor may suggest increasing your preventer therapy or adding an additional preventer therapy to control your symptoms. 

How long do seasonal asthma treatments take to work?

Most seasonal asthma treatments work straight away, but treatments that are used to prevent symptoms work best when taken for at least 7 days. Once you take the treatment for a longer period of time, it can dampen down inflammation in your lungs and help control your symptoms. 

Medications used to relieve symptoms as they happen usually take a few minutes to work. 

How to manage seasonal asthma

Seasonal asthma is best managed when you understand your triggers. This means you can try to avoid them or take precautions. You should have an annual asthma review with a doctor or nurse to keep your asthma action plan up to date, or sooner if anything changes. Take your medications as prescribed, even if you do not have any symptoms.

To manage seasonal asthma in any season, you should:

• always keep your reliever inhaler with you, if you have one, even if you haven’t needed it for a while
• use your preventer inhaler every day, if you have one
• let your doctor know if your symptoms have changed and your medication is not working

To manage seasonal asthma in cold or damp weather, you should:

• keep as warm and dry as possible
• wear a scarf over your mouth and nose when you go outside to help warm the air you inhale
• try breathing in through your nose instead of your mouth, as this helps warm the air

To manage seasonal asthma in hot seasons, you should:

• never leave your inhalers lying around in direct sunlight or anywhere they might get too hot, like a parked car
• manage your hay fever well, like taking antihistamines if necessary or avoiding high pollen areas
• avoid exercising outdoors between 11 am and 3 pm
• try to go out earlier in the day to make the most of better air quality
• drink plenty of water
• keep doors and windows closed when you are indoors

To manage seasonal asthma during pollen seasons and avoid asthma attacks, you should:

• keep an eye on the pollen forecast, either on TV or with an app on your phone
• avoid going outside when pollen is at its highest if you can
• shower and wash your clothes after going outside
• dry your sheets and clothes indoors
• if you have it, use air conditioning instead of open windows indoors or in your car
• keep your grass short and if you can, get someone to take care of it for you
• exercise indoors wherever possible

To manage seasonal asthma during thunderstorms you should:

• keep an eye on the weather forecast or download a weather app that can tell you when storms are approaching
• get indoors as soon as you can and stay indoors with the windows closed before, during, and after the storm
• shower and change your clothes if you’ve been outside, to get rid of any pollen
• Keep your reliever inhaler close by
• take antihistamines if you have hayfever
• avoid smoking or letting other people smoke around you

If you are short of breath, wheezy or tight chested despite taking your reliever inhaler as instructed on your asthma action plan this can be a sign of a severe asthma attack and you should  call 999 or go to A&E straight away. 

Sources

Antihistamines (2020) NHS [accessed 13th July 2022]

Asthma (2021) NHS [accessed 13th July 2022]