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Common cold

Dr Roger Henderson
Reviewed by Dr Roger HendersonReviewed on 13.10.2023 | 7 minutes read
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Most of us have felt the effects of a common cold – adults catch one once or twice every year, and children up to six times a year. The symptoms of a cold are caused by a viral infection, with rhinovirus being the most likely culprit. Colds typically circulate in autumn and winter, especially among children at school or nursery.

There is no cure as such, your immune system will fight the virus and overcome it within 1 to 2 weeks. Antibiotics have no benefit for the common cold as they are only effective against bacterial infections. Treatments aim to relieve symptoms, but they won’t speed up getting rid of a cold.

Colds usually appear in autumn and winter, although common viruses have been thrown out of sync by the COVID-19 pandemic, where we weren’t mixing as usual, with lockdowns, limited social or work interaction and with mandatory mask-wearing.

It’s thought that our immune system needs to keep meeting these common viruses to keep us protected, and during the pandemic, this immunity was lost to an extent. So as doctors, we’ve been seeing coughs and colds during the summer in the last couple of years, when this would have previously been very rare.

What are the symptoms?

A cold virus infects via the nasal passage and airways, inflaming the nose and throat. You’re likely to experience sneezing, a runny or blocked nose, sore throat and mild muscle aches. Less common symptoms include a mild headache, a hacking cough, a low-grade fever and a feeling of pressure in your ears and face.

Sometimes a runny nose can turn into thicker mucus of green or yellow, but this doesn’t mean you have a bacterial infection. A cold is usually mild and gets better within a week or two.

As we learn to live alongside COVID-19, we have been told to expect different symptoms to cold or flu. As the COVID-19 virus evolves and most people get vaccinated, its symptoms have changed and it’s actually very difficult to tell them apart. A swab is the only definitive way, but these are not freely available in the UK as previously, and may not turn positive early on.

The ZOE Health Study app by King’s College London advises that symptoms can be very similar, with the only real determinant a loss of taste or smell, which is more likely in those who are unvaccinated and catch COVID-19 over a common cold. For those who are fully vaccinated, the most common 5 symptoms are runny nose, headache, sneezing, sore throat and persistent cough. A cold is much less likely to cause diarrhoea, vomiting or breathlessness, whereas COVID-19 can.

COVID-19 can also mimic flu (influenza virus), especially with a dry cough common to both.

But flu can be distinguished from a common cold as it usually causes a high temperature of 38°C and above, severe muscle aches, feeling tired or exhausted, a dry cough and headaches. It’s much less likely to cause sneezing, and less likely to cause a runny nose or a sore throat.

Doctors often say that you can tell a cold from flu, as patients will walk into the surgery with a cold to complain of being unwell, whereas they would tell you they had flu the week before and had only just got out of bed. This may be simplistic, but it gives an indication of the all-encompassing nature of the influenza virus versus the milder common cold viruses.

Causes & triggers

The common cold is very contagious and is caught by airborne spread. Tiny virus-filled droplets from a cough or a sneeze are breathed in by anyone nearby, or the virus can spread simply by talking closely with someone with a cold. The cold virus can contaminate surfaces, where it can survive for up to 24 hours, or on your hands that then touch your face and mouth.

You are contagious from a couple of days before you develop symptoms until your symptoms have cleared up – about 1 to 2 weeks later.

Regular hand washing can lower your chance of catching or passing on a cold. Wearing a face mask can prevent you from passing on the cold via airborne droplets, and similarly, sneezing or blowing your nose into a tissue and then throwing it away will reduce spread.

You do not have to isolate if you have a cold, flu or COVID-19, but it’s courteous to others, especially those who are vulnerable, to keep your distance and stay home if you can.

Colds are more likely in autumn and winter, although it’s a common myth that you can catch a cold in cold weather or by getting wet. It’s more likely to do with people staying indoors and being in close proximity to one another, especially children in their classrooms. Low humidity may also play a role, drying out nasal passages to make them more vulnerable to cold viruses getting in.

Anyone and everyone can catch a cold, but children are at higher risk as their immune system is still developing. They often have milder symptoms, but it can feel a bit constant during the first term back at school.

Occasionally a cold can disrupt our natural skin barrier, which allows bacteria to get in and cause infection, like a bacterial ear infection. This will be obvious if pain in one ear gets suddenly worse, and there may be redness in the cheek or pain around the ear, especially in children.

Treatment: home & drug-free

There is nothing to chase a cold away any sooner, but there are measures to ensure you feel better with your symptoms. Looking after yourself so your immune system can get to work will ensure it doesn’t hang around any longer than it needs to.

Getting rest

Make sure you’re getting the sleep you need, as this is when your immune system is working at its best. Early nights are generally more restful than lie-ins in the morning.

Keeping hydrated

Fighting an infection requires more fluids than usual. It’s recommended you drink 8 glasses of water (or 1.5 litres) per day, but it’s a good idea to increase this with a cold, especially if you have a fever, and it might be worth replacing any lost salts with rehydration or electrolyte mixes.

Eating well

While we’d suggest a healthy diet all year round to keep your body and immune system in good balance, good nutritious food is vital while you’re feeling ill with a cold. Chicken soup has traditionally been advocated as good for soothing and comforting, but any flavour of soup might play a role in delivering vitamins and minerals, and the warmth of it can help decongest a stuffy nose or scratchy throat. Less science, more home comforts.

Gargling with salt water

Saline gargles in the throat may help relieve a sore throat by drawing out any virus and fluid swelling. Similarly, saline nasal lavage (washing out the nasal passages with salt water) may help relieve nasal congestion and wash out any remnants of the virus. It’s very much a personal choice: some people love the feeling of these, but others can’t imagine anything worse.

These aren’t appropriate for children and are only temporary measures, but they're a good alternative to medications like decongestants. They may relieve some symptoms, but they won’t speed up recovery.

Avoiding chapped skin

Streaming from the nose and constant wiping with tissues can cause the skin barrier to break down around the base of the nose and the lips. It’s worth using tissues with balm to be kinder and less abrasive to your skin. Kleenex Balsam tissues, for example, contain a moisturising complex of aloe vera, vitamin E and calendula. Keep lips protected from chapping with lip balm or Vaseline. A non-perfumed emollient can also help to protect and repair the skin barrier and avoid flaking and breakdown. Haymax balm, often used in the hay fever season to protect nostrils, may also be useful as a barrier during a cold.

Steam for congestion

It’s a commonly held belief that warm steam will help clear nasal congestion, but studies – most recently in the respected medical journal The Lancet – have quashed this myth. The authors determine that there is no additional symptomatic relief to treat the common cold, and it carries a risk of scalding to children, which can be serious and require hospital attention. That said, a bath or shower provides a warm humid environment and can help ease muscle aches, which may aid a good night’s sleep and make you feel a bit better.

Vitamin C and other supplements

Everyone seems to turn to vitamin C when they get a cold, but there’s little evidence that this boosts your immune system in the short term – much better to keep a healthy varied diet going at times of wellness and illness. Similarly, there’s no evidence echinacea or garlic help prevent colds or aid recovery.

When should I see my doctor?

Colds rarely need input from your doctor, but it’s worth booking an appointment if you have concerns about breathlessness, chest pain, high fever that’s not coming down with simple measures, or symptoms suddenly get worse.

You’re at higher risk of complications like a cold becoming a bacterial pneumonia if you have long-term health conditions, like diabetes or problems with your heart, lungs or kidneys, or if your immune system is suppressed from certain conditions or medications.

If your symptoms persist without improvement for more than 3 weeks, contact your doctor. And if you are concerned about your child’s symptoms, seek advice from your doctor.

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Dr Roger Henderson
Reviewed by Dr Roger Henderson
Reviewed on 13.10.2023
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