Phantom smells

Overview

Phantom smells, also called phantosmia, is when you smell something that is not actually there. It can be a pleasant or unpleasant smell, and it happens without any source of the odor nearby.

Phantom smells are not very common, but they do happen to some people. It is more common in older adults and those with certain health conditions.

It can affect anyone, but it is more common in people with sinus infections, head injuries, or neurological conditions like Parkinson's disease. It also affects some people after a viral illness like COVID-19.

Symptoms

Common symptoms

• Smelling odors that aren't there
• Usually the same smell each time
• May be pleasant or unpleasant
• May come and go or be constant

Symptoms in children

• Children may describe a bad smell that others cannot smell
• May complain of a strange taste in their mouth

Symptoms in older adults

• More common in older adults
• May be associated with memory problems or other changes in smell

Causes

Main causes

• Sinus infections or allergies
• Head injury
• Neurological conditions such as Parkinson's disease or epilepsy
• Aging
• Anxiety or depression
• Certain medications
• COVID-19 infection

Risk factors

• History of head injury
• Chronic sinus problems
• Neurological disorders in family
• Advanced age

When to see a doctor

See a doctor urgently if:

• If phantom smells come with a severe headache, vision changes, or weakness
• After a head injury

Book a routine appointment if:

• If phantom smells persist for more than a few weeks
• If they are bothersome or affecting daily life
• If you also notice changes in taste

Diagnosis

Your doctor will ask about your symptoms, medical history, and any recent illnesses or injuries. They may look inside your nose and possibly refer you to an ear, nose, and throat (ENT) specialist.

Tests that may be done

• Nasal endoscopy (a thin camera to look inside your nose)
• MRI or CT scan of the head
• Smell tests

What to expect at your appointment

The doctor will try to find the underlying cause. Many phantom smells go away without treatment, but if a cause is found, treating it often helps.

Treatment

Treatment depends on the underlying cause. Often, no treatment is needed because phantom smells go away on their own.

Self-care at home

• Rinse your nose with a saline (salt water) spray or neti pot
• Keep your room well-ventilated
• Use a humidifier if the air is dry
• Practice relaxation if stress seems to trigger it

Medical treatments

If a cause is found, treatments may include antibiotics for sinus infections, allergy medicines, or neurological treatments. In some cases, nasal corticosteroid sprays or surgery may be considered. Your doctor will discuss the best option for you.

When is surgery considered?

Surgery might be an option if the cause is a nasal polyp, tumor, or other structural problem in the nose that cannot be treated with medicine.

Living with this condition

Living with phantom smells can be annoying, but most people learn to manage it. Keep a diary of when smells happen and what you were doing. This can help you and your doctor.

Lifestyle tips

• Avoid strong odors that might trigger episodes
• Talk to your family about what you are experiencing
• Use a fan or air purifier to clear the air

Diet and exercise

A healthy diet and regular exercise can support overall health, but there is no specific diet to treat phantom smells.

Mental health and emotional wellbeing

Phantom smells can be distressing and may cause anxiety or worry. If you feel it is affecting your mood, talk to your doctor. If you need immediate support for mental health, please reach out to a crisis helpline in your area.

Prevention

There is no guaranteed way to prevent phantom smells. However, taking care of your sinuses and avoiding head injuries may reduce the risk.

Complications

If left untreated

• If caused by an underlying condition like a sinus infection, not treating it could lead to more serious infection
• In rare cases, phantom smells can be a sign of a neurological problem that needs attention

Long-term outlook

For most people, phantom smells improve or go away on their own over weeks to months. Even when they persist, they are rarely harmful. With proper diagnosis and support, most people can manage the condition well.

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