While millions of people have asthma, your asthma is unique to you. That means you need to work closely with your doctor to devise a treatment plan that’s especially for you, says Dr. Norman H. Edelman, senior scientific adviser to the American Lung Association. “Your treatment plan will depend on the severity of your asthma symptoms and may need to be adjusted over time,” he says.

The first treatment is always a good defense, Edelman says. As much as you can, you want to avoid those things that can set off your asthma attacks. Of course, everyone’s triggers are different. For many people, it's animal dander, dust, mold, pollen, cigarette smoke or extreme cold that can bring on an attack. Being sick with a cold or flu or having other health conditions also can affect the severity of your asthma symptoms and what medications you can take safely.

The Path to Asthma Control

You may need medicines known as bronchodilators to help you control your asthma. For most people, that means two kinds of bronchodilators:

  • One for quick relief during an attack
  • One for long-term control

Quick-relief bronchodilators open your bronchi, the passages into your lungs, so air can move in and out more easily. They also help you cough, so you can move mucus from your lungs.

If you have asthma, you should always have your quick-relief medicine on or near you in case you need it unexpectedly.

Long-term bronchodilators help you prevent and control symptoms over time. “Most people with significant asthma need controller medicines to reduce the amount of inflammation going on in the lining of their airways,” Edelman says. These are medicines you must take every day, even if you have no symptoms.

You may have short-term and long-term medicines that you inhale as a spray or mist, that you take as a pill or syrup or that you get as an injection. You might use an inhaler or puffer or a nebulizer machine that provides a medicated mist to take your medications. You also may be given oral steroids to treat a more severe asthma attack.

New medicines for severe asthma, designed to block cells that trigger the inflammation that results in an asthma attack, are coming, Edelman says. Some medications that block IgE, an antibody in your immune system that initiates allergic reactions, are on the market, and others are being developed, he says. A medicine was approved in 2016 by the U.S. Food and Drug Administration as an add-on for long-term asthma control in people age 18 and older with severe asthma who have increased levels of a white blood cell type associated with asthma.

Your Bottom Line

You always want to use the smallest amount of medicine necessary to maintain control and yet prevent asthma from damaging the airways deep in your lungs long term, Edelman says. “If you have long stretches of excellent control, your doctor may say, ‘Let’s see how you do without it.’” But, you should never stop your treatment without your doctor’s approval.

Just as your symptoms can vary over time, so can the effectiveness of your medicines. You'll see your doctor more often in the beginning, until you have your asthma under good control and you've found the asthma management plan that works best for you, but regular checkups will always be key. So will symptom tracking—and that's something only you can do.