The decision to fly with a common cold balances necessary travel against physical discomfort. While mild symptoms like a runny nose or sore throat are not typically a barrier to travel, the primary concern is how the pressurized airplane cabin interacts with respiratory congestion. The enclosed environment of an aircraft presents a unique medical risk that goes beyond simple inconvenience.
Why Pressure Changes Cause Severe Discomfort
The most significant risk of flying with a congested cold is barotrauma, a pressure injury. This occurs because the middle ear is an air-filled cavity connected to the back of the throat by the Eustachian tube. When a person has a cold, inflammation and mucus buildup can block or swell this tube, preventing it from functioning correctly.
The air pressure inside the airplane cabin changes rapidly during ascent and, more acutely, during descent. Normally, the Eustachian tube opens briefly to equalize the pressure difference between the middle ear and the cabin environment. When the tube is blocked by cold-related congestion, the pressure cannot equalize, creating a vacuum-like effect on the eardrum.
This pressure imbalance, often called “airplane ear,” can cause intense pain, muffled hearing, and a feeling of fullness. In severe cases, the sustained pressure difference can lead to middle ear fluid accumulation, prolonged dizziness, or even a ruptured eardrum. Sinus passages, which are often congested during a cold, can experience a similar phenomenon, causing severe facial or head pain known as sinus barotrauma.
Managing Contagion and Travel Etiquette
Choosing to fly while ill carries a responsibility to minimize the spread of germs to fellow passengers and crew in the confined cabin space. Frequent hand washing with soap and water or using an alcohol-based hand sanitizer is necessary after sneezing, coughing, or touching surfaces. Practicing cough and sneeze etiquette, such as covering the nose and mouth with a tissue or the elbow, is paramount to containing respiratory droplets.
Many travelers elect to wear a high-quality surgical or N95 mask throughout the airport and flight as a gesture of consideration to others. While most airlines do not prohibit flying with a mild cold, symptoms like a high fever or severe, uncontrollable coughing should prompt a traveler to reconsider their plans.
Strategies for Mitigating Symptoms During Flight
For those who decide to travel, preparation with appropriate medication and techniques can significantly reduce the risk of pain. Oral decongestants, such as pseudoephedrine, should be taken approximately one hour before the flight to allow the medication time to reduce swelling in the nasal passages and Eustachian tubes. Nasal spray decongestants, like oxymetazoline, offer a more targeted effect but should be used with caution and only for a short duration to avoid rebound congestion. A single application 30 minutes before takeoff and again 30 minutes before landing is recommended.
Non-medicinal methods are important for actively equalizing pressure, particularly during descent. Chewing gum or sucking on hard candy promotes frequent swallowing, which helps open the Eustachian tubes. The Valsalva maneuver, performed by gently exhaling against a closed mouth and pinched nose, can force air into the middle ear to restore pressure balance. Perform this maneuver gently and stay awake during takeoff and landing, as sleeping prevents the necessary frequent swallowing and pressure-equalizing actions.