Do children “outgrow” their asthma?

Parents of children with asthma are concerned about their child. Two questions they almost invariably ask the specialist are:

1. Doctor, is this really asthma?
2. Will my child outgrow it?

There is a popular misconception (based on false hope) that asthma will simply go away as the child grows up and that this happens around puberty. This hope is strengthened by non specialist doctor’s reassurance that the child will become all right at puberty. The parents of a child with asthma have a more optimistic rather than  realistic view of this.

This hope and belief prevents children with asthma from getting timely treatment.

Does asthma really go away as the child grows older?

What is the truth?

The truth is that some children do outgrow asthma but most don’t.

Is it possible to predict which child will outgrow asthma? Not exactly. But there are some indications:

• Boys are more likely to out grow asthma than girls.
• The milder the asthma the more likely that the child would outgrow it.
• Family history of milder asthma and others outgrowing asthma make it more likely that the child could also outgrow it too.
• Kids are more likely to outgrow asthma if their blood tests show fewer and fewer allergy markers (such as IgE levels) as they get older.
• Kids are more likely to outgrow asthma if they have less sensitive lungs.
• Kids are more likely to outgrow asthma if they have good lung function on testing.
• Kids are more likely to outgrow asthma if they have less need for daily asthma medicines to lessen the frequency and severity of asthma attacks.
• If kids need daily asthma medicines, it’s important for them to take them. But long-term use of asthma drugs has no effect on outgrowing asthma. Even using inhaled steroids has no effect on the outgrowing of asthma by kids.

All in all about 30 to 40 % of the children who have asthma will outgrow it. In some of them, symptoms will return adulthood (generally at the age of 30 to 40 years.)

Adult onset asthma very rarely, if ever, goes into remission.

There is a scientific therapy that can cure asthma, at least in some patients and that is Allergen Specific Immunotherapy (Allergy Shots).

Many small children wheeze. Some wheeze only in response to viral infections. These young wheezers may have small airways and as these children grow up wheezing disappears. These children did not have asthma. But yes their asthma like symptoms disappear as they grow older.

So what is the message for the parents? One can hope (and pray) for a spontaneous resolution but certainly cannot count on it or depend on it to happen invariably. Avoidance of allergens helps.. For more details on the prevention aspect please sees the earlier newsletter “Is asthma preventable”. Meanwhile, the treatment must go on

On a more optimistic note:
Contrary to popular belief, asthma usually does not become more severe with time. Actually, with the patient’s coping ability becoming better, asthma is better controlled with the passage of time.