Asthma can cause permanent changes to the function and structure of your lungs, particularly when it goes unmanaged for a long time.

If you have asthma, you might wonder whether it can have long-term effects on your lungs, and the answer is: yes.

Over time, asthma can lead to structural changes in the tissues of your airways. These changes, known as airway remodeling, arise from scarring and cellular damage resulting from asthma inflammation, particularly when you have difficulty managing your asthma. Airway remodeling can negatively impact how well your asthma medications work and can leave you with persistent symptoms despite treatment.

Having asthma isn’t a guarantee you’ll develop lung damage. Lung damage from asthma is preventable for many people — especially if you start treatment early and manage your symptoms well.

The air you breathe may contain asthma triggers that cause attacks or asthma exacerbations, times when symptoms become more severe. Not everyone with asthma has the same triggers.

If you can predict and avoid encounters with your triggers, you may be able to reduce the number of asthma flares you experience. Reducing the frequency of asthma exacerbations means reducing the frequency with which your lungs receive exposure to inflammatory processes that promote airway remodeling.

Common asthma triggers include:

  • tobacco smoke
  • dust mites
  • pests
  • pet fur
  • mold
  • household disinfectants
  • indoor and outdoor pollution

Monitoring your air quality

Monitoring your air quality is a great way to stay on top of environmental triggers.

Your air quality relays information about particles and atmospheric conditions that determine whether the air is “safe” or “unsafe” for breathing. It monitors pollutants, ozone levels, greenhouse gases, pollen, molds, and atmospheric variables such as humidity. Many factors associated with air quality can be individual asthma triggers or can promote inflammatory processes that compound asthma inflammation.

The American Lung Association (ALA) describes lung inflammation from inhaling ozone, for example, as a kind of bad sunburn in your lungs, and recommends checking the air quality forecast for your area before planning outdoor work or exercise.

The Environmental Protection Agency (EPA) has a webpage, Airnow.gov, where you can check your local air quality.

According to the ALA’s State of the Air Report for 2025, 11.8 million adults and 2.5 million children with asthma live in counties with unhealthy levels of at least one pollutant. Consider an indoor exercise option as part of your asthma management plan on bad air quality days.

Asthma is a chronic condition that requires ongoing management to prevent and reduce inflammation in your airways, which can lead to lung damage.

When you follow your treatment plan exactly as your doctor prescribes, it’s called having good treatment adherence. This includes taking your medications as directed, without missing doses, and keeping up-to-date with recommended asthma testing and appointments.

Adherence to asthma treatment is notoriously low. According to a 2024 study, the cost of asthma medications alone causes approximately 1 of every 6 adults with asthma to have difficulty adhering to their treatment.

Other barriers can include

  • drug regimen complexity
  • fear of side effects
  • inhaler technique
  • forgetfulness
  • misunderstood instructions
  • denial of a health condition
  • inappropriate expectations
  • dissatisfaction with healthcare professionals
  • cultural or religious reasons

If you’re not following your asthma treatment plan accordingly, now’s the time to start. Higher medication adherence results in:

  • positive health outcomes
  • improvements in disease control
  • reduced mortality

You can improve your medication adherence with some simple strategies, such as:

  • asking your doctor for directions again to ensure you remember them correctly
  • asking for help with your inhaler technique to make sure it’s effective
  • using a reminder tool like an app or symbol on a calendar

It’s essential to be honest with your doctor about your adherence to treatment. If they’re not aware you haven’t been taking your medication, they may prescribe additional medications or place you at a dose that’s unnecessarily high.

Respiratory infections can trigger asthma attacks and worsen symptoms by promoting and compounding inflammatory processes in your airways. Avoiding infection protects your lungs.

Here are some steps the ALA suggests you can take to prevent infection:

  • Get a flu vaccine.
  • Stay away from crowded places during flu season.
  • Wash your hands often.
  • Brush your teeth at least twice per day.
  • Avoid touching your face.

Starting self-care at the first sign of symptoms can help. Sometimes, the signs of an infection, such as a cough, can mimic those of asthma, making it difficult to tell the difference. Coughing, wheezing, and congestion are also symptoms of asthma and an infection, but asthma won’t cause:

Learning the difference between your asthma symptoms and infection signs can help you know when to stay home, drink extra fluids, and get the rest you need.

You don’t always have to avoid exercise with asthma. While some people experience asthma symptoms when they work out, the right level of exercise can offer a variety of lung health benefits.

Daily exercise has several benefits, per the ALA. These include:

  • increased lung capacity
  • improved blood flow
  • decreased airway inflammation
  • higher endurance and stamina
  • immune system support

If you have exercise-induced asthma attacks, your doctor can help you identify the reason. For example, it may be a fitness issue, and you may need to build up endurance. If it’s because you have issues managing your asthma, a medication change may help. Your doctor can also provide guidance on which exercises and at what intensity are right for you. Everyone’s fitness level and ability are different.

The ALA recommends the following exercise strategies for people with asthma:

  • Include a warm-up first and a cool-down afterward.
  • Cover your mouth and nose when exercising outside in cold weather.
  • Check the air quality before you exercise outdoors and, if necessary, choose an indoor activity instead.
  • Stop immediately if you experience chest discomfort such as pain, coughing, or shortness of breath. Use your inhaler and sit and relax.

If you have any health condition, including asthma, check with your doctor before starting a new type of exercise.

Top ways to keep your lungs healthy with asthma include:

  • stopping smoking and avoiding second hand smoke
  • engaging in regular exercise
  • eating a healthful diet
  • getting regular check ups
  • using your medication as directed
  • look to improve the air quality around you

The 2-2-2 rule for asthma helps check if a person’s asthma is controlled well. It asks questions such as:

  • do you take a quick relief inhaler more than twice a week?
  • do you awaken at night with asthma more than twice a month?
  • do you refill your quick relief inhaler more than twice a year?
  • do you use prednisone more than twice a year for asthma flares?

If you answer yes to any of these questions, speak with your doctor or healthcare professional.

Unmanaged asthma can lead to long-term lung changes, as chronic inflammation promotes scarring and damage to the cells lining your airways. These structural changes, known as airway remodeling, can impair lung function, reduce your response to asthma medications, and lead to persistent symptoms such as wheezing.

Exercising to strengthen your lungs, adhering to medication, and protecting yourself from pollution and infection can all help keep your lungs healthy when you have asthma.