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My 12-year-old has used inhaled steroids since she was 2. Should I be worried?

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The question: Will my 12-year-old ever grow out of her asthma? She's been taking inhaled steroids since she was 2. I'm not sure that's a good thing, but her illness is under control. Should I be worried?

The answer: Asthma is the most common chronic disease affecting children in Canada. Asthma rates vary, but generally about 15 per cent of Canadian children have asthma. That's about half a million kids! Fortunately, most children's asthma can be well controlled.

Children who experience symptoms regularly, or who have more severe symptoms, are usually prescribed an inhaled steroid daily. These come as both puffers and dry-powder inhalers. It is natural for parents to be nervous whenever treatment with steroids is suggested. But it is important to remember that steroids come in many different forms and with vastly different safety profiles. Steroids taken long term by pill or injection are associated with serious side effects, including weight gain and growth suppression. By contrast, the inhaled steroids used daily for asthma are very well tolerated with few, if any, side effects. In standard doses, these products can be used every day for years without fear of serious complications. As with any medication, strive to use the lowest dose that completely controls asthma symptoms.

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Many children find that their asthma symptoms improve by the time they are adults. But that doesn't work for everyone. In my experience, children with a history of eczema (sensitive skin) or environmental allergies are more likely to have life-long symptoms. In addition, those with an asthmatic parent and children who have more severe asthma symptoms are less likely to outgrow their illness. Fortunately, children and teens who are able to minimize exposure to asthma triggers and who take their medicine as prescribed can participate fully in all activities and lead long and healthy lives.

Send pediatrician Michael Dickinson your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail website. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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