Cough drops are common over-the-counter remedies used to soothe the irritation and discomfort associated with a cough or sore throat. They are designed to provide temporary relief by moistening and coating the sensitive tissues of the throat. However, some users report that these remedies might occasionally be counterproductive, leading to a lingering or worsening cough. This observation raises questions about the true effect of these products and warrants a closer look at their mechanisms and ingredients.
How Cough Drops Are Designed to Provide Relief
The primary goal of a cough drop is to create a soothing barrier in the throat and stimulate saliva production. This demulcent effect helps reduce the sensation of a tickle or scratchy feeling that often triggers a cough reflex. Ingredients like pectin, honey, or glycerin dissolve slowly to form a thin, protective film over the irritated mucous membranes.
Many cough drops also contain active ingredients intended to suppress the cough more directly. Menthol is a common additive that provides a mild, local anesthetic effect by temporarily numbing the nerve endings in the throat, which decreases the sensitivity of the cough reflex.
Mechanisms That Can Exacerbate Coughing
Paradoxically, the ingredients designed to help can sometimes cause increased irritation, especially with overuse. Excessive consumption of cough drops containing menthol has been correlated with increased cough severity and a longer duration of symptoms. One theory suggests that menthol’s cooling sensation may have a drying effect on the mouth and throat tissues. The resulting dryness can become a new irritant, triggering a persistent, dry cough reflex known as rebound irritation.
Some medicated drops contain ingredients that can trigger an underlying condition, such as gastroesophageal reflux disease (GERD). Menthol and certain strong flavors can relax the lower esophageal sphincter, allowing stomach acid to back up into the esophagus and throat. Since GERD is a significant cause of chronic cough, a cough drop that induces reflux will worsen the cough rather than relieve it.
The high sugar content in many cough drops, or the sugar alcohols like sorbitol found in sugar-free varieties, can also present problems. Frequent exposure to sugar can irritate the sensitive throat lining, while excessive intake of sorbitol may lead to gastrointestinal distress. Furthermore, dyes, preservatives, or artificial flavorings can occasionally cause a mild localized allergic reaction in sensitive individuals. This irritation can manifest as swelling or increased inflammation in the throat, which intensifies the coughing reflex.
The Risk of Masking Serious Underlying Conditions
A serious risk is that the temporary relief provided by a cough drop can lead to a delay in seeking necessary medical care. By mildly suppressing the symptom, cough drops can mask the severity of an underlying health problem. This is a concern when the cough is a symptom of a serious infection or a chronic condition.
Conditions such as bacterial pneumonia, severe asthma, or chronic obstructive pulmonary disease (COPD) can present with a cough that is temporarily quieted by a lozenge. These diseases require specific medical treatment, such as antibiotics or inhaled corticosteroids. Relying on over-the-counter remedies may provide enough comfort to prevent a person from seeing a doctor, allowing the underlying illness to progress unchecked.
A cough that persists for more than three to four weeks, or one that is accompanied by “red flag” symptoms, warrants professional evaluation. These serious warning signs include:
- Wheezing
- Shortness of breath
- Fever above 100.4 degrees Fahrenheit
- Coughing up blood
Using cough drops to manage a cough with these symptoms can be dangerous, as it postpones a diagnosis and the initiation of appropriate treatment.