Dermatologic Manifestations of Pulmonary Disease

Just Wondering: Is A Lingering Cough After A Cold Something To Worry About?

So you've finally kicked that cold you've had for a couple weeks, but the lingering cough after the cold? It just won't seem to quit. If you're wondering why you're still hacking up a lung after the worst of your cold is behind you, there are many possible culprits.

For one, you could have leftover irritation in your airways. Or you could have a postnasal drip that keeps that ticklish feeling in the back of your throat going. Most of the reasons for your lingering cough are nothing to worry about, but it's still an irritating side effect that you likely want relieved—especially if all your other cold symptoms are gone.

Experts In This Article

Nima Majlesi, DO, director of medical toxicology at Northwell Staten Island University Hospital

Wayne Altman, MD, FAAP, professor and chair of family medicine at Tufts University School of Medicine

William Schaffner, MD, infectious disease specialist and professor of preventive medicine and health policy at the Vanderbilt University School of Medicine

Here, we break down the top reasons why that post-cold cough happens, and what to do to get rid of it for good.

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What causes a lingering cough after a cold

While most run-of-mill coughs clear up after a week or two, some stubborn ones insist on overstaying their welcome. The following issues may be to blame for a cough that won't budge.

1. Postnasal drip

Among the many possible reasons for a lingering cough, postnasal drip tops the list, says Nima Majlesi, DO, director of medical toxicology at Northwell Staten Island University Hospital. Postnasal drip happens when mucus accumulates and drips down the back of your throat. You tend to produce more mucus (which helps fight infections) during a cold. But even after, you might still have residual sinus congestion, which can cause the irritating drip, Dr. Majlesi says.

One clue your cough is related to postnasal drip: It bothers you mostly at night, says Wayne Altman, MD, FAAFP, professor and chair of family medicine at Tufts University School of Medicine. Other signs of postnasal drip to look out for include the following, per the Cleveland Clinic:

Sore throat

Feeling like there's a lump in the back of your throat

A feeling of mucus draining into your throat

Frequent swallowing

Gurgling or hoarseness

Urge to clear your throat

Bad breath (halitosis)

Nausea and vomiting from excess mucus draining to your stomach

2. Bronchial irritation

"Bronchial irritation can also occasionally linger after the acute phase of infection," Dr. Majlesi says. Your bronchial tubes are the airways that carry air to and from your lungs. When they become irritated, mucus builds up.

This irritation is often caused by prolonged inflammation from your cold. "The original viral infection initiates the body's inflammatory response, which is the way the body fights off the infection," says William Schaffner, MD, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center. "Sometimes, even after the cold virus is gone, the inflammatory response continues, irritating the mucus membranes and producing a cough."

3. Lack of rest

In Dr. Altman's opinion, this is the most likely cause for a cough that won't quit. And it makes a lot of sense: when you're sick, lack of sleep can slow down your recovery time. "When you have a viral infection, antibiotics do not help," he says. "You are at the mercy of your immune system, which is powered up by getting more rest."

As you snooze, your immune system "powers up" by releasing cytokines—a type of protein that helps protect you against infection and inflammation, according to the Mayo Clinic. Without enough sleep, you won't have as many cytokines (or infection-fighting antibodies and cells) to fend off a virus, and your cold symptoms, including cough, will last longer.

4. Over-the-counter cold medicines

Hate to break it to you, but the medicines you take to alleviate cold symptoms—like antihistamines and decongestants—could be prolonging your cough. "I find that these medications dry up secretions, which may give some mild short-term relief from congestion and runny nose, but they often cause secretions to thicken, making them harder to drain," says Dr. Altman. If thick mucus builds up, it can cause problems like postnasal drip, which, as we know, can trigger a cough.

5. Another underlying condition

A chronic cough could be a sign of other health issues. For example, allergies are infamous for triggering a tickle in your throat. If you also have sneezing, itchy eyes, runny nose, and watery eyes, chances are allergies are behind your persistent cough.

Similarly, silent reflux (also known as laryngopharyngeal reflux) can irritate your vocal cords and make you cough, according to UT Southwestern Medical Center. Silent reflux happens when stomach acid travels up your esophagus into your voice box and throat. It's called "silent" because it doesn't cause your run-of-the-mill acid reflux symptoms like heartburn.

On top of a chronic cough, other signs of silent reflux may include the following, per UT Southwestern Medical Center:

Asthma

Bitter taste in the throat

Excessive throat clearing

Difficulty swallowing

Hoarseness

Postnasal drip

Sensation of a lump in the throat

Sore or burning sensation in the throat

A cough that lasts longer than four weeks could also be due to reactive airway disease (RAD), Dr. Altman says. RAD describes a collection of breathing symptoms (that are similar to asthma) that develop when your bronchial tubes swell. Researchers aren't clear on the cause of RAD, but people who have it tend to get chronic cough, shortness of breath, difficulty breathing, wheezing, and chest tightness, according to the Cleveland Clinic.

If your cough lags for longer than two weeks, see your doctor. They can examine you, take a history of your symptoms, and help rule out (or identify) any underlying medical conditions that might be causing your chronic cough.

6. Your immune system is weakened

When your immune system isn't working at its best, it won't be able to fend off a cold like it should. That means symptoms, like cough, can stick around. If you're immunocompromised due to an underlying condition, older than 65, or a smoker, you're more likely to have a persistent cough, according to UnityPoint Health.

7. Other medications

"If you have a dry cough that you cannot shake," the culprit might be in your pillbox, Dr. Altman says. A chronic, pesky cough can be a side effect of some medications. For example, certain kinds of blood pressure drugs, such as lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, can cause a dry cough, he says.

If you suspect your medicine is making you cough, don't stop taking it. First, talk to your doctor who may be able to give you a different drug or a lower dose.

How long does a cough usually last?

Typically, a week. However, "a residual cough after a viral upper respiratory infection can occasionally last as long as two weeks," Dr. Majlesi says. Sometimes it can stretch on longer than that. "A cough after a chest cold can be a bother for some time, even up to several weeks," Dr. Schaffner says.

If a cough persists for more than eight weeks, it's considered chronic, per UnityPoint Health.

How to treat a chronic cough

If you have a lingering cough, your symptoms could stick around for a few weeks. That doesn't mean you have to feel like crap. The following strategies might help you feel better.

1. Get enough sleep

"I offer my patients the #3NightChallenge: get eight to 10 hours of sleep for three nights in a row while taking it easy during the day," Dr. Altman says. "This almost always results in an improvement or resolution of cold symptoms."

2. Try saline nose spray

"If congestion is the issue, a saline nasal spray may effectively assist in drying out sinuses," Dr. Majlesi says.

3. Hydrate

Keep a water bottle within reach and sip on warm fluids like soups, which can help loosen mucus, Dr. Altman says. "You know that you are adequately hydrated when your pee is clear," he adds. On the flip side, steer clear of caffeinated drinks and alcohol that can lead to dehydration.

4. Try honey

A cup of herbal tea with a drizzle of honey can help soothe a sore, hoarse throat due to chronic cough and postnasal drip, Dr. Altman says.

5. Sleep with an extra pillow

If your cough is related to postnasal drip, try elevating your head when you sleep, Dr. Altman says. This can help prevent mucus from running down your throat. Plus, if you're more comfortable at night, you'll sleep better. Quality sleep equals a stronger immune system.

6. Prescription medications

While home remedies may help, in some cases, they may not cut it. You might need to see your doctor, who can prescribe stronger medications like the following, per Dr. Majlesi:

Benzonatate: a cough suppressant that may help for postnasal drip

An albuterol inhaler (similar to what is used in people with asthma): may help relieve the bronchial spasm that happens during the coughing episodes

Corticosteroids (such as prednisone): can help with lingering inflammation

When to see a doctor

While inconvenient, it's not uncommon for a cough to lag on after a cold. In most cases, you can wait it out and treat your symptoms with home remedies to keep you more comfortable.

But if your cough doesn't show any sign of letting up after two weeks, it might be time to check in with your doctor. You might have a bacterial infection (like acute bronchitis) or a secondary viral infection (like a sinus infection or pneumonia), according to UnityPoint Health.

Other red flags to keep an eye out for include the following, per Drs. Majlesi and Schaffner:

You're coughing up blood

Your mucus changes to a thick green, brown, or blood-tinged color

You have chest pain

You have difficulty breathing or shortness of breath

You have fatigue

You have loss of appetite

You have a persistent fever, or you develop a fever after not having one initially

You have weight loss

"Also, if the prolonged cough comes in distinctive episodes of several coughs close together (cough seizures) that interrupt work, eating, or even sleeping, and if there is associated vomiting, you may have whooping cough (pertussis)," Dr. Altman says. This respiratory illness is caused by a type of bacteria called Bordetella pertussis, which can damage the cilia (tiny, hair-like extensions in the upper respiratory system) and cause the airways to swell, according to the Centers for Disease Control and Prevention (CDC).

As the name implies, cough is the signature symptom, and it can go on for weeks. Whooping cough can develop into a more serious infection if you're immunocompromised or you have asthma, so don't wait to seek medical attention if you have symptoms.

Final takeaway

In most cases, a residual cough after a cold is nothing to worry about. Usually, it's a sign that your body needs a little extra time and help to recharge and recover. "Think of fighting off a cough/cold as a tug-of-war with your immune system on one side and the virus on the other," Dr. Altman says. "Power up your immune system by getting rest, eating healthy, and managing your stress effectively. When you do that, your coughs and colds will be fewer and shorter in duration."

—medically reviewed by Jennifer Logan, MD, MPH

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Symptoms Of Bronchitis

Your bronchial tubes, which carry air to your lungs, can get infected and swollen. When that happens, it's called bronchitis. Symptoms of this condition include a nagging cough, and you might cough up mucus that's yellow or green.

There are two types of bronchitis:

Acute bronchitis. It is the more common type. Symptoms last a few weeks, but it doesn't usually cause any problems beyond that.

Chronic bronchitis. This keeps coming back or doesn't go away at all. It's more serious and is part of a group of conditions called "chronic obstructive pulmonary disease," or COPD. You're more likely to have this if you smoke.

The symptoms of bronchitis result from inflammation in the bronchial tubes. (Photo Credit: iStock/Getty Images)

Symptoms of acute bronchitis

Acute bronchitis usually starts when you have inflammation in your airways due to a cold, COVID-19, or other respiratory infections. In fact, you might hear it called a chest cold.

Its symptoms are similar to those of other conditions that affect your lungs and breathing. Bronchitis often starts with cold symptoms — your nose is runny, your throat sore, and you feel run-down. But one of the hallmark signs of bronchitis is a hacking cough that lasts 5 days or more. Here are some other symptoms:

A runny or stuffy nose

Clear, yellow, white, or green phlegm

A low fever at times

Tenderness or soreness in your chest when you cough

Constant tiredness

Whistling or wheezing while you breath

A rattling feeling in your chest

Chills

You usually recover from acute bronchitis in about 7-10 days, though your cough may last a bit longer.

Symptoms of chronic bronchitis

If your symptoms last longer than 3 months, you may have a chronic case. Your symptoms may improve, then worsen, from time to time. But they never really go away. Cold weather can set them off.

The symptoms are similar to those of acute bronchitis and include:

A stubborn cough that produces phlegm, lasts at least 3 months, and happens at least 2 years in a row

Shortness of breath

Chest tightness or discomfort

Abdominal pain

See your doctor if you have symptoms of acute bronchitis and also have ongoing lung, heart, or other medical problems or are infected with HIV, the virus that causes AIDS.

Also call your doctor if:

Your cough is so frequent or bad that you can't sleep well or do your daily activities.

You cough up blood or mucus.

Your cough lasts longer than a week. In otherwise healthy people, a cough from acute bronchitis can last 3 weeks.

Your mucus becomes darker, thicker, or increases in volume.

Your cough has a barking sound and makes it hard to speak.

You also have unexplained weight loss.

Call 911 if you have chest pain or difficulty breathing.

A cold isn't the only condition with symptoms that can look like those of bronchitis. Others include:

Asthma

Like bronchitis, an asthma attack can cause coughing, wheezing, shortness of breath, and a feeling of tightness in the chest. But asthma doesn't cause a cough that produces mucus, a runny or stuffy nose, chest pain, fever or chills, or body aches — which are all symptoms of bronchitis.

It's possible to have both conditions at the same time. Having asthma puts you at a higher risk of getting bronchitis. 

Bronchiectasis

Bronchiectasis is permanent scarring of the airways caused by repeated or serious infections or lung disease.Both bronchiectasis and bronchitis can cause:

Coughing

Mucus in the lungs

Shortness of breath

Wheezing

Bronchiectasis sometimes causes clubbed fingernails (swollen fingers with curved nails) and coughing up blood.

Bronchiolitis

Bronchiolitis is an inflammation of smaller airways (bronchioles) that branch off the bronchi. It's caused by an infection, usually respiratory syncytial virus (RSV), and is most likely to affect young children. Symptoms include coughing, shortness of breath, and irritability. It usually clears up in about a week.

COVID-19

COVID is one of the infections that can trigger acute bronchitis. The two conditions also share several symptoms, including:

Coughing

Trouble breathing

A sore throat

Fatigue

Fever

COVID doesn't usually cause wheezing, though. And it can cause you to lose your senses of smell and taste, which usually doesn't happen with bronchitis.

Emphysema

Emphysema is a condition that happens when air sacs in your lungs, called alveoli, are damaged. The damage may come from long-term smoking, pollution, or infections. Your genes can also play a role. Its symptoms include shortness of breath, wheezing, a lasting cough, and increased mucus.

Like chronic bronchitis, emphysema is a type of COPD. You can have the two conditions together.

Heart failure

Chronic heart , which happens when your heart isn't pumping enough blood to meet your body's needs, can cause discomfort or pressure in your chest. It can also cause shortness of breath, fatigue, and a long-lasting cough. Other symptoms may include swelling of your legs, ankles, feet, and belly, as well as a fast or irregular heartbeat. See your doctor if you have these symptoms.

Pneumonia

While bronchitis is inflammation of the airways to your lungs, pneumonia is a more serious inflammation of the lungs themselves. It's caused by infection with a virus, bacteria, or fungi. Pneumonia causes swelling and fluid in your lung sacs (alveoli), making it harder to breathe. Along with coughing and trouble breathing, symptoms may include a high fever, chills, and nausea.

Any time you have a fever above 100.4 F and a loss of appetite, wheezing or shortness of breath, and general achiness, you should see your doctor right away.

You get bronchitis when the bronchial tubes that carry air to your lungs get infected and swollen. This leads to coughing, excess mucus, and other symptoms. Bronchitis can be acute, which means it lasts for a short time, or chronic, which means it lasts at least 3 months and keeps coming back. See your doctor if you have a cough that lasts longer than a week.

How long do acute bronchitis symptoms last?

In most cases, symptoms of acute bronchitis last from a few days to a couple of weeks and go away on their own. But recovery could take up to 6 weeks. See your doctor if you have symptoms for longer than 3 weeks.

Do chronic bronchitis symptoms go away?

While symptoms of chronic bronchitis get better from time to time, they never fully go away. The condition may get worse as time goes on.

Can bronchitis turn into pneumonia?

You could get an infection that causes both conditions. But bronchitis doesn't normally turn into pneumonia.

Do you need antibiotics for bronchitis?

Acute bronchitis is most often caused by a viral infection, which antibiotics can't treat. But if your doctor thinks a bacterial infection caused your bronchitis, they may recommend antibiotics.

How Long Do Cold Symptoms Last?

Daniel de la Hoz / Getty Images

Cold symptoms typically last seven days but may last as long as 10 days. Some symptoms, such as a cough, can linger up to three weeks. A head cold causes symptoms that affect your head, such as a runny or stuffy nose. A chest cold, in contrast, typically causes a cough and chest congestion.

Adults tend to have two to three colds per year. The average child, in contrast, has seven to 10 colds per year. You can usually treat a cold at home by getting plenty of rest and staying hydrated.

The typical cold lasts between seven and 10 days. Do not worry if your symptoms last longer. This is just the typical duration, meaning it's not out of the ordinary if your cold lasts a little longer than 10 days. A runny or stuffy nose (congestion) can last up to two weeks. You might have lingering symptoms for days or even weeks after your cold has gone away. This is known as a post-viral syndrome, which mostly takes the form of a cough that sticks around for up to three to eight weeks. A cold typically occurs in four stages, which include: Incubation: Colds spread from person to person through respiratory droplets. An infected person emits these droplets when they cough or sneeze. The virus will replicate in your body during the incubation period before you develop symptoms. This period typically lasts two to three days but can be as long as one week. Symptoms: You'll then develop cold symptoms, which peak after two to three days. Remission: Cold symptoms generally improve within seven days but may last as long as 10 days. It's also normal for certain symptoms, such as a cough, to linger for up to 14 days. Recovery: Most people recover from a cold at home. Make sure you get plenty of rest and stay hydrated to feel better during this period. A cold typically develops two to three days after exposure. It might take as long as one week for symptoms to appear. Common cold symptoms include: Coughing Headache Loss of appetite Muscle aches Post-nasal drip Runny or stuffy nose Scratchy or sore throat Sneezing Symptoms in Children Children may develop cold symptoms like: A tickle in the throat Cough Headache Loss of appetite Mild fever Muscle aches Runny or stuffy nose with thick mucus that's green or yellow Sneezing Sore throat Tiredness Children might be sick longer and get colds more often than adults. Symptoms can last up to 14 days in young children. There's no cure for a cold, but certain medicines can manage symptoms. These medicines will not shorten a cold but can help you feel better in the short term. Symptom Remedy Aches Use pain relievers, such as Tylenol (acetaminophen) and non-steroidal anti-inflammatory drugs (NSAIDs), to ease headaches and body and muscle aches. NSAIDs include Advil (ibuprofen) and Aleve (naproxen). Cough Try cough suppressants that contain dextromethorphan (DM). Be wary of combination products, such as Dayquil, which contains acetaminophen. Too much acetaminophen may lead to liver damage. Runny nose and sneezing Expectorants thin mucus, making it easy to cough up if you have a runny nose. A common brand name is Mucinex (guaifenesin). An antihistamine might help alleviate sneezing if you take it at the start of your illness. Sore throat Pain relievers can reduce discomfort from a sore throat. Throat lozenges help increase saliva to lubricate your throat. Stuffy nose Decongestants like Sudafed (pseudoephedrine) and Afrin (oxymetazoline) narrow blood vessels in the nasal passages. This reduces inflammation. Do not use decongestants for long periods to avoid rebound congestion. Your nose may feel more congested. Medications in Children Keep in mind that some of the above medications are unsafe for young children. Do not give dextromethorphan, guaifenesin, or pseudoephedrine to children younger than 4. It's important to use caution in children aged 4 to 11. Oxymetazoline is not safe for children younger than 6. Talk to a healthcare provider if you are unsure whether a medication is safe for your child. More than 200 viruses may cause a cold, the most common being rhinoviruses. These viruses spread from person to person if an infected person coughs or sneezes near you. Viruses are too small to see, but you can protect yourself and others from them in several ways. Prevent Getting a Cold You cannot always prevent a cold, but you can take steps to lower your risk. To avoid getting a cold: Disinfect commonly touched surfaces (e.G., countertops and door knobs) Opt for small daycare classes if you have young children Use hand sanitizer with at least 60% alcohol if you do not have access to soap and water Use disposable paper towels instead of cloth towels Wash your hands with soap and water regularly for at least 20 seconds Prevent Spreading a Cold  You are probably not contagious if you are in the post-viral syndrome stage. Assume you are contagious if you are still in that stuffy nose, sneezy, full-blown cold period. To avoid spreading a cold: Cover coughs and sneezes with a tissue or the crook of your elbow Stay home if you are sick Use hand sanitizer with at least 60% alcohol if you do not have access to soap and water Wash your hands with soap and water regularly for at least 20 seconds A cold can present similarly to COVID-19. Make sure you test negative for COVID before returning to work. Contact a healthcare provider if your symptoms last longer than seven to ten days or worsen. Get medical attention right away if you have trouble breathing. A healthcare provider can rule out and diagnose other causes of a lingering cough. A chest X-ray, for example, can check for a mass. Pulmonary function tests look for asthma or chronic obstructive pulmonary disease (COPD). A typical head or chest cold lasts three to 10 days, but it's normal to have lingering symptoms for two weeks or more. Common cold symptoms include aches, cough, runny or stuffy nose, and sore throat. No cure exists for your cold, and experts say there's not much you can do to make it go away faster. Certain medications can help you manage symptoms. It can take up to four weeks to feel completely over a cold. That's not necessarily cause for worry. See a healthcare provider to rule out other underlying health concerns if your symptoms do not improve or worsen after four weeks.

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