Q: I was recently diagnosed with asthma. How do allergists go about determining what triggers an asthma flare? 

Martha White, MD: Asthma symptoms and/or flares can be triggered by a variety of stimuli, including allergy to pollen, mold, pets with fur and pests such as dust mites and cockroaches. Non-allergy-related asthma triggers may include cold infections, flu, cold and dry air, exercise, and irritants such as cigarette smoke and strong smells.

It’s important to see your doctor or board-certified allergist to discuss and manage your asthma triggers. An initial visit with an allergist includes a family health record, a physical exam and pulmonary function testing (spirometry) to determine the severity of your airway obstruction. A detailed history of when and where your symptoms occur will often help identify your non-allergic triggers, and diagnostic testing can determine allergies.

Allergy testing can be done either with a skin test (results in a few minutes) or with a blood test (results in several days). I prefer to use the skin test, as the results are almost immediately available and it’s often helpful for a person to be able to actually see the effect that an allergen has on their skin. While numbers on a lab result are helpful, it’s pretty easy for patients to comprehend that something that causes a big itchy hive on your arm will also produce symptoms in your nose or lungs.

Avoidance of known triggers, strategies for monitoring your asthma, and proper use of medications are important components of an asthma management plan.

Your allergist can help, not only with identifying triggers but also with techniques to limit exposure at home, school or work, or outside.

Your allergist can also provide instruction on peak flow monitoring at home and proper use of asthma inhalers. I can’t stress enough the importance of the latter. There are many different inhaler devices on the market that require different techniques for effective use, and it’s important to know how to use your inhalers correctly in order to achieve full benefit of the medication.

Finally, your allergist can help you decide whether allergy immunotherapy — allergy shots or under the tongue tablets — is appropriate for you. Both work by building tolerance to allergens over time.

Each asthma patient is different and there’s no “one size fits all” category when it comes to determining asthma triggers. However, excellent therapies are available. Your allergist can help you develop a personalized Asthma Action Plan that, when followed, can lead to excellent symptom control in most people.

Martha White, MD, FACAAI, is a board-certified allergist at the Institute of Asthma and Allergy in Wheaton, Md., Board Emeritus with Allergy & Asthma Network’s Board of Directors, and a fellow of the American College of Allergy, Asthma & Immunology (ACAAI).

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