Medically Reviewed On: May 09, 2008

ANNOUNCER: One problem in treating asthma among adolescents is that the course of the disease can change, sometimes unpredictably.

NANCY OSTROM, MD: Some adolescents will have less asthma symptoms. As a matter of fact, young males in their late adolescence and early adulthood can often have their symptoms become more quiescent or notice less symptoms. In female adolescents, again, going through puberty, they can have hormonal influences where at different times of the month they may have more asthma symptoms.

ANNOUNCER: Even if asthma symptoms remain unchanged, adolescents may refuse to pay attention.

NANCY SANDER: Teens with asthma are invincible. And they oftentimes think they can just discontinue their medications because they do believe they're invincible.

ANNOUNCER: Sometimes the problem is not "attitude." Instead, adolescents may just be too busy, or distracted.

NANCY OSTROM, MD: There's a challenge in adolescence of having the patients recognize their symptoms. They're often less aware of physical symptoms than they are of what they might be doing on the weekend or that they need to get their homework in on time. So we do have to be more aware of the more subtle cues that they're having cough at night, that they're having exercise limitations, that they are having colds or coughs that are lasting longer than normal.

ANNOUNCER: If teens don't pay attention to their asthma, they may put themselves at higher risk of serious attack.

ELLEN CRAIN, MD: The typical situation is that they get sicker than a younger child might get before they arrive at medical attention, because they don't do what their parents said, sometimes. They won't go to the doctor for checkups. They're going to a doctor who takes care of a lot of young children and may not be as comfortable seeing adolescents. And so all of these factors kind of work together to lead to under treatment, in general, of adolescents. So they're more at risk of serious problems.

ANNOUNCER: According to federal guidelines, the cornerstone of proper treatment for adolescents with persistent asthma is an inhaled corticosteroid, to reduce inflammation.

There are four inhaled steroids approved for use in adolescents: Aerobid, Azmacort, Flovent and Pulmicort Turbuhaler

Even when there's no debate about whether an adolescent has asthma and should be on medication, good communication about treatment can be difficult.

NANCY SANDER: They love to tell mom and dad that they did take their medications, when, in fact, they didn't. And mom and dad have to figure a way to give them just enough rope for them to learn their own lessons without them, you know, having a disastrous result at the end.

NANCY OSTROM, MD: Adolescents often don't tell me what's really going on, don't tell me their symptoms or haven't even recognized themselves that, when they tried to throw a Frisbee with their friend, they couldn't run very fast or very far. Or that they're kind of sleepy because they've been coughing through the night with asthma cough.

ANNOUNCER: Sometimes adolescents can't ignore their asthma, for it can have a real impact on their quality of life.

ELLEN CRAIN, MD: Sometimes they're really limited in their activities in lots of ways. Those who wish to participate in sports often can't participate up to their full capabilities because of their asthma. Others just get used to the limitations that asthma puts on them and don't even try anymore to run around, play with their friends, you know, do all kinds of activities. And some are really very incapacitated and stay home most of the time.

ANNOUNCER: Good communication, and finding out what matters to individual teens, often can lead to more effective treatment of asthma.

ELLEN CRAIN, MD: I think one of the great skills of a doctor who takes care of teenagers is to figure out what it is that motivates the patient.

NANCY SANDER: And so, for example, if Jason wants to play football. Well, the strategy then becomes, "OK, Jason, if you want to play football, you're going to be using your medications twice a day. This is going to treat that underlying inflammation that just wants to sap all your energy from you when you're on the playing field."

NANCY OSTROM, MD: When I speak to adolescents who may be denying their symptoms or not want to treat their symptoms or think that this'll be not worth it, because it's going to limit their life anyway, I talk about the fact that a large percentage of, for example, the year's Olympic swim team has exercise-induced asthma. But it's manageable to the point that they are the most elite athletes in the world. I do tell them that I don't expect that they will necessarily be Olympic qualifiers, but that I don't expect their asthma to be an excuse for not living a full, active, fun life.

ANNOUNCER: Breaking through to teenagers may be difficult. But when it comes to asthma, driving the treatment message home can make a big and important difference in their lives.

NANCY SANDER: Well-controlled asthma means that they are involved and active, and does it mean that they don't have to take medication? No. Does it mean that they don't have symptoms from time to time? No. It just means they have a strategy for staying on top of it and they're not missing out on the fun of life.