Coughing is a natural reflex for clearing the throat and lungs of irritants. Infection is a common reason for a dry cough, but other causes range from a post-nasal drip to lung cancer.
A dry or sometimes tickly cough is a cough that does not bring up any phlegm or mucus. Dry coughs may cause a tickling sensation and are often due to irritation in the throat.
Doctors often refer to dry coughs as non-productive coughs. In contrast, a wet, or productive, cough brings up phlegm that helps clear the airways of irritants.
Doctors also classify coughs as either acute or chronic. A cough is chronic if it lasts longer than 8 weeks, according to the American Lung Association.
In this article, we describe some of the possible causes of a dry cough and the treatment options. We also discuss diagnosis, general treatments, prevention tips, and when to see a doctor.
Various infections, diseases, and other factors can lead to a dry cough.
COVID-19 and other coronavirus infections
COVID-19 is one disease that results from infection with a coronavirus. Others include severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). They can all involve a dry cough.
COVID-19 is caused by the coronavirus SARS-CoV-2.
The most common
People may also have:
- body aches
- nasal congestion, a runny nose, or both
- a sore throat
- changes in the senses of taste and smell
In time, a person may develop chest pain and difficulty breathing. COVID-19 can be fatal for some people. The
Learn more about COVID-19 and other coronaviruses.
There is currently no cure for COVID-19, but acetaminophen
Some people have an underlying condition that increases their risk of developing severe illness. For these people, a doctor may
- Paxlovid (Nirmatrelvir with Ritonavi): Paxlovid is an antiviral that people can take at home by mouth. They need to start it within 5 days of symptoms appearing. It is suitable for people aged 12 years and over.
- Remdesivir (Veklury): Remdesivir is an antiviral that comes as an intravenous infusion given at a healthcare facility. People need to start taking it within 7 days of symptoms appearing, for 3 days in a row.
- Molnupiravir (Lagevrio): Molnupiravir is an oral antiviral for adults. People need to start it within 5 days of symptoms appearing.
If a person experiences a medical emergency, such as breathing difficulties, they need emergency medical attention. Someone should
Learn about treatment options for COVID-19.
Asthma is a long-term lung condition that leads to inflammation and narrowing of the airways. One of the most common symptoms of asthma is coughing, which is often worse at night or early in the morning when a person first wakes up.
The cough is often productive, meaning a person brings up phlegm. However, in a type of asthma called cough-variant asthma, the main symptom people experience is a dry cough.
Other symptoms of asthma can include:
- shortness of breath
- chest tightness or pain
Learn about home remedies for wheezing.
There is currently no cure for asthma, so treatment focuses on relieving symptoms and preventing future attacks.
Typically, doctors prescribe the following treatments for people with asthma:
- a quick-relief inhaler containing a bronchodilator, such as a short-acting beta-2-agonist, for treating symptoms when they flare-up
- long-term medications, such as a low dose corticosteroid inhaler, to reduce inflammation and lower the risk of future attacks
Learn about treatments for asthma.
Idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF) is a condition in which scar tissue develops inside a person’s lungs. As the scar tissue thickens, it makes breathing in air increasingly difficult. The term idiopathic means that doctors do not know exactly what causes the condition.
One of the most common symptoms of IPF is a persistent, dry cough. Other symptoms can include:
- shortness of breath
- loss of appetite and gradual weight loss
- clubbing, or widening and rounding of the tips of the fingers or toes
- changes in nail shapes
In time, lung scarring can occur, leading to further complications.
There is currently no cure for IPF, so the aim of treatment is to relieve a person’s symptoms and slow disease progression.
Treatment options for IPF include:
- medications such as pirfenidone and nintedanib
- oxygen therapy
- pulmonary rehabilitation, which is a program of exercises, training, and support for people with long-term lung conditions
- lung transplantation
Learn about lung scarring and idiopathic pulmonary fibrosis.
Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) is a condition where acid leaks from the stomach back up into the esophagus, or food pipe.
According to a 2015 review, GERD causes a chronic, dry cough in up to
GERD typically also causes a number of gastrointestinal symptoms, which may include:
- pain or difficulty when swallowing
- bad breath
However, research suggests that up
Many people can manage symptoms of GERD through lifestyle changes,
- eating multiple small meals each day instead of three large meals
- avoiding eating too soon before bed
- limiting or avoiding foods that trigger or worsen symptoms, such as fatty or spicy foods
- maintaining a moderate weight
- quitting tobacco smoking
- reducing or avoiding alcohol intake
Over-the-counter (OTC) and prescription medicines, such as antacids, H2-receptor blockers, and proton pump inhibitors, may help relieve or prevent symptoms. In some cases, surgery may be necessary.
Postnasal drip is when mucus from the nose and sinuses drips down the back of the throat.
When the mucus drips into the throat, it can trigger a cough. Although this cough is often productive, it can sometimes also be dry. This will depend on how much mucus there is and how fast it is draining.
Postnasal drip may occur with a sinus infection, GERD, or a nasal allergy, such as hay fever.
Other symptoms of postnasal drip may include:
- runny nose
- a feeling of something in the back of the throat
- a sore throat
- frequent swallowing
Treatment options for postnasal drip include:
- nasal sprays
- nasal and sinus irrigation
- drinking fluids
- treatment for GERD, if appropriate
- treatment for an underlying condition, for example, an infection or allergy
Upper respiratory infections
Upper respiratory infections, such as common colds and the flu, can cause acute coughing. The cough often starts out productive. However, it may become dry as a person recovers from the infections.
Other symptoms of upper respiratory infections may include:
- a fever
- muscle aches
- runny nose
- sore throat
A person can usually
- staying hydrated
- taking OTC medications to relieve congestion, aches, and fever
- taking antihistamines, if a doctor advises it
A doctor may prescribe an antiviral medication for people with the flu or COVID-19. For a bacterial infection, such as strep throat, they may prescribe antibiotics.
A chronic, dry cough can sometimes be a symptom of lung cancer. However, other causes of dry cough are far more common.
Symptoms of lung cancer can include:
- coughing up blood or phlegm that contains blood
- chest pain that may get worse with breathing or coughing
- weight loss
- shortness of breath
- feeling weak
Treatment depends on the type and stage of the lung cancer. Early diagnosis and treatment can significantly improve a person’s outlook
Treatment options can
- radiofrequency ablation
- radiation therapy
- targeted drug therapy
- palliative care
Other causes of a dry cough can include:
- cigarette smoking
- prolonged exposure to pollutants, such as dust and irritating chemicals
- some medications, such as ACE-inhibitor drugs for high blood pressure
- whooping cough
- a collapsed or punctured lung (pneumothorax)
- heart failure
To diagnose the cause of a dry cough, a doctor will usually begin by asking about a person’s symptoms and medical history. They will then perform a physical examination.
A doctor may also need to order some tests to help with their diagnosis. These may include:
- Imaging tests: An X-ray or CT scan creates an image of the inside of the chest that allows doctors to check for problems.
- Spirometry: This involves breathing into a plastic device to check a person’s lung functioning. Doctors use spirometry to help diagnose conditions such as asthma or IPF.
- Endoscopy: An endoscope is a long, thin tube with a camera and light on the end. With upper gastrointestinal endoscopy, doctors can insert the tube through a person’s mouth and down the throat to check for problems inside the esophagus, stomach, and part of the small intestine. In a bronchoscopy, the doctor inserts a tube through the mouth and looks at the windpipe and airways.
Treating the underlying cause is usually the best way to reduce the severity and frequency of a dry cough.
Here is a summary of some treatment options:
|Cause of dry cough:||Treatment options include:|
|COVID-19||– paracetamol to relieve discomfort |
– antiviral drugs and help with breathing in some cases
|asthma||– medications delivered through an inhaler such as beta-2-agonists and corticosteroids|
|idiopathic pulmonary fibrosis||– medications|
– oxygen therapy
– pulmonary rehabilitation
– lung transplantation, in some cases
|GERD||– medications such as antacids, H2-receptor blockers, and proton pump inhibitors|
– lifestyle and dietary changes
|post nasal drip||– decongestants|
– nasal sprays
– nasal saline irrigation
|upper respiratory infections||– staying hydrated|
– pain relievers to manage symptoms
|lung cancer||– surgery|
– radiofrequency ablation
– chemotherapy, radiotherapy
– targeted drug therapy
– palliative care
Some home remedies may improve a person’s symptoms include:
- Sucking on throat lozenges: Throat lozenges contain ingredients such as honey, menthol, and eucalyptus, which may ease irritation and reduce coughing.
- Staying hydrated: Drinking plenty of water will help the body stay hydrated, which boosts overall health. It can also thin mucus, which can help people with a respiratory infection or post nasal drip.
- Taking cough suppressants: OTC cough suppressants, which often contain dextromethorphan, may reduce a person’s cough reflex.
- Elevating the bed: Sleeping with the upper body raised by
6–8 inchescan help decrease symptoms of postnasal drip and GERD. A person can elevate the bed by placing blocks or wedges under the bedposts.
- Taking a hot shower: The warm water and steam from the shower may ease throat dryness and irritation.
It is not always possible to prevent a dry cough.
However, tips that can help include:
- avoiding smoking and exposure to tobacco smoke
- avoiding exposure to air pollutants as much as possible
- drinking plenty of water
- using a humidifier to moisten the air
- allergy-proofing the bedroom to reduce irritants
- avoiding asthma triggers
- asking about flu, whooping cough, COVID-19, and other vaccinations
- staying away from people with an infection
- practice frequent handwashing
People with dry coughs that get worse, do not go away, or cause one to start producing blood or green mucus should see a doctor.
People should also see a doctor if a dry cough occurs with any of the following symptoms:
- a feeling that something is stuck in the throat
- shortness of breath or difficulty breathing
- trouble swallowing
It is also best to see a doctor if a cough lasts longer than 8 weeks. It could be a sign of an underlying condition that needs medical attention.
Here are the answers to some questions people ask about a dry cough.
How do you cure a dry cough?
The treatment will depend on the cause. However, lozenges and cough suppressants can often help manage a dry cough. It may also help to drink plenty of fluids and use a humidifier.
Does COVID start with dry cough?
A cough can be an
Is a dry cough serious?
This will depend on the underlying cause. Often, a dry cough will pass with rest and hydration in around 3 weeks. However, COVID-19, strep throat, allergies, and GERD can all lead to complications if people do not receive treatment.
If you have concerns about a dry cough or if a cough lasts longer than 8 weeks, it is best to seek medical advice.
A dry cough is one that does not produce phlegm or mucus. Dry coughs are often temporary and rarely a cause for concern. However, a chronic, dry cough may be a symptom of an underlying condition, such as asthma or GERD.
Treating the underlying cause is the best way of reducing the severity and frequency of chronic coughs. However, OTC remedies may also help relieve symptoms.
People should see a doctor for dry coughs that do not get better or if they start to cough up blood.