When to See a Doctor for a Cough or Cold

Sometimes a cough or cold simply needs to run its course; most of the time, they go away on their own after several days. Other times, home remedies or over-the-counter treatments can help them along. But there are cases where a cough or cold requires a medical evaluation to check for a more serious underlying cause and/or to more aggressively treat symptoms to prevent a worsening condition or complications.

If things aren't getting better or are getting worse, you or your child may need to see a doctor for an evaluation and, perhaps, a prescription-strength treatment. There are certain signs to look out for to help you make that call.

Colds are usually short-lived illnesses and most people recover within seven to 10 days, but sometimes, that could take up to two weeks.

You usually do not need to see a doctor unless severe symptoms appear. These may include:

• Trouble breathing or feeling short of breath: A cold or cough should not make you feel short of breath or cause chest pain. These could be signs of a more serious problem, including pneumonia, asthma, or heart disease. You should call your doctor or go to your local emergency room if you experience these symptoms.
• High fever, especially with chills and sweats: A fever that doesn’t go away might mean an infection that needs antibiotics.
• Not keeping anything down: Your body needs fluids, especially when you are sick. If you cannot keep anything down without vomiting, you should call your doctor who may recommend you go to the hospital to get IV fluids.
• Painful swallowing: Severe pain may mean a more serious infection requiring evaluation and antibiotics.
• Cough lasting more than two weeks: If your cough isn’t going away, it could be a sign of something more serious, such as whooping cough. Most of the time, however, a long-lasting cough is due to postnasal drip (when mucus moves from the nose to the throat).
• Congestion and headache that won’t go away: Long-lasting colds can block the nose with mucus and eventually cause sinus infections. When over-the-counter medicines don’t offer relief, your doctor can prescribe an antibiotic.
• Feeling faint or fainting: If you begin to feel lightheaded or dizzy, you should call your doctor. If you actually faint, have a friend or family member take you to a local emergency room.
• Feeling confused: It is normal to feel foggy when dealing with inflammation from sinuses and side effects of medications. But if that fog causes you to feel confused or disoriented, you should have a family member or friend take you to your doctor’s office or the nearest emergency room.

You should also see your doctor for:

• Ear pain
• Cough that produces yellow or green mucus or blood
• A painful cough
• Wheezing
• Night sweats
• Unexplained weight loss
• Cough that worsens even after cold symptoms subside

Colds and coughs in children usually run their course in a week or two, and children usually get better without medication.

That said, call your child’s doctor if any of the following apply:

• Your infant is younger than two months and has a fever
• A fever more than 102 F, regardless of the child’s age
• Blue lips
• Breathing problems, including labored breathing (increased effort to breathe), wheezing, fast breathing, and shortness of breath
• Your child is not eating and drinking
• Decreased urination
• Ear pain
• Cough lasting more than two weeks
• Your child's symptoms get worse

These symptoms may indicate something more serious than a cold.

If cold symptoms clear and cough doesn’t get better, there is a possibility that you or your child just needs more time to recover. But there's also a chance that this could be a sign of something serious.

Prolonged or serious coughing can be a symptom of a chronic condition lung condition such as:

• Asthma: Asthma causes the airway to become inflamed and narrowed, makes breathing difficult.
• Bronchitis: Bronchitis causes inflammation of the bronchial tubes, which carry air from the mouth to the lungs. Production of thick mucus related to bronchitis interferes with breathing.
• Emphysema: Emphysema is usually caused by smoking or inhaling chemicals and pollutants and results in irreversible damage to the walls of the lungs. Breathing becomes difficult due to fewer large air sacs in the lungs instead of many small ones. A cough that doesn't go away is the most common symptom.

It might seem inconvenient to visit your doctor. Reaching for an OTC medication may seem like the best choice. And in certain cases, it may just be. But it's important to remember that these medications are designed to be taken for specific illnesses and for short periods.

Self-medicating can also, at times, be counterproductive and even dangerous. It can:

• Mask symptoms and allow underlying health conditions to worsen
• Be useless: A drug you select might be the wrong medication for treating your issue.
• Cause you to unknowingly counteract the effects of other medications you are taking, either making them stronger and dangerous or rendering them ineffective
• Introduce the risk of an allergic reaction even if you have used the medications before
• Pose risks associated with incorrect dosing, potentially leading to overdosing that can cause liver, kidney and other vital organ problems

Many OTC medications are not helpful and even dangerous to children. With children under age 12, a pediatrician is in the best position to determine whether any medications are necessary.

Important reminders:

• Children should not receive aspirin because of the risk for Reye's syndrome.
• Talk to your child’s pediatrician before giving a fever reducer/pain reliever—Tylenol (acetaminophen), Advil (ibuprofen)—to a child under age 2.
• Read labels to ensure you are giving your child a proper pain reliever dose.
• The U.S. Food and Drug Administration (FDA) does not recommend giving young children over-the-counter (OTC) cold and cough medicines.
• Children under age 19 should not take any medication with codeine.

After taking medical history and performing a physical exam, your physician may order a chest X-ray and perform other testing, such as blood work to determine if the cause of symptoms is an infection or something else.

A rapid strep test can check for bacteria associated with a strep infection and is usually done for children who have high fevers and sore throats. In addition, an influenza test should be performed.

OTC (over-the-counter) products for upper respiratory infections are not curative, but they can make you feel much better. Examples of such medications are Tylenol, Sudafed, Afrin, and more.

Antibiotics can be prescribed for bacterial infections. For example, Pen-Vee K (penicillin), Amoxil (amoxicillin), or Keflex (cephalosporin) are all effective treatments for strep infections.

Inhaled and oral prednisolone (a corticosteroid) will not improve cold symptoms unless symptoms are exacerbated by asthma. Doctors can prescribe nasal and oral steroids for inflamed sinuses.

Sometimes, doctors will prescribe Tessalon Perles (benzonatate) for stubborn coughs. According to the FDA, benzonatate is not safe for children under age 10 because even a small amount can cause an overdose.

In addition, the following treatments can be performed at home and usually help to relieve the symptoms of an URI:

• Rest
• Sleep
• Staying home
• Tylenol and OTC medications
• Eating soup
• Drinking hot tea

If you are concerned a cough is something more serious than a common cold virus, make an appointment. If anything, it will put your mind at ease, and if there is something wrong, your doctor can prescribe treatment before things get worse.