Colds

Overview

A cold is a mild infection of your nose and throat caused by a virus. It is not the same as flu, which is usually more severe. A cold usually comes on slowly and clears up on its own within about a week to ten days, though a cough can linger a little longer. There is no cure, but rest, fluids and simple self-care help most people feel better while their body fights off the virus.

Very common. Adults typically get two to four colds a year, and young children may get six to ten or more, especially if they go to nursery or school. Colds are one of the most frequent reasons people visit a pharmacist or doctor.

Anyone can catch a cold. Young children catch them most often because their immune systems are still learning and they are in close contact with other children. Older adults, pregnant people, and anyone with a long-term lung or heart condition may find colds hit them a little harder or last longer.

Symptoms

Common symptoms

• Runny or blocked nose
• Sneezing
• Sore or scratchy throat
• Cough, often worse at night
• Mild fever or feeling shivery
• Headache
• Tiredness and low energy
• Aching muscles
• Watery eyes
• Mild loss of smell or taste
• Feeling congested or 'bunged up' in the ears

Symptoms in children

• Being more fussy, clingy or sleepy than usual
• A higher fever than adults tend to get
• Poor appetite or feeding less than usual
• Coughing at night, which can disturb sleep
• Vomiting after a coughing fit
• Ear pain or tugging at the ear
• Snoring or noisy breathing because of a blocked nose

Symptoms in older adults

• May have a mild fever or no fever at all, even with a real infection
• A cough that lingers longer than expected
• Feeling unusually tired or weak
• Reduced appetite and drinking less, which raises the risk of dehydration
• New confusion or drowsiness, which should always be checked
• A higher chance of the cold turning into a chest infection

Causes

Main causes

• Colds are caused by viruses — there are well over a hundred different types, which is why you can catch them again and again.
• The virus spreads through tiny droplets in the air when someone coughs or sneezes near you.
• It also spreads by touch: shaking hands, or touching a doorknob, phone or toy that has the virus on it, then touching your eyes, nose or mouth.
• You are most likely to pass a cold on in the first few days of symptoms, when you feel worst.

Risk factors

• Close contact with young children, who carry and share viruses readily
• Crowded or enclosed places such as public transport, schools and offices
• Smoking, or living with someone who smokes, which irritates the airways
• A weakened immune system from illness or some medicines
• Poor sleep, high stress, or feeling run down
• Dry indoor air in winter, which dries the lining of the nose
• Autumn and winter months, when people spend more time indoors together

When to see a doctor

See a doctor urgently if:

• You or your child has trouble breathing, or breathing looks like hard work
• A baby under 3 months has a temperature of 38°C or higher
• There are signs of dehydration — few or no wet nappies, no tears, sunken eyes, dry mouth
• You feel very unwell, confused, or cannot keep fluids down
• A fever with a stiff neck, severe headache, or a rash that does not fade when pressed
• You have a long-term lung condition such as asthma and your usual breathing is getting worse

Book a routine appointment if:

• Symptoms are not improving after about 10 days
• Symptoms seem to get better and then get worse again
• You have ear pain that does not settle in a day or two
• The cough is severe, or you are coughing up blood
• You keep getting colds one after another and want to talk it through
• You are pregnant, over 65, or have a long-term health condition and want advice

Diagnosis

A cold is usually diagnosed just by talking about your symptoms and how they started. Most people do not need to see a doctor at all. If you do go, your doctor or nurse will ask how long you have felt unwell, examine you briefly — perhaps checking your throat, ears, chest and temperature — and check your general health.

Tests that may be done

• Usually none — tests are almost never needed for a cold
• Occasionally a throat swab, if a bacterial throat infection is being considered
• Occasionally a chest examination or other tests, if a chest infection is suspected

What to expect at your appointment

Expect a short, simple appointment. Your clinician will explain what is likely going on and how long it should take to settle. They may suggest ways to ease your symptoms and will tell you what changes would mean you should come back. If antibiotics are not needed — which is the case for most colds — that is a helpful decision, not a missed one, because antibiotics do not work on viruses and can cause side effects.

Treatment

There is no cure for a cold — the aim is to ease your symptoms and let your body clear the virus. Most people can manage at home with rest, fluids and simple self-care. Ask your pharmacist which over-the-counter remedies are suitable for you, especially if you take other medicines, are pregnant, or are treating a child. Always read the label and follow the instructions, and never give adult medicines to children.

Self-care at home

• Rest as much as your body asks for, and try to sleep with your head slightly raised
• Drink plenty of fluids — water, warm drinks, and squash help keep your throat comfortable and prevent dehydration
• Breathe in steam from a warm shower or a bowl of hot water to help loosen a blocked nose
• Try a saline (salt water) nose spray or rinse, which is gentle and suitable for many people including children
• Gargle with warm salt water to soothe a sore throat
• Have a warm drink with honey if you are over one year old — never give honey to babies under 12 months
• Keep the room warm but not stuffy, and avoid smoky environments
• Stay home while you feel unwell, and cough or sneeze into a tissue, then throw it away and wash your hands

Medical treatments

Treatment is about symptom relief rather than curing the virus. Your pharmacist can advise on simple pain and fever relief and on decongestant or cough preparations — but these are not right for everyone, so always check first. Children, pregnant people, and people with conditions such as high blood pressure, heart problems or asthma need particular care with over-the-counter cold remedies. Because colds are viral, antibiotics do not help and are only considered if a bacterial infection such as an ear or chest infection develops. If your symptoms are severe, lasting, or you are in a higher-risk group, your doctor will advise on the best options for you.

When is surgery considered?

Surgery is not used to treat colds.

Living with this condition

Take things a little slower for the first few days, when symptoms are usually at their worst. Plan short days, go to bed earlier, and give yourself permission to do less. Keep tissues, water and any remedies your pharmacist has suggested within easy reach. Most people can return to normal activities once they feel up to it — staying home while you feel feverish and unwell helps protect others too.

Lifestyle tips

• Aim for regular sleep — being well rested helps your body fight infection
• Wash your hands often with soap and water, or use hand gel when out and about
• Avoid smoking and smoky rooms, which keep your nose and throat irritated
• Keep shared surfaces, phones and door handles wiped down when someone at home is unwell
• Use your own towel and cup while you are unwell
• Open a window now and then to freshen indoor air

Diet and exercise

There is no special diet that cures a cold, but eating regularly and drinking well supports your recovery. Warm soups, toast, fruit and yoghurt are good choices when your appetite is low. Gentle movement such as a short walk is fine if you feel like it. If you have a fever, aching muscles, or a cough in your chest, rest instead and wait until you feel better before going back to harder exercise — usually a few days.

Mental health and emotional wellbeing

Feeling low, foggy or frustrated during a cold is very common. Being unwell interrupts work, plans and sleep, and that can affect your mood. Remind yourself that this is temporary and should pass within a week or so. Fresh air, a chat with someone you trust, and keeping evenings calm can help. If low mood, anxiety or poor sleep lasts beyond the infection, speak to your doctor — and if you ever feel you cannot cope, contact your local crisis or mental health support service straight away.

Prevention

You cannot completely prevent colds, because so many different viruses cause them. But good hand hygiene, avoiding close contact with people who are unwell, and keeping shared surfaces clean can lower your chances. These habits are simple, cheap, and genuinely help.

Vaccines

There is no vaccine against the common cold, because so many different viruses cause it. Flu is a different illness and a yearly flu vaccine is offered to certain groups — it will not stop colds, but it protects against flu, which can be more serious.

Screening programmes

There is no screening test for colds. Colds are diagnosed from symptoms, and routine screening is not needed.

Complications

If left untreated

• Most colds settle without any treatment and without complications.
• Sometimes the virus spreads to the ears and causes an ear infection, especially in children.
• It can spread to the sinuses, causing facial pressure and a longer, thicker discharge.
• It can move to the chest, causing a chest infection, which is more likely in older adults, smokers and people with lung disease.
• Colds can trigger flare-ups of asthma or other long-term lung conditions.
• Dehydration can develop if you are not drinking enough, particularly in young children and frail older adults.

Long-term outlook

The outlook is very good. Nearly everyone recovers from a cold within one to two weeks, and a lingering cough often settles over the following couple of weeks. Colds are a normal part of life and catching them does not mean anything is wrong with you. If symptoms are unusually severe, keep returning, or do not settle, your doctor can check for other causes and help you get back on track.

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