Since there are more than 200 viruses that can cause a common cold, the symptoms tend to vary greatly. Most adults suffer from a common cold two to four times per year. Children, especially preschoolers, may have a common cold as many as six to ten times annually.
The rhinovirus is the most common virus causing the infection, and it is highly contagious, meaning it can be easily spread from one person to another. A cold virus enters the body through the mouth or nose and can spread through droplets in the air when someone who is sick coughs, sneezes or speaks to you. A cold virus can also be spread by direct contact with someone who has a cold or by using shared objects, such as telephones, toys, or utensils. Touching the nose, mouth, or even eyes after such contact or exposure, may lead to a cold.
Symptoms
Nasal allergies and colds share many of the same symptoms, which may make it difficult to identify the cause of the ailment. Signs and symptoms of a common cold usually appear about one to three days after exposure to a cold virus and may include:
- Runny or stuffy nose
- Cough
- Slight body aches or a mild headache
- Watery eyes
- Mild fatigue
- Itchy or sore throat
- Congestion
- Sneezing
- Low-grade fever (up to 102 F)
Colds can last up to about 2 weeks, and are contagious. During a cold, the discharge from the nose may become thicker and yellow or green in color as a common cold runs its course. It is uncommon to see a high fever with a cold. Nasal allergy symptoms can be distinguished from colds by the fact that they usually last longer, and cannot be spread.
Complications From a Common Cold
- Acute Ear Infection (Otitis Media). An ear infection occurs when bacteria or viruses enter the space behind the eardrum. This is a frequent complication of common colds in children and occasionally in adults. The signs and symptoms may include hearing loss, earaches, and fever.
- Sinusitis. A common cold that doesn’t resolve may lead to sinusitis.
- Other Secondary Infections. These include bacterial throat infections (strep throat), pneumonia, bronchitis, and croup in children.
- Wheezing. A cold can trigger wheezing in patients with asthma.
Treatment
There is no cure for the common cold. Fortunately, most patients feel better in about a week or two. If the symptoms of a common cold have not improved in that time, bacterial complications should be ruled out and further medical evaluation is necessary to determine the cause of the patient’s continued symptoms.
In cases where chronic sinus blockage or infection persists after a cold clears, sinus surgery may be recommended to restore normal drainage.
The goals of treatment of the common cold are to make the patient feel better and to help fight off the virus. Since the infection is caused by a virus, antibiotics are ineffective.
Although over-the-counter cold medications won’t cure a common cold or make it go away any sooner, they often reduce the symptoms. However, most over-the-counter cold medications have side effects and it is wise to read the medication labels carefully.
Most heavily advertised over-the-counter cold and flu medications contain multiple drugs to treat many symptoms.
A physician should be consulted before using over-the-counter medication for children under the age of 14.
Pain Relievers
These are effective in reducing fever, sore throat, body aches, and headaches. It is important to read the instructions carefully and to stay within the recommended doses. Aspirin should never be given to children as it has been associated with Reye’s syndrome, a rare but potentially fatal illness. Gargling with salt water (1/2 teaspoon of salt in 1 cup of water) is effective in reducing a sore throat.
Nutrition
Good nutrition is essential for resisting and recovering from a cold. It is important to eat a well balanced diet. Consume the recommended dietary allowances for vitamin A, vitamin B complex (vitamins B-1, B-2, B-5, B-6, folic acid) and vitamin C, as well as the minerals zinc and copper. If the diet does not provide an adequate amount of these vitamins and minerals, supplements should be added as needed.
Rest and Hydration
The more rest and sleep the better; this allows the body to heal itself faster. Increasing water consumption is very important since a lot of fluid is lost during a cold. Hydration makes the mucus flow more freely and helps with relieving the congestion.
Decongestants
Decongestants fight nasal congestion by temporarily constricting the blood vessels. By reducing the size of the blood vessels, the nasal mucosal swelling, and therefore the nasal congestion, is reduced. Decongestants are available in pill form as well as nasal sprays. Please be aware that over-the-counter nasal decongestant sprays can cause a “rebound effect” when used longer than the recommended period. This results in worsening of the nasal congestion after the medication has been stopped. In addition, decongestant pills may increase blood pressure and heart rate. Decongestants should not be taken without first checking with a physician if the patient has heart disease, high blood pressure, prostate problems, diabetes, or thyroid problems.
Saline Nasal Sprays
Over-the-counter saline nasal sprays help reduce nasal congestion. They are effective, safe and nonirritating. Saline nasal sprays provide moisture to the nasal passages, especially during cold or dry seasons. When the nasal passages are dry, stagnation of mucus and mild nasal crusting may occur. Thus, viruses may not be cleared from the nasal passages in a timely fashion and viral infections can develop under these crusts. Saline sprays clean the nasal passages of crusts and mucus and also help the naturalcleaning system of the nasal passages.
Cough Syrups
Over-the-counter cough suppressants can be helpful if the cough is so severe that it interferes with sleeping or talking. If this is not the case, do not suppress the cough, because coughing removes mucus and germs from your throat and lungs. Coughs associated with a cold usually last less than two to three weeks. If a cough lingers longer than that, you should see your doctor.
When to See a Doctor About a Cold That Will Not Go Away
Most colds clear up on their own within 7 to 10 days, and nearly all resolve within two weeks. If your cold has stretched into a third week, that is not just bad luck. A cold lasting three weeks or longer usually means something else is going on, and it deserves a proper medical evaluation.
One of the most common reasons lingering cold symptoms persist is the development of sinusitis, a sinus infection that develops when a cold inflames and blocks the sinus passages. Untreated nasal allergies and structural problems such as a deviated septum can also keep congestion, drainage, and pressure going long after the original virus has cleared.
Contact a doctor promptly if you notice any of the following:
- Symptoms lasting longer than 10 days without improvement
- Symptoms that improve and then suddenly return worse than before
- Fever above 101.3 F, or any fever lasting more than three days
- Facial pain, pressure, or fullness around the eyes, cheeks, or forehead
- Thick, discolored nasal discharge paired with facial pain
- Severe headache, ear pain, shortness of breath, or wheezing
For patients whose colds repeatedly turn into stubborn sinus infections, medication alone may not be enough. In those cases it helps to understand when sinus surgery becomes an option for lasting relief.
Prevention
There is no effective vaccine for preventing the common cold. However, certain precautions will help slow the spread of cold viruses:
- Hand Washing. Clean hands thoroughly and often. Carry an alcohol-based hand rub, containing at least 60 percent alcohol, for times when soap and water aren’t available. These gels are effective at killing most germs.
- Domestic Hygiene. It is important to keep kitchen and bathroom countertops clean, especially when someone in your family has a common cold. You should also wash the children’s toys after play.
- Use Tissues. Always sneeze and cough into tissues. Discard used tissues right away, and then wash your hands carefully. If there is no tissue available, you should cough into the bend of your elbow so that your mouth is covered without using your hands. This helps to reduce the spread of the common cold by hand contact.
- Don’t Share. Don’t share drinking glasses or utensils with other family members.
- Steer Clear. Avoid close or prolonged contact with anyone who has a cold.
Dr. Zadeh’s practice offers a full range of ENT services for conditions beyond the common cold. Contact the Los Angeles Sinus Institute to schedule an initial consultation with Dr. Zadeh, a board-certified otolaryngologist (head and neck surgeon), in Los Angeles, CA.
Frequently Asked Questions About Colds
How long should a cold last?
Most colds clear up in 7 to 10 days, and nearly all resolve within two weeks. Symptoms usually peak around day three or four and then gradually improve. If your symptoms are not improving after 10 days, it is time to check in with a doctor.
Is it normal to have a cold for 3 weeks?
No. A cold that lasts three weeks or longer is a sign that something else may be going on, most often sinusitis, nasal allergies, or a secondary bacterial infection. A medical evaluation can identify the cause and get you on the right treatment.
Why won’t my cold go away?
Lingering cold symptoms often mean the original viral infection has led to a complication, most commonly a sinus infection. Untreated nasal allergies and structural issues such as a deviated septum can also keep congestion and drainage going long after the virus has cleared. An ENT specialist can pinpoint the cause with a simple in-office evaluation.
When should I see a doctor for a cold?
See a doctor if your symptoms last longer than 10 days without improving, you have a fever above 101.3 F or one lasting more than three days, you develop facial pain or pressure, or your symptoms improve and then return worse than before. These are signs your cold may have progressed to a sinus infection.
Do I need antibiotics for a cold?
No. Colds are caused by viruses, so antibiotics are not effective against them. Antibiotics are only appropriate when a cold leads to a bacterial complication such as bacterial sinusitis, which a doctor can diagnose and treat.