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Nose and sinuses MediBilbao Salud

Can Allergies Make You Cough? How an Allergy Cough Feels and How to Treat It

A cough that keeps going during pollen season, around pets or in dusty rooms is often an allergy cough. Allergies inflame the lining of the nose, which produces extra mucus that drips down the back of the throat and triggers coughing. Allergies can also make the airways themselves more sensitive, and in some people they trigger asthma. This guide explains, from an ear, nose and throat (ENT) point of view, how to recognise an allergy cough and the treatments that work.

Topic
ENT
Updated
Reading time
5 minutes
Reviewed by
Dr. Itziar Gotxi Erezuma · Medical doctor (ENT) · Bizkaia Medical Association no. 484809757

How allergies cause a cough

In allergic rhinitis, the immune system overreacts to harmless particles such as pollen, house dust mite, animal dander or mould. The lining of the nose and sinuses becomes swollen and produces more mucus. There are three main ways this leads to coughing:

  • Postnasal drip: mucus drains down the back of the throat and stimulates cough receptors. This is also called upper airway cough syndrome and is one of the commonest causes of chronic cough. See postnasal drip.
  • Throat irritation: breathing through the mouth when the nose is blocked dries the throat and makes it tickly.
  • Airway sensitivity and asthma: the same allergens can inflame the lower airways, causing cough, wheeze and chest tightness. Allergic rhinitis and asthma often occur together.

What an allergy cough feels like

  • A dry, tickly or slightly productive cough with clear mucus.
  • Frequent throat clearing and a feeling of mucus at the back of the throat.
  • Worse at night when lying down and on waking, when mucus has pooled.
  • Sneezing, itchy nose, runny or blocked nose and itchy, watery eyes.
  • Symptoms that follow a pattern: pollen seasons, after cleaning, around pets, in damp rooms.
  • No fever and no body aches.

Allergies can also give a sore throat, and coughing at night is discussed in dry cough at night.

Allergy cough, cold or something else?

  • Common cold: starts over a day or two, often with a sore throat, sometimes a mild temperature and aches, and improves within 7 to 10 days, though a cough can linger for up to three weeks.
  • Allergy: no fever, itchy eyes and nose are prominent, and symptoms persist as long as you are exposed, often for weeks or seasonally.
  • Asthma: cough with wheeze, chest tightness or breathlessness, often at night or with exercise and cold air.
  • Reflux: cough after meals or lying down, with heartburn or throat clearing; see acid reflux sore throat.
  • Sinusitis: thick coloured discharge, facial pain or pressure and reduced smell for more than 10 days.
  • Medicines: some blood pressure tablets (ACE inhibitors) cause a dry cough.

Common triggers and how to reduce them

  • Pollen: check pollen forecasts, keep windows closed on high-pollen days, shower and change clothes after being outdoors, and wear wraparound sunglasses.
  • House dust mite: wash bedding weekly at 60 °C, use allergen-proof covers, reduce soft furnishings and vacuum with a HEPA filter.
  • Pets: keep animals out of the bedroom and wash hands after contact.
  • Mould: ventilate kitchens and bathrooms, fix damp and avoid drying clothes indoors.
  • Smoke and strong smells: avoid tobacco smoke and strong perfumes, which irritate already sensitive airways.

Treatment for an allergy cough

  • Saline nasal rinses: wash away allergens and mucus; see neti pot sinus rinse.
  • Steroid nasal sprays: the most effective treatment for allergic rhinitis and postnasal drip. They work best used every day and take several days to reach full effect. Aim the spray slightly outwards, away from the septum.
  • Antihistamines: non-drowsy antihistamines help sneezing, itching and runny nose; they are less effective for blockage.
  • Combination sprays: a steroid with an antihistamine in one spray can help when single treatments are not enough.
  • Eye drops: for itchy, watery eyes.
  • Immunotherapy: for people with persistent allergy to specific allergens (such as grass pollen or dust mite), desensitisation tablets or injections can reduce symptoms over years.

Cough medicines that suppress the cough do little for an allergy cough; treating the nose usually works better. Home measures are covered in home remedies for postnasal drip.

When to see an ENT specialist

An ENT specialist can help when the nose stays blocked despite treatment, when there are nasal polyps or a deviated septum making symptoms worse, when the cough persists for more than eight weeks, or when the voice is affected. Examination of the nose and throat with a small camera shows the state of the nasal lining, the turbinates and the larynx. Allergy testing (skin prick or blood tests) identifies specific triggers and guides immunotherapy. Enlarged turbinates that do not respond to sprays can sometimes be reduced with a short procedure.

When to see a doctor

  • A cough lasting more than three weeks.
  • Wheezing, chest tightness or breathlessness.
  • Coughing up blood.
  • Fever, chest pain or feeling very unwell.
  • Weight loss or night sweats.
  • A change in voice lasting more than three weeks.
  • Swelling of the lips, tongue or throat, or difficulty breathing after exposure to an allergen: call emergency services.

Key points to remember

  • Allergies can cause a cough, mainly through postnasal drip.
  • An allergy cough has no fever and comes with sneezing, itching and a runny or blocked nose.
  • Trigger avoidance, saline rinses and a daily steroid nasal spray are the mainstays of treatment.
  • Wheeze or breathlessness may mean allergic asthma.
  • Any cough lasting more than three weeks should be checked.

Questions about allergies and cough

These answers are general information and do not replace an examination or individual medical advice.

Can allergies make you cough?

Yes. Mucus from an inflamed nose drips down the throat and triggers coughing, and allergens can also irritate the airways.

What does an allergy cough sound like?

Usually dry or tickly, with throat clearing, and without the fever or aches of a cold.

How long does an allergy cough last?

As long as you are exposed to the trigger, which can mean weeks or a whole pollen season, unless it is treated.

Why is my allergy cough worse at night?

Lying down lets mucus pool at the back of the throat, and bedroom dust mites can add to exposure.

Do antihistamines stop an allergy cough?

They help sneezing and runny nose. A steroid nasal spray is usually more effective for postnasal drip and cough.

Can allergies cause a cough without a runny nose?

Yes. Postnasal drip can occur with little visible nasal discharge, and allergic asthma can cause cough alone.

Sources

  1. NHS · Allergic rhinitis
  2. NHS · Hay fever
  3. NHS · Cough
  4. NHS · Asthma
  5. NHS · Sinusitis (sinus infection)

This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.