The 3 Different Types of Cough: What They Mean

Coughing is a natural reflex that is important for keeping your lungs and airways clear and functioning properly. While coughing is often not serious, a persistent cough that does not seem to go away is bothersome and may be related to an illness.

This article discusses the causes and treatments for the three types of coughs: acute, subacute, and chronic.

Acute Cough

Acute coughs last only up to about three weeks and are usually caused by a virus. This type of cough may be either productive (produces mucus) or nonproductive (dry, no mucus). An acute cough is usually caused by one of the following illnesses:

• Cold
• Flu
• COVID-19
• Pneumonia
• Sinus infection
• Croup
• Whooping cough
• Bronchitis
• Pulmonary embolism

Unfortunately, studies have not found existing treatments for acute coughs to be effective. In fact, there is a movement away from even using cough suppressants to ease your symptoms unless a cough is causing other problems.

If the cause is a treatable bacterial infection like pneumonia, then antibiotics would be the proper treatment to help fight the underlying cause of a cough. In most cases of an acute cough, however, the cause is a virus and your body must fight off the infection on its own. Talk to your healthcare provider about your specific circumstance and if any treatment options will be beneficial for you.

Subacute Cough

Subacute coughs typically last between three and eight weeks. This type of cough may need to be evaluated by a healthcare provider depending upon the severity of symptoms. However, about 60% of subacute coughs spontaneously resolve. In other words, there's a pretty good chance of a subacute cough going away on its own.

Common causes of a subacute cough include:

• A post-infectious cough (most common)
• Postnasal drip
• Cough-variant asthma
• Eosinophilic bronchitis

If your healthcare provider suspects that the cause of your subacute cough is a post-infectious cough or postnasal drip, they may prescribe antihistamines plus a decongestant (such as chlorpheniramine and pseudoephedrine) for approximately three weeks to see if the cough will clear up.

Chronic Cough

Chronic coughs last longer than eight weeks. Causes of this type of cough can sometimes be difficult to pin down. To help isolate the cause of your chronic cough, your healthcare provider may find it necessary to run several tests or even recommend that you see another specialist.

The most common cause of a chronic cough is smoking. However, other common causes include:

• Asthma
• Allergies
• Postnasal drip
• Gastroesophageal reflux disease (GERD)
• COPD
• Medications, notably ACE inhibitors
• Heart failure
• Lung cancer (rare)

If you are a smoker, it is important for you to begin a smoking cessation program. Smoking not only will likely be the cause of your chronic cough but will also put you at risk of developing other health-related disorders. Get started today.

Treatment for the cough depends on the specific cause. Your healthcare provider will take a thorough history to look for likely causes of a cough. If you are taking ACE inhibitors for blood pressure, for example, your healthcare provider may have you try an alternative medication to see if your cough resolves.

Your healthcare provider might also want to order a chest X-ray and another test called spirometry to help figure out the cause of your cough. If the chest X-ray is abnormal, a high-resolution computed tomography (CT) scan of the lungs and/or a bronchoscopy (a procedure used to look inside the airways and the lungs) may be necessary.

It can sometimes be challenging to find a physician or a healthcare provider to evaluate and treat a chronic cough. Initially, you may find that you are referred to a pulmonologist to "work up" or diagnose a chronic cough. Finding a healthcare provider you like who is willing to be patient is probably the key to success in treating your chronic cough.

When a Cough Is an Emergency

Because the cough reflex is natural and protective, sometimes it is the body's way of letting us know of an impending emergency. If you have a sudden bout of coughing and have the potential for any of the following disorders, you should seek medical attention immediately.

• Allergic reaction (anaphylaxis)
• Asthma or chronic obstructive pulmonary disease (COPD) exacerbation, or worsening, when medications can't control the symptoms
• Inhalation of a foreign object
• Pertussis (whooping cough)
• Pneumonia

In addition to coughing, you may also experience difficulty breathing or other worrisome symptoms such as swelling of the tongue.

If you have problems breathing, especially if you are at risk of any of these emergent conditions, you should not delay seeking medical treatment, as these can be life-threatening.

Additionally, if you have a type of cough that persists for more than one or two weeks, you should consult your healthcare provider.