Common Cold: Symptoms, Causes, and Treatment

Cold vs flu: what's the difference?

Although cold and flu symptoms are similar, the flu is generally more serious and can lead to more severe symptoms.

Here's a comparison of the two:

Is it a cold, the flu, or COVID-19?

Colds, flu and COVID-19 are all infections of the airways, and their symptoms overlap a lot. Fever, aches, headache and cough can happen with any of them, so you can't reliably tell which one you have from symptoms alone.

Some general patterns:

• The common cold is usually caused by a virus. It tends to come on over a few days and is often milder.
• Flu can come on suddenly and often makes people feel more unwell.
• COVID-19 can start gradually or suddenly, and can range from very mild to severe. Loss of taste or smell can happen, but many people don't have it.

These are only tendencies, and any of the three can be mild or severe.

How do you catch a cold?

Colds are caused by viral infections and spread through droplets released into the air when someone with the virus coughs or sneezes. If these droplets come into contact with your eyes, nose, or mouth, you can catch the virus.

While winter weather doesn't directly cause colds, it does increase the likelihood of catching one. This is partially due to people spending more time indoors, where close contact makes it easier for viruses to spread, as well as some viruses thriving in cold conditions.

To reduce your chances of catching a cold, follow these simple precautions:

• Wash your hands regularly with soap and warm water.
• Avoid sharing cups or towels with someone who has a cold.
• Stay clear of people showing cold symptoms.

Over-the-counter cold medicines

Over-the-counter medicines do not cure a common cold, but they can provide targeted relief for specific symptoms like pain, fever, and nasal congestion.

Pain and fever relief

You can usually take either paracetamol or ibuprofen, but it is important to read the package instructions carefully and always take the lowest effective dose for the shortest possible time.

Decongestants for blocked noses

Decongestants shrink any swollen blood vessels inside your nose so you can breathe more easily. They come in two types.

Nasal sprays and drops

• They work quickly, right where you need them.
• Don't use them for more than 7 days. Using them for longer than the label says can cause rebound congestion.
• If you're still blocked after stopping, ask a pharmacist or online GP rather than starting again.

Tablets and liquids

• They work throughout your body, so they don't cause the rebound blocked nose that sprays can.
• The benefit is modest, and they aren't recommended for children under 12. They may raise blood pressure. Check with a pharmacist or online GP first if you have high blood pressure or heart or kidney problems, or take other regular medicines.
• Many cold and flu remedies already contain a decongestant, so check the label before combining products.

Cough remedies: suppressants and expectorants

Over-the-counter cough medicines fall into two broad types, but the evidence that either helps is limited, and most coughs clear up on their own.

• Expectorants (such as guaifenesin) are designed to thin mucus so it is easier to cough up. Any benefit is likely to be small, and they are not suitable for everyone, so check the age guidance on the packaging.
• Cough suppressants (non-codeine) aim to reduce the urge to cough. They may be tried in people aged 12 and over with a short-lived cough that isn't producing much mucus. They aren't suitable for children under 12 or for a chesty cough, where coughing helps clear the airways. Codeine-containing cough medicines are unlikely to help.

If you're unsure which product is appropriate, a pharmacist or online GP can advise. Speak to a GP if your cough lasts more than three weeks, or sooner if you have breathlessness, chest pain, coughing up blood, or feel very unwell.

Combination remedies

Many pharmacy brands sell all-in-one cold remedies containing a painkiller, a decongestant, and a cough medicine. While convenient, these carry the risk of overmedicating if you only have one or two symptoms. There is also a risk of accidental overdose if you take them alongside standard paracetamol. It is generally safer and more effective to treat specific symptoms individually.

Colds and antibiotics

Antibiotics work against bacteria, not viruses, like colds, so they won't help you get better from a cold. Taking them when you don't need them can cause side effects and add to antibiotic resistance, which makes infections harder to treat in the future.

Most people recover from a cold without prescription medicine, but occasionally a cold can be followed by a bacterial infection, or your symptoms may turn out to have another cause. See a GP or call NHS 111 if you're getting worse rather than better, your symptoms last longer than expected, or you have difficulty breathing, chest pain, or a high temperature that won't settle. See a GP if you are still coughing after three weeks.

When to get medical help

Most colds get better on their own. Get advice if you or your child develop any of the signs below.

Adults

Call 999 or go to A&E if you have:

• Sudden, severe difficulty breathing
• Chest pain that spreads to your arms, back, neck and jaw
• Sudden confusion, slurred speech, or you're unusually drowsy or hard to wake

Call NHS 111 or contact a GP if you:

• Are getting worse rather than better, or feel very unwell
• Have a high temperature, or feel hot and shivery.
• Are short of breath, have a sharp chest pain, or cough up blood stained phlegm.
• Still have a cough after 3 weeks (sooner if you are short of breath or unwell)
• Have facial pain or pressure, with thick discoloured discharge, or a blocked nose that hasn’t started to improve after about 10 days or gets worse after seeming to improve
• Have a long-term lung condition or a weakened immune system. Get advice sooner, rather than waiting for a cold to clear.

Children

Call 999 if your child:

• Has difficulty breathing, is breathing very fast, or their tummy is sucking in under their ribs
• Is very drowsy, floppy or can’t be woken properly
• Has blue, grey, pale or blotchy skin, lips or tongue.
• Has a rash that doesn’t fade when you press a glass against it

Call NHS 111 or get an urgent GP appointment if:

• Is under three months with a temperature of 38C or higher
• Signs of dehydration, like dry nappies for 12 hours or no tears when crying.
• Has had a fever for more than 5 days