Does blowing your nose make cold symptoms worse?

By Jocelyn Solis-Moreira, CNN

(CNN) — Every time I get the sniffles, I long for the days when I can breathe freely again. Like most people, grabbing a tissue and blowing my nose is the usual go-to move, and with good reason.

The human nose creates 1 to 2 liters of mucus daily — and when we’re sick, the nose thickens mucus to trap viruses. Nose blowing pushes out the thick mucus, giving us a respite, said Dr. Peter Filip, a rhinologist and skull base surgeon at Rush University Medical Center in Chicago.

Before you blow your nose like a foghorn, know that nose blowing is helpful when done correctly. Forceful blowing can actually worsen your cold symptoms.

Nose blowing “gives you temporary relief, but there are more effective ways of clearing that mucus and helping in the long run,” Filip said.

Ear, nose and throat doctors, or ENTs, recommend abandoning the tissues altogether and stocking up on saltwater sprays. And if you want to blow, consider how you do it.

When you blow your nose too hard

Excessive nose blowing can cause a backward pressure of fluid draining from the sinuses, according to Filip, which means you’re pushing mucus back into the sinuses when you blow too often.

In a notable 2000 study, researchers put a dye in people’s noses to track where mucus goes when they forcefully blow. Imaging scans revealed the dye going backward into the sinuses from the nasal cavity.

“While some mucus came out, there is some effect of pushing mucus back into the sinuses in a backward direction where you don’t want it to go,” Filip said. “It’s possible that could cause worsening of an infection.”

It could cause ear pain

Dr. Kanwar Kelley, an ENT in California and cofounder of Side Health, said the fluid from the sinuses could travel through the narrow Eustachian tube that connects the back of the nose to the middle ear on both sides. A burst of pressure and fluid into the middle ear can cause the eardrum to rupture possibly, allowing bacteria and viruses to enter the ear and cause an ear infection.

“It’s pretty rare to blow your eardrums from nose blowing,” Kelley said. “It requires some pretty significant force.”

Nosebleeds

Forcefully blowing the nose can also damage blood vessels and cause nosebleeds, Filip said. When mucus linings are inflamed or dried out, blood vessels become exposed. While blood vessels are all around the nose, the ones in the front of the nose can easily burst from the pressure of nose blowing.

“Excess nose blowing many times a day can cause further irritation of the inside of the nose, which leads to more swelling of the lining of the nose and even nosebleeds,” Filip said. He added that use of rough tissue and constant nose-picking also increase the chances of a nosebleed.

Nasal vestibulitis

Nasal vestibulitis is a bacterial infection occurring near the entry of the nose that creates pimples and boils. Kelley said the force from constant nose blowing and friction of rough tissue irritate the nasal area, creating micro-cuts in the nose that give bacteria an opportunity to cause infection. Staphylococcus aureus is commonly the bacterium that causes nasal vestibulitis.

Orbital fracture

In extreme cases, there have been reports of people blowing their noses so hard that they caused an orbital fracture, resulting in eye swelling and possible vision loss in the affected eye. In those situations, the high intranasal pressure fractured one of the bones of the eye socket. Rest assured, Filip said these are exceedingly rare cases of forceful nose blowing, and people were able to recover once they stopped blowing their noses.

Headaches

Filip said experts are still divided on whether forceful nose blowing causes headaches because people with runny noses usually have a flu or cold that would induce migraine symptoms. He said it’s possible that harsh nose blowing can cause or exacerbate headaches because of the backward pressure to the sinuses.

What’s the right way to blow your nose?

People should opt for gentle nose blowing every time to avoid side effects, Kelley said.

He recommended placing a finger on the opposite nostril from the side being blown on. Close the nostril to prevent air from escaping through the opposite side. Then, blow gently so air and mucus are ejected through the side people are trying to clear.

Kelley also recommended using softer and more moisturized tissue to prevent irritation on the outside of the nose. Doing so includes looking for tissues with ingredients to moisturize and soothe the skin such as aloe and menthol.

Alternatives to nose blowing

One of the best ways to clear congestion is to use saline irrigation, Fillip said. The saltwater solution clears the nasal cavity, flushing away mucus, bacteria and other irritants. “People with a common cold or sinus infection get some relief with saline irrigation and feel better from both a nasal breathing standpoint and mucus standpoint,” he said.

Nasal decongestants are another way to clear up a stuffy nose, Filip said. Popular nasal decongestants contain phenylephrine and oxymetazoline to lower swelling from blood vessels to open airways.

Filip said these nasal decongestants work well to relieve congestion quickly. However, he warned people to use them only for three days because overuse makes them less effective. Additionally, excessive use of these topical sprays can cause a condition called rhinitis medicamentosa in which people have more inflammation in the nostrils, resulting in additional congestion.

Warm compresses over the face and steam also help loosen up mucus and let it come out naturally, Kelley said.

Jocelyn Solis-Moreira is a New York-based freelance health and science journalist.

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