Help for Your Eosinophilic Asthma Flare-Ups

Medically Reviewed by Dan Brennan, MD on February 03, 2022

If you have eosinophilic asthma, you may asthma attacks often. Those episodes may be more severe than with more common types of asthma. And it may be harder to spot the flares coming because eosinophilic asthma usually isn’t set off by allergens like pollen and pet dander.

But with your doctor’s help, you can take steps to ease your flare-ups. Here’s how:

Recognize the symptoms. It’s easy to overlook the signs of a flare. This is because your first clue is often a cough, not the chest tightness and wheezing that’s usually the case with asthma. Another clue is if you feel very tired and winded after simple exercises, like walking and household chores. Be sure to always have your rescue inhaler on hand. Use it as soon as you notice symptoms. Ask your doctor about a written asthma action plan in case of an emergency and how to use quick-acting medications to control a flare.

Use your rescue medication right. It may seem easy, but many people don’t use inhalers correctly. That can keep enough medicine from reaching your lungs. Here’s how to do it right.

  • Shake the inhaler, then take off the cap and hold it upright. If you have a spacer (a hollow plastic chamber), use it. It helps get more medicine into your airways and keeps it from irritating your throat.
  • Tilt your head back and breathe out to get all the air out of your lungs.
  • Put the inhaler in your mouth. Wrap your lips around the mouthpiece for a tight seal.
  • Press down on the inhaler quickly and breathe in slowly for 3-5 seconds.
  • Hold your breath for 10 seconds to allow medicine to reach deeply into your lungs.
  • Breathe out slowly.
  • Repeat puffs as directed by your doctor. Wait 1 minute before taking the second puff.
  • Most people use a metered-dose inhaler. If you have a dry powder inhaler, close your mouth tightly around the mouthpiece and breathe in quickly.

Keep your asthma well-controlled. This is the best way to avoid an asthma attack. Your asthma is considered uncontrolled if you:

  • Have asthma symptoms such as coughing, wheezing, or shortness of breath more than twice a week
  • Wake up in the middle of the night with asthma symptoms more than twice a month
  • Can’t do all your activities, including exercise and sports
  • Use your rescue inhaler more than twice a week
  • Have a lung test reading of under 80%

If your asthma is not under control, you may need to change the dosage of your medication. You also should see your doctor more often -- usually every 2-6 weeks -- until you get a handle on your asthma.

Manage triggers at home. Having eosinophilic asthma means your airways are swollen and are sensitive to things that may not bother others. What triggers a reaction can vary from person to person. Figure yours out with an asthma journal. Write down what you did on the days you had a flare. Record things like activities, the temperature, your emotional state, and any exposure to chemicals or irritants like cigarette smoke. 

Get a flu shot. Respiratory infections like a cold, the flu, or a sinus infection are common causes of asthma flare-ups. You can avoid them by washing your hands often and staying away from people who seem sick. The best way to prevent influenza is to get a flu vaccine every year. You should also get the pneumococcal vaccine (Pneumovax 23). This helps lower your risk of pneumonia.

Test for allergies. They are less common in eosinophilic asthma than with “classic” asthma. Still, it’s good to rule out allergies. You can get skin or blood tests at your allergist’s office. If you do have allergies, eliminating or reducing your exposure to them should help make flare-ups less likely. 

Show Sources


American Partnership for Eosinophilic Disorders: “Eosinophilic Asthma.”

J. Allen Meadows, MD, president, American College of Allergy, Asthma and Immunology.

ERJ Open Research: “Management of the patient with eosinophilic asthma: a new era begins.”

Asthma & Allergy Foundation of America: “Asthma Action Plan.”

Rachel Taliercio, DO, pulmonologist, Cleveland Clinic.

American Academy of Family Physicians: “How to Use a Metered Dose Inhaler.”

Mayo Clinic: “Asthma Treatment: 3 Steps to Better Asthma Control.”

American Lung Association: “Reduce Asthma Triggers.”

Asthma & Allergy Foundation of America: “Strong Emotions, Stress and Depression Can Trigger Asthma.”

American Academy of Allergy, Asthma and Immunology: “Pneumococcal Vaccination in Asthma,” “Allergy Testing.”

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