That persistent tickle in your throat doesn’t usually mean you’re still sick. Here’s why cold symptoms can stick around after our bodies have fought off the illness.
You’re finally over that nasty cold, but can’t seem to get rid of the lingering cough it left behind.
Should you be worried?
“Many patients want a cold to last just a couple days, but people can have symptoms for a week or two, or even three, from a simple virus,” Dr. John Dougherty, primary care physician at UCLA Health in Beverly Hills, California.
He explains that symptoms like a cough brought on by a cold virus or infection are as much caused by the condition as they are by the immune system’s response to fighting off the illness.
“You’ll have white blood cells that move to fight off whatever is causing [the illness], so then, even after the cold or flu or virus is eradicated, your body is still resolving that inflammation and can cause persistent symptoms,” said Dougherty.
The most common reason people can’t kick a cough, though, is postnasal drip.
“Mucus builds up when you have a cold, and your nasal cavity and sinuses will keep dripping [the mucus] in the back of your throat, creating a tickle effect that will make you want to cough,” Dr. Laura Boyd, primary care physician at Elmhurst-Edward Health Center in Addison, Illinois.
Boyd says sinus cleanses like SinuCleanse can help rinse out your sinuses, while antihistamines, such as Claritin or Zyrtec nasal sprays, can help dry up the mucus.
Other reasons for a persistent cough might include the following:
Secondary infection, such as post-viral pneumonia
“Sometimes you get a viral infection, such as a cold, and then your immune system is busy fighting that off and can get distracted. A bacterial infection can take hold, which would need a second or different treatment,” Dougherty said. “If you get sick, then get better, then redouble and get worse, the worsening can be a sign of another infection that has taken hold.”
A cough can be caused by asthma, or, when some people get a cold, they can have an asthmatic response.
“Their small airways to the lungs can constrict and that will cause a wheeze. When you hear a wheeze with the cough, that’s a concern that it could be something other than just a cough with a cold,” Boyd said.
You never had a cold
Symptoms that mimic a cold can turn out to be caused by something else. There’s a variety of other things that can mimic cold symptoms, such as nasal drip, acid reflux, and heartburn.
“The common cold should only last five to seven days,” said Boyd. “If you have a high fever or are feeling like you’re getting worse and not getting better, get checked out to make sure nothing else is going on.”
For more serious concerns with a cough, such as heart disease and lung cancer, Dougherty says very few people who have a cough have lung cancer.
“But no one knows your body as well as you do, so if you feel something isn’t quite right, then go get checked out,” he said.
Signs to get reevaluated include:
- if your cough is lasting much longer than you think it should
- if something is changing with your cough, such as it turns from a dry cough to one with mucus
- if you’re coughing up blood
Am I contagious if I’m coughing?
Boyd says you’re contagious for at least 24 hours before you have symptoms of a sickness because your body is harboring the illness.
As far as colds go, even though most last 5 to 7 days, she says you can continue to give off the virus for up to 21 days. “So, it’s hard to know, exactly,” Boyd said.
Dougherty adds that if you have an infection that causes a fever, typically once the fever is gone, you are less likely to be contagious.
“If you have a cough that’s caused by something that requires antibiotics, generally once you’re on the antibiotics for 24 hours, then the infection will be mostly gone,” he said.
How can I treat a lingering cough?
For a cough caused by a common cold, Dougherty says over-the-counter cough medication that contains dextromethorphan can be helpful.
However, he suggests taking caution with cough medicine that includes codeine. “Codeine has potential for adverse effects or addictive potential,” he said.
Prescription medications may also be effective.
“Cough is caused by irritation receptors in the throat and lungs, so infection can increase the sensitivity of those receptors,” Dougherty said. “There are prescription medications that can address that sensitivity to help lighten the cough.”
He adds that cough drops and topical sprays like Chloraseptic are generally safe, too.
And what about home and herbal remedies?
Again, Dougherty advises caution.
“They are not closely regulated from the FDA, so sometimes you might not always know what you’re getting. What’s in the bottle might not match what the label says because of the lack of regulation,” he said.
However, if tea and honey is your go to, Boyd says go for it.
“Honey coats our throat and so that’s why it works. For kids over the age of 1, honey helps with the irritation by soothing the symptom,” she said. “It doesn’t make the cough go away, though.”
And if you like to take vitamin C, zinc, or Echinacea when a cold strikes, both doctors say there isn’t much evidence that proves their effectiveness.
“In fact, you shouldn’t take Echinacea on a regular basis to help prevent a cold because it won’t help your immune system, but as soon as you feel symptoms coming on, taking it, zinc or vitamin C sometimes can decrease the length or severity of your cold, but won’t cure it,” said Boyd. “Unfortunately, there is no cure for the common cold.”