Keeping Sneezes from Becoming Wheezes



By Purvi Parikh, MD

You know the signs: a tickle in the back of the throat … a few sneezes here and there. All too often they’re the beginning of a full-blown head cold.

And if you have asthma, the next stop could be your lungs.

Why does a sneeze turn into a wheeze?

Your nose, mouth, throat, sinuses and lungs are all one airway. Think of it as a long hallway with rooms off the sides. The front door is your nose and mouth: That’s where the germs get in. They reproduce and swarm around in the passageway, squeeze through doorways into the sinuses and ear canals, then tiptoe down the hallway into the lungs.

A healthy immune system comes in like a housecleaning service, trapping germs with mucus and using tiny hairs called cilia to move them out of the airways.

Children and elderly people with undeveloped or inefficient immune systems are less able to fight the spread of germs. And people with asthma have sensitive airways already compromised by underlying inflammation, primed and ready to react to irritants.

Prevention tips

The first thing, of course, is to do what you can to prevent the germs from getting through the front door. Wash your hands regularly, especially before eating; keep your distance from people with active colds; teach children not to share drinks and toys with others; keep your hands away from your nose and mouth, if possible. Use a nasal wash to flush out germs before they take hold.

In addition, get your flu shot early in the season each year. If you have asthma and are over the age of 18, you should also get a pneumonia vaccination.

Work with a doctor to draw up a written Asthma Action Plan – a personalized set of instructions that includes exactly what to do when cold symptoms begin. Be sure to keep your medications up to date and equipment like nebulizers at the ready.

Treatment Options

Start preventive medications at the first sign of a cold to try to ward off lung congestion. Recommendations are different for each person, so talk with your doctor or asthma specialist before taking medication:

  • Nasal corticosteroid sprays – Now available over the counter, these are the most effective medications for stopping a runny nose, fighting a cold and easing postnasal drip.
  • Antihistamines – Antihistamine nasal sprays (prescription only), liquids and pills help dry up a runny nose caused by colds as well as allergies. They are also effective for postnasal drip, but slower acting than nasal corticosteroid sprays.
  • Albuterol – Keep your fast-acting asthma bronchodilator close at hand at all times to treat any wheezing or difficulty breathing. Follow the dosing schedule on your Asthma Action Plan to prevent symptoms. Some people like to use a nebulizer when they’ve got a cold, as it can provide better lung deposition than an inhaler and can be soothing to the throat and lungs.
  • Inhaled corticosteroids – Some doctors recommend increasing the dose of these anti-inflammatory medications to prevent the cold from triggering asthma symptoms. Patients at risk of severe asthma flares or lung infections may require oral corticosteroids.

Cough medicines may not be very helpful for asthma patients, as they often simply mask symptoms.


Purvi Parikh, MD, is a board-certifed allergist and immunologist in New York City. She is a member of the Board of Directors for the Advocacy Council of the American College of Allergy, Asthma & Immunology.