Loss of smell

Overview

Loss of smell, also called anosmia (an-OZ-mee-uh), is when you cannot smell anything at all. Some people have a reduced ability to smell, known as hyposmia.

Yes, loss of smell is quite common. Many people experience it at some point, often due to a stuffy nose from a cold or allergy.

It can affect people of all ages, but it becomes more common as you get older. It also tends to affect men and women equally.

Symptoms

Common symptoms

• Not smelling anything at all (anosmia).
• Noticing a weaker sense of smell (hyposmia).
• Not being able to taste food well.
• Feeling like familiar smells have changed or are unpleasant (parosmia).
• No nasal congestion or other cold symptoms in some cases.

Symptoms in children

• Children may not complain but might lose interest in food or seem unhappy at mealtimes.
• They often get loss of smell from colds, allergies, or sinus infections.
• If a child cannot smell, they may not notice dangers like smoke or spoiled food.

Symptoms in older adults

• Loss of smell in older adults is often gradual and may be linked to normal aging.
• It can also be an early sign of Parkinson's disease or Alzheimer's disease.
• Older adults might eat less because food doesn't taste as good, which can lead to weight loss.

Causes

Main causes

• Viral infections such as the common cold, flu, or COVID-19.
• Nasal polyps (soft growths inside the nose).
• Chronic sinusitis (inflammation of the sinuses).
• Head injury (damage to the nose or the smell nerves in the brain).
• Aging (the sense of smell naturally declines with age).
• Some medications (rare).
• Neurological diseases like Parkinson's or Alzheimer's.

Risk factors

• Smoking or exposure to strong chemicals.
• Allergies that cause chronic nasal congestion.
• Having a family history of Parkinson's or Alzheimer's disease.
• Repeated nasal infections or sinus problems.

When to see a doctor

See a doctor urgently if:

• See a doctor urgently if loss of smell happens suddenly after a head injury or with signs of a stroke.
• Also see a doctor urgently if you cannot smell at all for no clear reason and it lasts more than a few weeks.

Book a routine appointment if:

• Make a routine appointment if loss of smell is mild or comes and goes, and you want to know the cause.
• Also see your doctor if loss of smell affects your appetite, weight, or mood.

Diagnosis

Your doctor will ask about your symptoms, when they started, and any other health issues. They will also examine your nose and sinuses with a small light or camera (nasal endoscopy).

Tests that may be done

• Smell identification test – you will be asked to sniff different scents (like lemon, rose, or coffee) and identify them.
• Nasal endoscopy – a thin, flexible tube with a camera is inserted into your nose to look for polyps, swelling, or infection.
• Imaging tests (CT scan or MRI) – if your doctor suspects a blockage or needs to look at the sinuses or brain.

What to expect at your appointment

The doctor’s exam is usually painless and quick. Smell tests are simple and take about 10–15 minutes. You may be asked to return if results are unclear.

Treatment

Treatment depends on the cause. If loss of smell is due to a virus, time and smell training can help. If another condition like allergies or sinusitis is causing it, treating that condition may restore your sense of smell.

Self-care at home

• Smell training – sniff strong scents (like lemon, rose, clove, or eucalyptus) twice daily for at least 4 months. This can help the nerve cells recover.
• Keep your nasal passages clear using a saline (salt water) rinse.
• Use a humidifier or steam to soothe irritated nasal passages.
• Avoid smoking and second-hand smoke.

Medical treatments

Doctors may recommend nasal sprays (corticosteroids) or rinses to reduce inflammation. For allergies, they may suggest antihistamine medications. If a bacterial sinus infection is present, antibiotics may be prescribed. No specific drug names or doses are recommended here – always follow your doctor’s advice.

When is surgery considered?

If nasal polyps or a structural blockage in the nose is found, surgery to remove them may be an option. This can improve the sense of smell in some cases.

Living with this condition

You may need to rely on your other senses more. Install smoke alarms and gas detectors in your home. Label food with dates and ask someone else to check if food is spoiled. Be careful when using gas appliances.

Lifestyle tips

• Install smoke and carbon monoxide detectors.
• Check food expiration dates and use your eyes to look for mold or spoilage.
• Ask a friend or family member to help smell-check food or gas leaks.
• Use a calendar or reminders for taking medications, since you might not be able to smell medicine odors.

Diet and exercise

Add extra flavor to meals with herbs, spices, and textures. Try new recipes to keep eating enjoyable. Regular exercise can help your overall health and mood.

Mental health and emotional wellbeing

Loss of smell can be frustrating and lead to sadness or depression. It is normal to feel upset about it. If you are struggling, talk to your doctor or a counselor. If you are having thoughts of harming yourself, please reach out to a crisis support line in your area immediately.

Prevention

Not all cases can be prevented, but you can reduce your risk. Avoid smoking, get vaccinated against flu and COVID-19, and treat allergies and sinus infections early.

Vaccines

Getting recommended vaccines, such as the flu vaccine and COVID-19 vaccine, may help prevent viral infections that can cause loss of smell.

Complications

If left untreated

• You may not notice dangerous smells like smoke, gas leaks, or spoiled food.
• Loss of appetite and weight loss can occur because food doesn’t taste as good.
• Depression or social withdrawal from frustration or embarrassment.

Long-term outlook

Most people regain some or all of their sense of smell over time. For some, it may take months. Even if it does not fully return, people can adapt and live well. Treating the underlying cause often helps. Stay hopeful and work with your doctor.

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