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For some people, asthma symptoms begin early in childhood. For others, asthma shows up later in life after an illness or years of exposure to irritants at work or in their environment. No matter how or when you develop asthma, the condition can cause wheezing, shortness of breath, and tightness in the chest. These symptoms can range from mild to life-threatening.
So, how does asthma develop? Doctors and researchers know a lot about what raises the risk of asthma, but the full picture is still complex. Genetics, allergies, infections, and daily surroundings all play a role.
In this article, we’ll dive into the seven main causes of asthma. We’ll explain how people can develop the condition through different pathways, and what factors can make asthma symptoms worse over time.
There’s no single cause of asthma. Instead, it usually develops from a mix of:
Asthma tends to run in families. As many as 70 percent of people with asthma have genes that make it more likely to develop. If one parent has asthma, a child’s risk of getting it is about 25 percent. If both parents have it, the child’s risk rises to 50 percent.
Genes influence how the lungs grow, how the immune system reacts to allergens, and how the body fights respiratory infections. These are some of the inherited traits that can set the stage for asthma. You get inherited traits — like eye color or hair type — from your parents through your DNA. Inherited traits can also affect your health. Certain traits can make airways more sensitive and more likely to develop asthma.
Scientists have discovered more than 100 unique genes that are linked to asthma. Some of these genes affect swelling in the airways. Still, genes alone don’t usually cause asthma. The role of the environment matters too.
Asthma is often linked to allergies. An allergy is when the immune system reacts too strongly to something normally harmless, like pollen, dust mites, or pet dander. A reaction to allergens can cause the airways to swell and tighten.
Common allergic conditions linked to asthma include:
Studies show that up to 90 percent of children with allergies also have asthma. Adults with asthma are also very likely to have allergies. About 75 percent of adults under 40 and 65 percent of adults over 55 with asthma have at least one allergy. When allergies set off asthma symptoms, it’s called allergic asthma — the most common type of asthma.
Where you grow up or live can play a big role in developing asthma. Breathing in certain irritants — especially during pregnancy or early childhood — can raise the risk. These exposures don’t cause asthma on their own, but when combined with genetics or allergies, they can set the stage for the disease.
Common environmental risk factors for asthma include:
These factors can make the lungs more sensitive and more likely to react with wheezing, shortness of breath, or flare-ups later in life.
Some people may develop asthma because of substances in the air where they work. This is called occupational asthma or work-related asthma. It develops when repeated exposure to chemical fumes, dust, or other irritants damages the lungs and makes them more sensitive over time.
There are more than 400 workplace chemicals and substances that can trigger occupational asthma. Some of the most common ones include:
People who work in certain jobs are more likely to encounter these triggers. The highest-risk jobs include:
Sometimes, occupational asthma can persist even after a person stops working with the trigger. Proper protective equipment and regular check-ins with your healthcare team can limit the risk.
Certain illnesses that affect the lungs can increase the risk of developing asthma. These are called respiratory infections. Respiratory infections in early childhood may change how the lungs grow and make the airways more sensitive.
Viruses such as respiratory syncytial virus (RSV) and even severe colds are linked to a higher risk of asthma in young children. In adults, repeated lung infections can make asthma symptoms worse or harder to control. Protecting yourself with good hygiene, recommended vaccines, and early medical care can help lower the impact of respiratory infections.
Certain health conditions can raise the risk of asthma or make symptoms worse. Obesity is one of the strongest. Having a higher body weight can lead to more inflammation in the body, putting more stress on the lungs and leading to shortness of breath or more frequent flare-ups.
Acid reflux — or gastroesophageal reflux disorder (GERD) — can also irritate the airways. When stomach acid flows back into the throat, it can trigger coughing or wheezing. Between 30 percent and 80 percent of people with asthma also have GERD.
Another condition that can raise the risk of asthma is chronic obstructive pulmonary disease (COPD). This is a long-term lung disease that makes it harder to breathe. When someone is diagnosed with both asthma and COPD, it’s called asthma-COPD overlap syndrome (ACOS). People with ACOS may have more severe asthma attacks or worse symptoms of both diseases.
Some medicines can trigger asthma or make asthma symptoms worse. The most common ones are:
If a medicine seems to make your asthma worse or leads to new breathing problems, talk with your healthcare team or an allergist about it. Don’t stop taking prescribed medications without talking to your doctor.
Once someone has asthma, certain triggering situations can set off symptoms or even cause an asthma attack. Many of these triggers overlap with the environmental risk factors that raise the chance of asthma in the first place.
The most common asthma triggers include:
There’s no guaranteed way to prevent asthma, but research shows that certain factors may lower the risk. Some evidence suggests that being exposed to other children in daycare and growing up in a rural environment may lower a person’s risk of developing asthma. Children whose mothers take fish oil or vitamin D supplements during pregnancy may also have a lower risk.
You can also protect yourself by avoiding smoking, improving indoor air quality with air purifiers, and using protective gear at work. Prevention isn’t certain, but these steps may reduce the risk of asthma or frequency of flare-ups.
Currently, there’s no cure for asthma. However, thanks to the recent development of newer treatments, some people can hope to achieve remission. Remission means having little to no asthma symptoms, no severe flare-ups, and no need for strong medicines like oral steroids. To count as remission, these improvements must last for at least 12 months.
While remission is not the same thing as a cure, it’s a big improvement over symptom control. With proper asthma management, remission is becoming possible for more people.
On MyAsthmaTeam, people share their experiences with asthma, get advice, and find support from others who understand.
What risk factors do you have for asthma? Let others know in the comments below.
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