Is Your Cold Causing a Wet or Dry Cough?

A cough is a common cold symptom, and it can be wet or dry. A dry cough is nonproductive and doesn't bring up phlegm, while a wet, productive cough is associated with phlegm or mucus.

A cough from a cold is typically treated with over-the-counter (OTC) medications, but there are many varieties to choose from with different active ingredients—and the best choice depends on whether your cough is wet or dry.

This article explains the common causes of a wet or dry cough and describes the most common treatments for a cough.

Nonproductive Cough

A nonproductive cough is one that does not bring up any mucus or other secretions. Also known as a dry cough, a nonproductive cough often is caused by irritation in the throat. Many people describe the irritation as a "tickling" or "scratchy" sensation.

While a cold is a common cause of a dry cough, a nonproductive cough may also be caused by swelling of the airways, which often occurs with asthma or bronchitis. Allergies, the flu, coronavirus, or other upper respiratory infection may also trigger a dry cough.

Some people develop a dry cough as a side effect of ACE inhibitors. a type of medication that's used to treat high blood pressure.

Productive Cough

A cough that brings up mucus or other fluid, including blood, is a productive cough. It is often referred to as a chesty or wet cough because you can often hear a gurgling sound during the cough.

Most coughs caused by cold or flu will go away after a few days. But if a cough is productive, lasts more than a few weeks, and involves fever, greenish-yellow phlegm, and shortness of breath, it may be due to a lung infection.

Pneumonia, acute bronchitis, bronchiectasis, chronic obstructive pulmonary disease (COPD), and cystic fibrosis are among the other possible causes of a productive cough. GERD can also sometimes cause a chesty cough if there is severe inflammatory damage to the esophagus.

And while COVID-19 is usually associated with a dry cough, it can sometimes cause a wet cough, especially if it leads to pneumonia.

Other Causes

What you think is a cough from the common cold could be something more serious. If your cough persists, is severe, or rapidly worsens, talk to your healthcare professional, who may recommend a test for influenza or COVID-19.

If you have a dry cough, your healthcare professional may perform tests to rule out other conditions including:

• Asthma: Can often be diagnosed with spirometry. During this test, you would breathe into a device to measure the force of your breath and the capacity of your lungs.
• Gastroesophageal reflux disease (GERD): While it's often associated with heartburn, 40 percent of people with GERD experience a dry cough. The condition can be diagnosed with endoscopy (a flexible scope is inserted into the esophagus and stomach) and an ambulatory pH acid test.
• Sleep apnea: Cough is a feature in up to 44 percent of cases of sleep apnea. This condition can be diagnosed with an in-lab sleep test or a home version that can measure blood gases, heart rate, and airflow/breathing patterns.
• Vocal cord dysfunction: An inhaled irritant or extreme exercise can cause abnormal narrowing of the larynx. You might be referred to an allergist, who can evaluate allergic causes or a combination of stress tests and imaging studies to detect breathing abnormalities during exercise.

Less commonly, heart failure, a collapsed lung, or lung cancer can manifest with a persistent dry cough. If these are suspected, your healthcare provider may recommend imaging tests, such as chest X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and other tests.

If you have a wet cough, your healthcare provider may perform tests to diagnose the cause of a productive cough including:

• Chest X-ray
• Sputum analysis (in which coughed-up mucus or phlegm is evaluated in the lab for infection)
• Blood tests (to check for signs of infection)
• Pulmonary function tests (including spirometry and blood gases)

Treatment

Humidifiers and breathing in steam can often help provide you with relief.

The treatment of cough depends on the underlying cause.

If a nonproductive cough is caused by a cold, a cough suppressant containing dextromethorphan may be enough to provide control.

Other treatments may include inhaled bronchodilators for asthma, antacids and proton-pump inhibitors for GERD, antihistamines for allergies, and continuous positive airway pressure (CPAP) breathing machines for sleep apnea.

For a productive cough due to a cold, an expectorant can loosen and thin the mucus so that it's easier to cough up. Your doctor or pharmacist can point you in the direction of an OTC expectorant that's appropriate and safe for you.

Chronic productive coughs are more concerning and may require aggressive treatment of the underlying causes. Infections may require antibiotic therapy, while chronic disorders like COPD and cystic fibrosis may require ongoing care with oxygen therapy, inhaled or oral medications, and pulmonary rehabilitation.

When to Call a Healthcare Provider

A cough accompanying a cold typically lasts a week or two and can be treated with over-the-counter medicine.

Call your healthcare provider if:

• Your cough is severe.
• Your cough lasts more than three weeks.
• You cough up yellowish-green, pink, or bloody sputum.
• You have a fever of over 103 degrees F.
• You experience shortness of breath or a rapid heartbeat.
• You have had close contact with someone who has COVID or pneumonia before your cough started.

If you are coughing up a lot of blood, a condition known as hemoptysis, call 911 or seek emergency care.