As we approach the colder, shorter days of winter, it is not unusual to “catch a cold”. There are over two hundred viruses that cause the common cold, the most common being the rhinovirus. At the beginning of infection of the nose and sinuses, the body produces increasing clear mucus to try to wash out the germs (rhinorrhea). After a few days, the mucus thickens and changes to white or yellow as the immune system kicks in. As the natural bacteria reestablish themselves, the mucus may turn greenish, which is a normal finding. It also occurs as the mucus thickens from the significant dryness of our region in winter, known as inspissation.
As the virus continues to grow, it will increase mucosal inflammation and produce complaints including low grade fever, sneezing, stuffy or runny nose, sore throat and painful swallowing, coughing, watery eyes, headaches and body aches. The best treatments for the common cold are rest and lots of fluids. Over-the-counter (otc) medications may help to make you feel better in relieving the symptoms. However, the virus will run its course, typically over a period of days to a week or so. If you use the otc medicines, make sure to use them only as directed. These medicines will list the symptoms that they treat, so read the labels and pick the appropriate medicine for your complaints. You may want to avoid multi symptom treatments, as they often contain treatments for symptoms you don’t have or need.
Antihistamines such as Claritin (loratadine), Zyrtec (cetirizine) or Allegra (fexofenadine) may help to reduce the inflammatory response. Guaifenesin such as Mucinex or Robitussin helps loosen and thin mucus. Dextromethorphan – commonly seen as “DM” in the medication name (Robitussin DM) may help control the cough. You may want to avoid decongestants, as their drying effect may worsen symptoms. Tylenol or ibuprofen may help the fever, aches and pain with plenty of hydration.
Antibiotics do not help get a common cold better, as these medicines do not affect viruses. In fact, using antibiotics may actually worsen the infection from a virus. These meds may kill the bacteria that normally would compete with the virus, allowing your infection to worsen. Unnecessary antibiotics may increase complaints from the medicine itself, including gastrointestinal effects, skin rashes, and increase the risk of acquiring an allergic reaction to the medication.
The diagnosis of the viral sore throat (pharyngitis) does have challenges. Our environment will contribute to a sore throat due to allergies, pollution and smoking or smoke exposure. Another common culprit in the winter is the cold, dry air so common in Northern Arizona. The viral sore throat typically includes low grade fevers of under 101F as a common symptom of a “head cold”. However, with persisting sore throat, high fevers, skin rash, redness or pus in the throat, the infection may be the bacterial Group A Streptococcus (or “strep”). Strep infections can only be determined by a lab test, as the infection cannot be diagnosed on appearance alone. Strep infections are important to diagnose, and DO need treatment with antibiotics. Strep is a highly infectious disease, and is readily spread. If you do have a diagnosis of strep and are treated with antibiotics, please stay home from work, school or daycare for at least 24 hours after starting the Rx in order to not spread infection to others.
Some important things to do stay healthy are to wash your hands often, either with soap and water, or waterless antibacterial such as Purell. Avoid close contact with others who have a sore throat or head cold. Stay home and away from others if you are already sick. Avoid smoking or vaping and avoid second hand smoke. And, of course, seek care with your primary care provider if you have any concerns or questions regarding your proper care.
Bradford Croft, DO
East Flagstaff Family Medicine