Can Steroids Help Your Cough? Maybe — Here’s When

Have you ever had a cough that you thought would never go away? A cough is often the last symptom to resolve after a cold or viral respiratory infection. Coughs are more than annoying. They can stop you from sleeping, make eating difficult, and cause chest wall pain.

It's natural to look for a quick fix for a cough. And you might have heard that corticosteroids - or steroids for short - can make a cough quickly disappear.

But unless your cough is related to asthma, chronic obstructive pulmonary disease (COPD), or side effects from a respiratory illness, steroids are unlikely to help. Plus, they can do more harm than good. Here's what you need to know about taking steroids for your cough.

How do steroids help a cough go away?

Steroids work by calming down your immune system and lowering inflammation. When you're sick with a respiratory illness, steroids calm the inflammation in the parts of your body that cause a cough.

The lining of your nose and throat gets inflamed when you have a cold or upper respiratory tract infection. This can cause symptoms like congestion and runny nose, which cause post-nasal drip and coughing. Steroids help calm this inflammation, which can improve cough and other cold symptoms.

If you have a lower respiratory tract infection - like bronchitis or pneumonia - your lungs and airways become inflamed. This causes a cough. People experiencing asthma or COPD flares also have inflammation around their lungs and airways, which leads to coughing. Steroids calm the inflammation in your lungs and airways, and this improves a cough.

Which steroids are usually prescribed for a cough?

Steroids come in many forms:

• Inhalers

• Sprays

• Liquids

• Pills

For a cough, inhaled (inhalers) and/or oral (pill, liquid) steroids are the most common.

Inhaled steroids are often prescribed over oral steroids since they stay localized to your lungs and can have fewer side effects. These can be prescribed alone, such as:

• Budesonide (Pulmicort Respules)

• Fluticasone (Flovent)

• Beclomethasone (Qvar RediHaler)

• Asmanex (mometasone)

Inhaled steroids also come as combination medications with a bronchodilator, like:

• Fluticasone / salmeterol (Advair)

• Budesonide / formoterol (Symbicort)

• Fluticasone / vilanterol (Ellipta)

Oral steroids that can be used to treat a cough include:

• Prednisone

• Prednisolone

• Dexamethasone

When do you need steroids for a cough?

In theory, steroids should help improve a cough triggered by inflammation in your respiratory tract. But in real life, steroids only help stop coughs in specific situations. Here are three situations where steroids can stop coughs and help people recover from their illness.

Asthma

"Asthma is a condition involving airway inflammation, which usually causes wheezing and poor airflow," says Dr. Baljinder S. Sidhu, pulmonologist and co-owner of Pacific Coast Critical Care Group in Southern California.

Daily inhaled steroids can help keep inflammation under control so people don't experience asthma symptoms. Steroids also play an important role in treating asthma flares. Most people need to take at least a few doses of steroids by mouth during an asthma flare. This stops inflammation and relieves asthma symptoms like cough, shortness of breath, and trouble breathing.

COPD

COPD is a lung condition that makes it hard to breathe. People with COPD have inflammation around their airways, causing swelling, coughing, and increased mucus production.

Daily inhaled steroids help keep COPD symptoms under control, making it easier to breathe. Oral steroids also play a role in treating COPD flares. People need to take several days of oral steroids during a flare to calm inflammation and keep symptoms from getting worse.

Post-illness cough

It's common to have a lingering cough after a respiratory illness. But sometimes this cough can last for months. This is called a post-infectious cough, triggered by a virus or bacteria causing an upper or lower respiratory tract infection. The cough continues even after you have otherwise fully recovered.

"This is a condition that occurs following recovery from a viral or bacterial respiratory infection," Dr. Sidhu said. "This can last up to 3 to 6 months due to inflammation."

According to Dr. Sidhu, steroids can help this cough finally go away. But it can be tricky to know if steroids will help in these situations. That's because other things - like reflux or allergies - can contribute to a lingering cough, and steroids won't help if these things are playing a major role.

When are steroids not used for coughs?

Steroids aren't used to treat coughs from viral upper respiratory tract illness - like colds and sinusitis - caused by:

• Common cold viruses

• The flu

• Respiratory syncytial virus (RSV)

• COVID-19

Steroids also aren't routinely used to treat viral bronchitis, says Dr. Sidhu, because they aren't proven to help improve symptoms. Research shows that oral steroids don't help cough duration or severity in people without lung disease. There's also a risk of side effects, he says.

But there are exceptions.

If you have asthma or COPD and become sick with a viral respiratory tract infection, your doctor may ask you to take oral steroids or increase your daily inhaled steroids. This can help prevent a flare.

If your viral upper respiratory tract infection leads to a more serious illness, like a lower respiratory tract infection, your primary care provider or pulmonologist may prescribe steroids too. People who require hospital care for an illness that started as an upper respiratory tract infection may also need steroids.

But if you just have a regular cold, mild flu, COVID, or RSV illness, you don't need steroids for your cough.

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