Pneumothorax (collapsed lung)

A pneumothorax happens when air leaks from one of your lungs into the gap between your lungs and ribcage. This gap is called the pleural space. A pneumothorax can cause few symptoms and heal by itself, but sometimes they require treatment.

When air builds up in the pleural space it can squash your lung and cause it to collapse. This is why a pneumothorax is sometimes called a collapsed lung.

Spontaneous pneumothorax

A pneumothorax is described as spontaneous when there is no known reason for it happening. There are different names that your healthcare professional might use: 

Primary spontaneous pneumothorax (PSP)

This is when a pneumothorax happens in someone without an existing lung condition. 

PSP is more common in: 

• younger people, aged between 15 and 34
• people who smoke cigarettes
• tall, thin people.

Blebs and bullae are often found in people with PSP. Blebs are small air-filled blisters that can form on the surface of your lung. Bullae are pockets of air that can form within your lung tissue.   

Some experts think PSP could be linked to blebs and bullae bursting, but they are still researching this.    

Secondary spontaneous pneumothorax (SSP) 

This is when a pneumothorax happens in someone with an existing lung condition. 

SSPs are more common in:  

• older people, aged between 60 and 64
• people with chronic obstructive pulmonary disease (COPD), cystic fibrosis, tuberculosis (TB) or lung cancer.  

Traumatic pneumothorax

This is when a pneumothorax is caused by an injury, for example, after a car crash.

Familial pneumothorax

Around 1 in 10 people that have a PSP have a family member who has also had one. This is called familial pneumothorax.

If other people in your family have had a pneumothorax, your healthcare professional should see if you have a genetic condition that caused your pneumothorax. For example:  

• Birt-Hogg-Dubé syndrome
• Ehlers-Danlos syndrome
• Lymphangioleiomyomatosis (LAM)
• Marfan syndrome
• Tuberous sclerosis.

Catamenial pneumothorax

If you have a pneumothorax three days before or after the start of your menstrual period, it could be a catamenial pneumothorax. This is a type of PSP. This type of pneumothorax is rare. 

A catamenial pneumothorax is more common in your right lung and can happen more than once. The reasons for this are unknown, but early research has linked it to endometriosis.  

Bilateral pneumothorax 

A bilateral pneumothorax is when air leaks out of both of your lungs and causes them to collapse. This is uncommon.  

Tension pneumothorax

If air continues to get into the pleural space when you breathe, pressure can build in your chest. This can start to squash organs like your other lung and your heart. This is called a tension pneumothorax. 

A tension pneumothorax is a medical emergency. It might need different treatment to other types of pneumothorax.

Spontaneous pneumothorax is rare. In England, fewer than 1 in 2000 people aged 15 or above go to hospital because of a spontaneous pneumothorax every year.

Pneumothorax symptoms in adults and children   

You might get: 

• a sudden, sharp stabbing pain in your chest or shoulder
• chest pain that gets worse when you breathe in
• breathlessness
• a cough
• clicking, bubbling or crunching in your chest.

When to get medical help for a pneumothorax

Your healthcare professional might use these tests to work out if you have a pneumothorax:

• a chest X-ray
• a CT scan
• an ultrasound
• blood tests.

Sometimes, your pneumothorax can heal by itself if you have no symptoms or your symptoms are not affecting you.  

If your pneumothorax needs treatment, there are different ways to remove the extra air from your chest:  

• Chest drain. A small tube is put into your chest to help remove extra air. You might need a chest drain for a few hours or a few days. You’ll need to stay in hospital while you have a chest drain in.
• Needle aspiration. A small needle or tube is put into your chest to suck out the extra air through a syringe. You can usually go home a few hours after this is done.
• A vent. A small one-way valve is put into your chest to let air out. You’ll need to keep it in for a few days, but you will not need to stay in hospital.

Your healthcare professional will work with you to pick the treatment that is best for you.  You will get local anaesthetic before having any of these treatments, so you should not feel any pain.

Mental health and wellbeing

There is help available if you feel anxious, worried or stressed after having a pneumothorax. These are normal feelings. We can help: 

• read our advice about looking after your mental health with a lung condition
• join our online support forum to meet other people with similar experiences to you
• call our helpline, we have a team of nurses and advisors trained to give you practical and emotional advice.   

Will it happen again? 

If you have a spontaneous pneumothorax, there is a risk it will happen again:  

• around 3 in 10 people that have a primary spontaneous pneumothorax have another one
• up to 4 in 10 people that have a secondary spontaneous pneumothorax have another one. 

If a pneumothorax happens more than once on the same side, you might have a small operation to make sure it cannot happen again.    

Get help to stop smoking

If you’ve had a pneumothorax and you smoke, stopping smoking will reduce the risk of it happening again.  

Physical activity 

Your healthcare professional can give you the best advice about exercise and physical activity after your pneumothorax.  

You should not scuba dive after having a pneumothorax as there is a high risk that it will happen again. 

Flying 

The high altitude that planes reach could cause you to have another pneumothorax, so you should not fly until your pneumothorax is completely gone. This is usually a week after your pneumothorax heals. 

When you can fly again, tell your travel insurance company about your pneumothorax. If you do not tell them, it could affect any claims. We have more advice about travelling safely with a lung condition.