I Have a Dry Cough, What Helps?
17 Remedies for a Persistent Throat Tickle
Medically reviewed by Josephine Hessert, DOMedically reviewed by Josephine Hessert, DO
A dry cough feels like a tickle in the back of your throat. It occurs as a natural reflex when inflammation or irritation affects your airway. A dry cough is also called a unproductive cough because it does not produce phlegm or mucus. Symptoms can range from mild to severe.
There are many causes of a dry cough. It often occurs as a result of an upper respiratory infection, such as the common cold or flu. A dry cough usually resolves with the course of the disease. However, a dry cough can also occur from chronic health problems such as asthma or acid reflux. Treatment of a dry cough depends on the cause.
This article reviews dry cough symptoms, causes, and diagnosis. It also explains treatments and ways to live with a dry cough.
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Dry Cough Characteristics
A dry, or unproductive, cough is a cough that does not produce phlegm or mucus. Instead, a dry cough typically occurs as a result of inflammation or irritation in your airway.
A dry cough differs from a productive (wet) cough, which helps to free phlegm or mucus from your lungs so you can breathe better.
Dry cough characteristics include:
Hoarse barking sound: A dry cough typically produces a consistent hacking tone because it lacks mucus. In contrast, a wet cough will vary in tone as the mucus shifts in your airway as you cough.
Tickle in the back of your throat: Since dry coughs are caused by physical inflammation or irritation of your airway, the urge to cough can be triggered by a sensation that feels like a tickle in the back of your throat.
Sore throat or throat irritation: A dry throat may cause a sore throat as your body tries to remove mucus that doesn't exist. Hoarseness, laryngitis (inflammation of your voice box), or a constant need to clear your throat can irritate the sensitive tissue of your voice box, resulting in more coughing.
Dry Cough Causes
A dry cough can occur for many reasons. In many cases, it can occur as a symptom of an upper respiratory infection such as those that accompany a cold, flu, or COVID-19. When this is the case, your dry cough typically resolves on its own as your illness improves.
When a dry cough lasts for more than eight weeks, it is considered a chronic cough. Up to 90% of chronic coughs are related to one of the following conditions:
Postnasal drip: Postnasal drip occurs when mucus gathers in your throat or drips from the back of your nose into your throat, where it triggers coughing. It is usually worse at night when you are lying down.
Asthma: Asthma is a chronic lung disease that triggers inflammation in your airways, causing them to become smaller and tighter. This makes it harder to breathe normally and triggers coughing.
Gastroesophageal reflux disease (GERD): This chronic disorder of the digestive tract occurs when your lower esophageal sphincter does not close properly. This allows stomach acid to creep up into your esophagus, causing heartburn, acid indigestion, trouble swallowing, and the feeling that food is trapped or stuck in your esophagus, which can trigger coughing.
Chronic bronchitis: Chronic bronchitis is a type of chronic obstructive pulmonary disease (COPD). It involves persistent irritation and inflammation of the bronchial tubes, making it difficult to breathe.
Smoking or inhaling cigarette smoke: Smoking or breathing in some can cause a smoker's cough, a persistent cough that occurs as your body tries to clear the irritants caused by smoking.
Other less common causes of a chronic dry cough include:
Therapy with angiotensin converting enzyme (ACE) inhibitors: ACE inhibitors, such as Vasotec (enalapril) and Zestril (lisinopril), are commonly used to treat high blood pressure. About 10% of people taking these medications experience a persistent cough as a side effect.
Bronchiectasis: This obstructive lung disease causes permanent widening of your airways. It occurs from inflammation and infection.
Cystic fibrosis: Cystic fibrosis is a progressive, genetic, and life-threatening disorder that damages your lungs and digestive tract.
Pneumonia or other lung infections: Lung infections are caused by viruses or bacteria in your lower respiratory tract. They are usually spread when an infected person coughs or sneezes.
Laryngopharyngeal reflux: This type of reflux triggers a sensation of postnasal drip, a feeling of a lump in your throat, and a dry cough.
Lung cancer: Lung cancer is cancer that starts in your lungs when cells grow out of control, usually in the cells that line your airways.
Sarcoidosis: This condition occurs when groups of cells in your immune system form small, red, and inflamed lumps called granulomas. These growths cause permanent scarring in the lungs and lymph nodes in your chest.
Environmental allergies: These types of allergies cause your body to overreact to substances in the environment that are otherwise harmless. They can be triggered by substances such as pollen, mold, pet dander, or grass.
Triggers During Allergy Season
If you have seasonal allergies, being exposed to allergens can trigger a dry cough. Common triggers include:
Tree, grass, and ragweed pollens
Wind-pollinated plants and trees
Molds that grow quickly in heat and high humidity
Ragweed pollen
Why a Dry Cough Lingers
Since a cough occurs as a symptom of another underlying health problem, the reasons a dry cough lingers are often related to its cause. A dry cough can be classified into one of the following categories based on how long it lingers:
Acute cough: Less than three weeks
Subacute cough: Between three and eight weeks
Chronic cough: Longer than eight weeks
An acute cough typically occurs as a result of a viral or bacterial infection. It may either worsen or improve with the course of the underlying illness, eventually resolving as the infection clears. Acute coughs may also be related to an allergy or asthma flare.
A subacute cough may outlast other symptoms of an infection resulting in prolonged inflammation of your airways. About 60% of subacute coughs resolve on their own.
A chronic cough may be linked to a more serious underlying chronic medical condition such as postnasal drip, asthma, GERD, chronic bronchitis, and treatment with ACE inhibitors. The cough may linger until you receive a proper diagnosis and begin the right treatment.
What Medications Can Cause a Dry Cough?
Research indicates that a dry cough can occur as a side effect of the following types of medications:
ACE inhibitors
Sitagliptin
Latanoprost
Phenytoin
How to Soothe a Dry Cough at Home
There are many ways to soothe a dry cough at home. However, conclusive research is often lacking, so finding what works for you may require trial and error. While these strategies are unlikely to cure a dry cough, they may help relieve symptoms of hacking and irritation until the cough resolves or an underlying cause is properly treated.
Honey
The natural antimicrobial and wound-healing properties of raw, unpasteurized honey make it an effective treatment for dry, raw coughs. To relieve a dry cough, take 1 to 2 teaspoons of honey alone or in warm water or herbal tea to soothe irritation.
Steam
Inhaling the warm, moist air of steam from a humidifier can help hydrate and soothe dry irritated airway passages. You can also breathe in steam by leaning a safe distance above a bowl of boiling water and draping a towel over your head to inhale as much moisture as possible.
Saltwater Gargle
The antibacterial and anti-inflammatory properties of salt make it effective as a natural remedy for infections. To help reduce the duration of a dry cough and the sore throat it causes, combine one-half teaspoon of salt with 8 ounces of warm water until the salt dissolves and gargle.
Ginger
Ginger has anti-inflammatory properties that may help reduce throat inflammation and irritation. It also contains compounds called gingerols that can help relax airway muscles and relieve coughing. Steep freshly grated ginger root in hot water to make ginger tea or add ginger to other herbal tea blends.
Capsaicin
Natural capsaicin (chili) has some powerful effects against dry coughs triggered by environmental irritants. Taking capsaicin orally can reduce your cough reflex and improve unexplained coughing. However, it is advised to begin with small amounts.
Thyme
Thyme contains an active compound called thymol, which acts as an antispasmodic to prevent coughing fits and help relax throat muscles. Make thyme tea by steeping 3 to 4 teaspoons of dried thyme leaves or powder in boiling water for five to 10 minutes.
Turmeric
Turmeric (Curcuma longa) contains a compound called curcumin that may have mild antiviral, anti-inflammatory, and antibacterial properties. Some research suggests it may ease cough caused by asthma. Turmeric tea is generally well-tolerated, while oral supplements may cause digestive irritation.
Garlic
Garlic (Allium sativum) has mild antiviral, anti-inflammatory, and antibacterial properties. While garlic is promoted to boost your immune system and relieve cough associated with the common cold, the evidence is inconclusive.
Hydration
Increase hydration by consuming plenty of warm fluids, such as water, herbal teas, or soup broths to moisten your throat and reduce dry cough symptoms.
Marshmallow Root
Marshmallow root is the root of the marshmallow plant. There is evidence that syrups and lozenges made with marshmallow root extract helped relieve mild dry cough, in just 10 minutes.
Slippery Elm
The inner bark of the slippery elm tree contains mucilage, a substance comparable to marshmallow root. Mix slippery elm with water to produce a gel-like substance that coats and protects your throat. It can be used in powder form that's added to hot water to make tea. Drink a few cups daily.
Licorice Root
Licorice root (Glycyrrhiza glabra) has been used since 2100 B.C. to treat pain and ease coughs. It can be used to make tea by steeping 2 tablespoons of shaved root in 8 ounces of boiling water for five to 10 minutes.
Thyme
Thyme (Thymus vulgaris) contains thymol, a compound believed to have antispasmodic effects that can help relax throat muscles. You can use dried thyme to make a tea that may help relieve a dry cough.
Cough Drops
Cough drops may reduce the discomfort of a dry cough and the sore throat it causes. Many cough drops contain menthol, which has a cooling effect. Other ingredients like peppermint, eucalyptus oil, or honey, may provide some relief from discomfort.
Marjoram
Marjoram (Origanum majorana) is a form of oregano. It has been used in traditional medicine for its reported anti-inflammatory, plant-based compounds (phytochemicals) that may help some types of dry cough. It can be steeped in hot water to make tea.
Holy Basil
Holy basil (Ocimum tenuiflorum), also called tulsi, is a green leafy plant used for thousands of years for medicinal purposes, including reducing inflammation, improving immunity, and treating a dry cough. It can be consumed as a tea or added to steam as an extract.
#17 Aromatherapy
Aromatherapy uses essential oils, or plant extracts, for health benefits. They can be put inside an oil diffuser to diffuse the oils into the air. Some can also be applied directly to your body with a carrier oil. Essential oils that may help a dry cough include holy basil, eucalyptus, peppermint, or thyme.
Learn More: How to Get Over an Allergy Cough
Dry Cough Not Getting Better
Having a dry cough that is not getting better may indicate the need for treatment to relieve the physical as well as emotional aspects of the problem. The frustration of dealing with a dry cough that lasts longer than three weeks may affect your quality of life and psychological well-being.
Contact your healthcare provider if your cough lasts longer than three weeks or if symptoms worsen despite home treatments. Based on the severity of your symptoms, your healthcare provider may prescribe cough suppressant to provide immediate relief of an acute cough.
Based on your symptoms, physical examination, and medical history, your healthcare provider may use one of the following diagnostic tests to determine the underlying cause of a dry cough that is not improving:
Lung imaging: This may involve a chest X-ray or computed tomography (CT) scan to examine the internal structure of your chest and lungs.
Spirometry (lung function test): Lung function tests can measure the pattern of airflow into and out of your lungs, which is useful in diagnosing asthma.
Acid reflux testing: Testing for acid reflux involves a pH probe, a test to measure the level of acid in your esophagus. An upper endoscopy can detect irritation of tissue in your esophagus and to obtain a biopsy (tissue sample) of your esophagus, if necessary.
Electrocardiogram (ECG or EKG): This test records your heart's electrical activity to identify abnormal heart activity, which may indicate heart disease or damage.
CT of the sinuses: This test can help identify sinus disorders that may be contributing to a cough.
When to Seek Medical Attention
While most coughs eventually clear on their own, a dry cough can also be a sign of a severe or worsening medical condition. Consider the following guidelines in determining when to seek medical attention for a dry cough.
Seek medical attention at an urgent care facility or your healthcare provider's office if your dry cough has any of the following characteristics:
Lasts longer than three weeks
Heart disease, swollen legs, or a cough that worsens when you lie down (signs of heart failure)
Thick, green or yellow phlegm
Unusual weight loss
A "whooping" sound when you breathe between coughs (a sign of pertussis, or whooping cough)
A stridor (high-pitched sound) when you breathe in
Contact with someone who has tuberculosis
An infant younger than 3 months
A violent cough that begins rapidly
Seek emergency medical attention by calling 911 or going to an emergency room if your dry cough has any of the following characteristics:
Bloody or pink mucus
Persistent or sharp chest pain
Vomiting or choking, especially in children
Medications for Dry Cough
There are many over-the-counter and prescription options for treating a dry cough. The type of medication your healthcare provider advises using depends on the cause of your dry cough. Some common medications used for dry cough include the following:
Cough Suppressants
A cough suppressant (antitussive) is advised for a dry, hacking cough. These medications can include:
Delsym (dextromethorphan) and Mucinex DM (guaifenesin and dextromethorphan) are nonprescription medications that may help suppress a cough reflex.
Tessalon (benzonatate) is a prescription medication that may help when dextromethorphan is ineffective.
Codeine and hydrocodone are prescription opioids that can be added to cough syrups when other treatments are ineffective
Lyrica (pregabalin) and Neurontin (gabapentin) are two prescription drugs effective in treating some types of dry cough by blocking nerve impulses.
Postnasal Drip Relief
A cough caused by postnasal drip may improve with the use of one or more of the following medications:
Antihistamines can improve nasal congestion, making it easier to blow your nose and reduce the congestion. Over-the-counter oral antihistamines such as Claritin (loratadine), Allegra (fexofenadine), or Zyrtec (cetirizine) are also effective for allergic postnasal drip. Nasal antihistamine sprays such as Astelin (azelastine) can also relieve postnasal drip.
Nasal glucocorticoids can help reduce postnasal drip and inflammation from allergies. Over-the-counter options include Flonase (fluticasone) or Rhinocort Allergy (budesonide).
Cough-Related Asthma Treatment
The standard asthma treatment often includes two types of drugs:
An inhaled glucocorticoid to decrease airway inflammation:
Flovent (fluticasone)
Pulmicort Flexhaler (budesonide)
Qvar Redihaler (beclomethasone dipropionate)
An inhaled bronchodilator to open your airways if you have shortness of breath or wheezing:
ProAir, Ventolin, or Proventil (albuterol)
GERD Treatment
GERD treatment typically the following medications:
Proton pump inhibitors (PPIs) slow acid production in your stomach. These medications include:
H2 receptor antagonists, or H2 blockers, block the action of histamine, a chemical that triggers the production of stomach acid. These medications include:
Pepcid AC (famotidine)
Axid AR (nizatidine)
Learn More: How to Choose the Best Over-the-Counter Cough Medicine
Managing Chronic Dry Cough
A chronic dry cough can linger as a symptom of an upper respiratory infection that continues after the disease clears. However, coughs that last longer than eight weeks are typically caused by an underlying medical condition. Managing chronic dry cough involves diagnosing and treating the underlying cause of the cough.
Treatment can vary widely based on the underlying condition. Based on the cause of your chronic dry cough, treatments may involve medications to address the following problems:
Treat cough symptoms
Reduce postnasal drip
Reduce stomach acid in cases of GERD
Control asthma symptoms
Relieve the pain and discomfort of coughing
Treat lung cancer
The following lifestyle modifications can support medical treatments for causes of chronic dry cough:
Drink plenty of liquids to keep a dry throat moisturized.
If you smoke or vape, stop.
Avoid secondhand cigarette smoke and airborne irritants in your home and workplace.
Consult your healthcare provider about changing your prescription if you take an ACE inhibitor or other medication known to cause a dry cough.
Avoid known allergens to reduce the risk of allergic reactions.
Take hot showers or use a humidifier to create moisture in the air.
Suck on hard candy or cough lozenges to treat the sensation of a tickle in the back of your throat.
Reduce your exposure to seasonal allergies such as hay fever by remaining indoors when airborne allergens are usually highest.
Use an air-conditioner rather than fans or open windows.
Encase pillows and mattresses inside dust mite covers.
After being outside, shower and change your clothes.
How to Breathe Better With a Dry Cough
Breathing better with a dry cough can often be a challenge at night. Try these strategies to improve your nighttime breathing:
Elevate your head and chest with extra pillows or a wedge.
Lie on your side not your back.
Use a nasal decongestant for a brief period to treat postnasal drip.
Continue GERD treatment for at least six weeks.
Take a warm shower before going to bed.
Use a humidifier in your room at night.
While you can't always prevent a dry cough, you can take the following steps to build your immune system to potentially reduce the effects of a dry cough if it occurs:
Get at least seven hours of quality, uninterrupted sleep nightly.
Reduce sources of physical and psychological stress.
Reduce your alcohol consumption.
Remain physically active with walks and exercises.
Consume as many fresh fruits and vegetables as possible every day.
Get recommended vaccines.
Consult your healthcare provider about the benefits of taking zinc at the start of a respiratory infection to reduce the duration and severity of symptoms.
Learn More: How to Stop a Dry Cough at Night
Summary
In many cases, a dry cough can sound worse than it is. Most dry coughs do not need treatment. They often occur as a symptom of a cold or flu and resolve soon after the disease ends.
However, a chronic dry cough may be a sign of a more serious health condition such as asthma, allergies, or occasionally, lung cancer. While home treatments and medications can treat the cough, they do not cure it.
Knowing the source of your cough can help you manage symptoms. In cases of allergies, an accurate diagnosis can help you avoid allergens and possibly the onset of a dry cough before it starts.
Contact your healthcare provider if you have a dry cough that lasts longer than 3 weeks or does not improve with home treatment. A cough caused by an underlying condition requires management of the health problem before it can improve.
Read the original article on Verywell Health.
