What Are the Different Types of Asthma?

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Medically reviewed by Susan Russell, MD

Asthma is a chronic condition that affects the lungs’ airways, which are tubes that carry air in and out of the lungs. Asthma causes narrowing and inflammation of the airways, leading to breathing problems. About one in 13 people in the United States has asthma—though they don’t all have the same type of asthma.

There are many types of asthma. The types often have similar symptoms, but the triggers, age of onset, severity, and treatment may differ. Knowing the type—or types—of asthma affecting you can help you avoid triggers and manage your symptoms.

The type of asthma that affects you depends on several factors, including the substances you’re exposed to where you live, work, or exercise. Black, Hispanic, and American Indian/Alaska Native people might live or work in areas with more substances that trigger asthma, so these groups may be at greater risk for the different types of asthma.

Types Based on Triggers or Symptoms

Several types of asthma are categorized based on symptom triggers. Several types are based on the symptoms themselves or when they develop.

Allergic Asthma

Allergic asthma is the most common type of asthma. It is triggered by allergens, which are substances the immune system defends against. When you swallow, inhale, or touch an allergen, your immune system might act in a way that creates an allergic reaction and causes asthma symptoms. Allergens are estimated to impact about 50-80% of people with asthma.

Common allergens that can trigger allergic asthma include:

• Dust mites
• Animal skin, saliva, or skin flakes
• Mold 
• Pollen from trees, grass, or weeds
• Cockroaches

People who live in older, lower-income housing may be exposed to allergens like rodents, insects, and mold more than other people, which is part of the reason why there are racial and socioeconomic disparities in asthma occurrence and control.

Symptoms of allergic asthma are similar to other types of asthma. Symptoms include shortness of breath, cough, wheeze (a whistling sound while breathing), and chest tightness. You may also have symptoms common with allergies, including stuffy or runny nose, red and itchy eyes, and itchiness around the nose or mouth.

Treatment for allergic asthma involves treating both your asthma and allergies. One way to do this is to identify your allergens and limit your exposure to them. Your healthcare provider may also recommend the following treatment approaches:

• Asthma medications: Your healthcare provider may recommend a quick-relief or long-term control medication to improve your asthma symptoms. Quick-relief medications are taken at the first sign of asthma symptoms for immediate relief; long-term control medications are taken daily to prevent asthma symptoms.
• Allergy medications: Healthcare providers may recommend antihistamines, which block chemicals (histamines) released during allergic reactions. They may also recommend decongestants or nasal corticosteroid sprays depending on your symptoms.
• Allergen immunotherapy: This treatment helps build tolerance toward the allergen. It comes in the form of allergy shots or tablets and can help control allergic asthma long-term.

Occupational Asthma

Occupational asthma is a type of asthma that occurs because of exposure to chemical fumes, gases, dust, or other harmful substances at the workplace. It accounts for about 15% of asthma cases in the U.S.

Common substances that can trigger occupational asthma include:

• Metal dust
• Wood smoke
• Dust from flour, wood, or grain
• Vapors from chemicals
• Animal skin flakes
• Chlorine-based cleaning products

People who are at higher risk for developing occupational asthma include:

• Farmers
• Plastic and woodworkers
• Detergent manufacturers
• Drug manufacturers
• Metal workers
• Bakers
• Laboratory workers
• Millers 

Because people in certain populations, including the Black and Hispanic communities, are likelier to have some of these jobs, occupational asthma may be a greater risk for some racial or ethnic groups—another reason why there’s a racial disparity in asthma occurrence and control.

The symptoms of occupational asthma usually appear during working hours and may improve or go away after work. They may also worsen toward the end of the week but go away over the weekend. Symptoms are similar to other types of asthma and can include cough, shortness of breath, wheezing, and chest tightness.

Your healthcare provider may advise you to change your job or move to an area at your workplace where there’s less exposure to the triggers—if either option is possible. They may also recommend medications to improve the condition. These could include quick relief and long-term control medications.

Quick-relief medications called bronchodilators are taken when you experience symptoms. They help open airways, allowing more air to pass in and out of the lungs, and they help clear mucus from the lungs. Bronchodilators include inhalers (short-acting inhaled beta-2-agonists) and anticholinergics.

Long-term control medications are taken every day and help reduce airway inflammation. They include inhaled corticosteroids, leukotriene modifiers, and long-acting inhaled beta-2-agonists (always taken in combination with inhaled corticosteroids or other medications).

Exercise-Induced Asthma

Exercise-induced asthma—medically referred to as exercise-induced bronchoconstriction—is a type of asthma that occurs as a result of exercise or physical activity. About 90% of people with asthma develop symptoms from exercise.

During exercise, your body demands more oxygen, leading to deeper and faster breathing. Usually, breathing takes place through the mouth during exercise. Air inhaled through the mouth is generally drier and cooler than air inhaled through the nose. This dry, cold air is responsible for triggering asthma symptoms.

Other factors that can lead to exercise-induced asthma include air pollution, a recent cold or asthma episode, and exposure to smoke or chemical fumes.

The symptoms of exercise-induced asthma usually begin within a few minutes of starting the exercise, peak within 10-15 minutes of activity, and resolve within one hour of stopping the exercise. Coughing is the most common symptom of exercise-induced asthma and may be the only symptom. You may also experience other traditional asthma symptoms like wheezing and shortness of breath.

Treatment options for exercise-induced asthma involve:

• Rapid-acting bronchodilators: Intake of these medications is often recommended 5-20 minutes before exercising. It is suitable for people who exercise once per day. Examples include Proair (albuterol), mostly taken using an inhaler.
• Long-acting bronchodilators: These medications work for longer and are suitable for people who exercise throughout the day. Serevent Diskus (salmeterol) is one example.
• Leukotriene modifiers: These medications are an alternative to rapid-acting bronchodilators and are usually taken in pill form. They can help reduce airway narrowing and inflammation. Examples include Singulair (montelukast) and Accolate (zafirlukast).

Cough-Variant Asthma

Cough-variant asthma is a form of asthma where a chronic cough (lasting more than eight weeks) is the only symptom. About 30% of people with untreated cough-variant asthma eventually develop other classic asthma symptoms.

You may develop cough-variant asthma for the following reasons:

• Exposure to allergens such as pollen, molds, or dust
• Cold or other respiratory diseases
• Changes in weather 
• Intake of certain medications
• Stress

The treatment option for cough-variant asthma depends on its severity. A mild cough can be treated with short-acting bronchodilators, and a persistent cough can be treated with inhaled corticosteroids.

Nocturnal Asthma

Nocturnal asthma is a type of asthma where symptoms worsen during the night. About 30%-70% of people with asthma report nocturnal asthma symptoms once per month.

Nocturnal asthma may occur due to changes in the circadian rhythm—the body’s 24-hour cycle. Other causes of nocturnal asthma include:

• Poorly controlled daytime asthma
• Exposure to allergens such as mold, dust, or tobacco smoke
• Air pollution
• Conditions like gastroesophageal reflux disease (GERD), obstructive sleep apnea, or sinusitis

Nocturnal asthma symptoms are similar to classic asthma symptoms but mostly appear at night. This often leads to poor sleep quality and decreased work performance.

Treatment of nocturnal asthma is similar to other types of asthma, involving inhaled corticosteroids and long-acting beta-2-agonists. If nocturnal asthma arises from another health condition, you’d also have to treat that condition.

Types Based on Age of Onset

The type of asthma you have can depend on when it first developed.

Childhood asthma develops when you are younger and can often improve or go away. Adult-onset asthma tends to be less stable, with a lower likelihood of improving or going away.

Childhood Asthma

Asthma is one of the most common chronic diseases in children, usually developing before 5 years of age. It affects about 4.5 million children in the U.S.

Childhood asthma can develop due to:

• Having a family history of asthma
• Having allergies or other respiratory diseases
• Being exposed to secondhand or thirdhand smoke after birth
• Living in an area with high air pollution

Symptoms of childhood asthma are:

• Faster breathing
• Persistent coughing
• Difficulty feeding
• Irritability
• Gasping for air

The treatment approach for childhood asthma includes avoiding triggers like tobacco smoke and taking medications such as quick-relief and long-term control drugs.

Adult-Onset Asthma

Asthma that develops when you are an adult is termed adult-onset asthma. Adult-onset asthma affects 9.8% of people assigned female at birth and 6.1% of people assigned male at birth.

Adult-onset asthma can develop due to:

• Hormonal changes that occur during pregnancy or menopause
• Respiratory infections such as the flu or cold
• Exposure to certain environmental irritants, including smoke, dust, mold, perfumes, or feather beds

The symptoms of adult-onset asthma are similar to those of other types of asthma and include cough, wheezing, chest tightness, shortness of breath, and difficulty sleeping. Especially because adult-onset asthma can lead to a faster decline in lung function, consider talking with a healthcare provider when symptoms appear so you can get early treatment.

A healthcare provider may recommend quick-relief or long-term control medications, depending on the severity of your symptoms. Inform your healthcare provider if you have cataracts, glaucoma, or osteoporosis since corticosteroids for asthma treatment may interfere with these conditions. Also, let them know if you take beta-blockers (medications used to treat heart issues) since this class of medications can worsen asthma severity.

Types Based on Severity

Asthma may also be categorized based on how severe your symptoms are and how well your body responds to treatment. The three types of asthma based on severity and treatment response are:

When To See a Healthcare Provider

If you have asthma or suspect you might have a certain type of asthma, talk to your healthcare provider if you are experiencing:

• Trouble performing daily activities
• A cough that doesn’t go away
• Dizziness or weakness
• Wheezing while breathing out
• Worsened wheezing despite taking medications

Even well-managed asthma can sometimes get out of control, leading to symptoms. Blue lips or nails, flared nostrils upon breathing in, and difficulty walking or talking at a normal pace are signs that urgent medical help is needed.

A Quick Review

There are various types of asthma. The type you have can be based on symptoms, triggers, age of onset, severity, and treatment response. Allergic asthma, occupational asthma, adult-onset asthma, and severe asthma are some of the types.

Contact your healthcare provider if you experience symptoms of asthma. They can help diagnose your particular type of asthma and recommend a suitable treatment plan.

Read the original article on Health.com.