Ammonia towelettes are small, sealed packets that release ammonia gas when torn open, and their oldest and most common purpose is reviving someone who has fainted. You will find them tucked into first aid kits, sideline medical bags, and gym bags across the country. Beyond that classic use, they have been adopted by athletes seeking a jolt of alertness before a heavy lift or a play, and a lesser-known formulation is used to relieve the itch of insect bites. The story behind these unassuming packets involves some genuinely interesting physiology and a few misconceptions worth clearing up.
How the Ammonia Hits Your System
The active compound inside most ammonia towelettes is ammonium carbonate. When you tear the packet and hold it near your nose, the ammonium carbonate releases ammonia gas. That gas is a powerful irritant to the moist tissue lining your nasal passages and lungs, and it triggers what is essentially an alarm response in your nervous system. The trigeminal nerve, the large cranial nerve responsible for sensation across your face, detects the irritant and fires off a reflex that forces you to inhale sharply. Your breathing rate jumps, your heart rate climbs, and your blood pressure rises as part of a broader spike in sympathetic nervous system activity.1PubMed Central. Smelling salts
The whole process is fast. Within a second or two of exposure, a person who was drowsy or unconscious is jolted into alertness. The sensation is not pleasant. People who have sniffed one for the first time often describe it as an intense burning sting in the sinuses, accompanied by watering eyes and an involuntary gasp. That unpleasantness is the point: the body reacts so strongly to the irritant that it overrides whatever state of low arousal or unconsciousness it was in.
Treating a Faint
The original medical purpose of ammonia inhalants, and still the one printed on most packaging, is to help someone recover from a simple faint. When a person passes out from a vasovagal episode (the common type of faint caused by a sudden drop in blood pressure), the ammonia triggers a cascade of cardiovascular responses that directly counteract what caused the faint in the first place. Inhaling ammonia causes blood vessels in the limbs to constrict, which raises systemic blood pressure. It also constricts the capacitance vessels, the larger veins that hold a reserve of blood, which pushes more blood back toward the heart and raises cardiac filling pressure.2The American Journal of Cardiology. Hemodynamic effects of inhalation of ammonia in man
In plain terms, the ammonia reverses the pooling of blood in the extremities that caused the person to black out. Blood pressure comes back up, the heart fills more efficiently, and the brain gets adequate perfusion again. This is why ammonia inhalants have persisted in first aid for so long: they do not just wake someone up through an unpleasant smell. They actually address the underlying hemodynamic problem of a simple faint.
That said, a few caveats matter. Ammonia towelettes are appropriate for simple fainting episodes, not for every kind of unconsciousness. Someone who has collapsed from a head injury, a seizure, a stroke, or cardiac arrest needs emergency medical attention, not a packet waved under their nose. Using the towelette on a person whose altered consciousness stems from a serious injury could delay real treatment and, in the case of a neck or spine injury, prompt a sudden head movement that makes things worse. The standard first aid guidance is to use ammonia inhalants only when you have good reason to believe the person simply fainted and to call for help if they do not recover quickly.
Why Athletes Sniff Them
Walk around the warm-up area at a powerlifting meet, a strongman competition, or an NFL sideline, and you will see athletes cracking open ammonia inhalant capsules or towelettes and taking a deep sniff right before a big effort. The practice has become a ritual in strength sports and is increasingly common in hockey, football, and combat sports. Athletes describe the experience as a shock to the system that sharpens focus and creates an intense, almost angry burst of energy. Some call it a “psyching-up” effect.3PubMed. Acute Effects of Ammonia Inhalants on Strength and Power Performance in Trained Men
The underlying idea is that the spike in sympathetic nervous system activity, the same fight-or-flight surge that helps revive a fainting victim, also primes the body for maximal physical effort. Heart rate goes up, pupils dilate, and the athlete feels more alert and aggressive. For a powerlifter about to attempt a one-rep max deadlift, that subjective feeling of being “switched on” can be genuinely useful, regardless of whether the ammonia changes the muscles’ actual capacity to produce force.
Ammonia inhalants are not banned by any major sports governing body. They are legal in the NFL, NHL, NCAA, and under World Anti-Doping Agency rules. Their status as a legal, over-the-counter product means they sit in a gray zone: clearly psychoactive in the moment, clearly not in the same category as performance-enhancing drugs. Some sports medicine professionals have raised questions about their widespread unregulated use, particularly among younger athletes who may not understand the risks of repeated or excessive exposure, but no organization has moved to restrict them.4PubMed Central. Ammonia Inhalants: Use, Misuse, and Role in Sports Performance
Do They Actually Improve Performance?
This is where the evidence gets thinner than the hype suggests. Athletes swear by ammonia inhalants, but the research backing actual measurable performance gains is limited and mixed. One study in trained men found that sniffing ammonia before an explosive movement produced a measurable increase in the rate of force development, meaning the speed at which force was generated went up. However, the same study found no significant improvement in peak force during countermovement jumps or isometric mid-thigh pulls.3PubMed. Acute Effects of Ammonia Inhalants on Strength and Power Performance in Trained Men So the ammonia may help you produce force faster without necessarily making you stronger in absolute terms.
A broader review of the available literature paints a more skeptical picture, concluding that there is a lack of evidence to support the anecdotal claims of increased cognitive arousal and greater strength performance.5Strength & Conditioning Journal. Effects of Ammonia Inhalants in Humans: A Review of the Current Literature Regarding the Benefits, Risks, and Efficacy The subjective experience of feeling more alert and aggressive is real, but translating that feeling into measurable barbell performance has proven difficult to demonstrate in controlled settings.
The honest read is that ammonia inhalants probably function as a psychological arousal tool more than a physiological one. If an athlete believes the ammonia sharpens their focus and it helps them commit fully to a heavy attempt, that effect is real in context even if a lab test cannot detect a meaningful change in force output. Sports psychology has long recognized that arousal management affects performance, and ammonia inhalants are one of the more dramatic ways to raise arousal levels on command. Whether the same effect could be achieved with a loud shout, a face slap, or an intense pre-lift visualization is an open question that nobody has bothered to study head-to-head.
Relieving Insect Bite Itch
A lesser-known use of ammonia involves topical solutions rather than inhalation. Ammonia-based solutions, sometimes sold as towelettes or wipes, have been marketed for decades as a remedy for mosquito bites. A controlled study tested an ammonium solution against a placebo for immediate-type mosquito bite symptoms like itching, burning, and pain. The ammonium solution provided significant relief from five minutes after application through an hour and a half, with about two-thirds of participants experiencing complete or partial relief compared to none in the placebo group.6PubMed. Effectiveness of ammonium solution in relieving type I mosquito bite symptoms: a double-blind, placebo-controlled study
The mechanism here is different from the inhalation use. When applied to skin, the alkaline ammonia solution is thought to neutralize some of the acidic components in the bite and reduce the local inflammatory response. These topical ammonia wipes are sometimes included in outdoor first aid kits alongside the inhalant versions, which can cause confusion since the two products look similar but serve completely different purposes. The topical versions are meant to be rubbed on skin. The inhalant versions are meant to be held near the nose. Mixing them up is not dangerous in most cases, but sniffing a mosquito-bite wipe will not produce the same intense arousal as a proper ammonia inhalant capsule, and rubbing an inhalant packet on a bug bite will not do much for the itch.
Ammonia as a Cleaning Agent
Outside the medical and athletic worlds, ammonia’s most familiar role is as a household cleaner. Dilute ammonia solutions cut through grease and grime effectively, and ammonia-based wipes are a staple in commercial cleaning. Ammonia’s chemical structure gives it both degreasing and disinfecting properties, making it useful for surface cleaning as well as killing certain bacteria and viruses.7ScienceDirect. Progresses in Ammonia: Science, Technology and Membranes
Cleaning towelettes containing ammonia are a different product category from the medical inhalant towelettes, but the shared ingredient means some safety precautions overlap. Both should be used in ventilated areas, and neither should be mixed with bleach. When ammonia and sodium hypochlorite (bleach) combine, they produce chloramine gas, which is toxic and can cause serious respiratory injury. This is one of the most commonly cited household chemical accidents, and it applies to ammonia in any form, whether you are cleaning a countertop or opening a first aid packet in a small, enclosed space.
Safety Risks and Who Should Avoid Them
At the concentrations found in commercial ammonia towelettes and inhalant capsules, the risk to a healthy person from occasional use is low. The amount of ammonia released is small and dissipates quickly in open air. The product is designed to be held several inches from the nose, not pressed directly against it, and a single brief inhalation is the intended dose.
Problems arise with misuse. Holding an ammonia inhalant directly against the nostrils, or sniffing it repeatedly in a short period, can cause chemical burns to the nasal mucosa. Ammonia has a strong affinity for mucous membranes, and at higher concentrations or with prolonged exposure, it can damage the lining of the nose, throat, and airways. In severe cases involving concentrated ammonia (far beyond what a towelette contains), injuries can include swelling of the airway, fluid in the lungs, and damage to the eyes.8Burns. Anhydrous ammonia burns case report and review of the literature Those severe injuries are associated with industrial anhydrous ammonia, not with consumer-grade smelling salts, but they illustrate why respecting the chemical even in small doses is sensible.
People with asthma or other reactive airway conditions should be cautious. The sharp inhalation reflex and the irritant properties of ammonia can trigger bronchospasm in sensitive individuals. Similarly, anyone with a known sensitivity to strong chemical fumes should avoid ammonia inhalants or at least try them conservatively in a well-ventilated setting before relying on them in competition.
Industrial-grade anhydrous ammonia is a different substance in terms of risk. It can cause severe chemical burns even with brief skin contact and requires immediate and extensive irrigation to limit tissue damage.9Journal of Burn Care & Rehabilitation. Anhydrous Ammonia Burns: Case Presentation and Literature Review Consumer ammonia towelettes contain vastly lower concentrations and are not comparable in hazard, but the shared name occasionally causes unnecessary alarm. If you are using a standard over-the-counter ammonia inhalant from a pharmacy or first aid supplier, you are dealing with a product that has been formulated for safe occasional use by the general public.
The Concussion Question
One of the more concerning historical uses of ammonia towelettes was on the sports sideline after a player took a hit to the head. For decades, trainers would crack an ammonia capsule under the nose of a dazed athlete to “wake them up” and get them back in the game. The logic seemed straightforward: the player is groggy, ammonia makes people alert, therefore ammonia fixes the problem.
That logic is now understood to be wrong and potentially dangerous. Current evidence questions the efficacy of ammonia inhalants as a medical intervention for concussion, and their use in that context has fallen out of favor in modern sports medicine.1PubMed Central. Smelling salts The ammonia does not treat the underlying brain injury. It merely masks the symptoms by overriding the grogginess with a chemical jolt, which can create the false impression that the athlete has recovered when they have not. A concussed athlete who appears alert after sniffing ammonia is still concussed and still at risk for second-impact syndrome if returned to play.
Most professional sports leagues and athletic training organizations now discourage or prohibit using ammonia inhalants on a player suspected of having a concussion. The shift reflects a broader change in how sports handle head injuries: the priority is evaluation and rest, not a quick return to the field. If you are a coach or a parent on a sideline and someone hands you an ammonia towelette to use on a player who just got their bell rung, the right move is to put it away and follow concussion protocols instead.
Ammonia Towelettes Versus Capsules
Ammonia inhalants come in two main forms, and the terminology can be confusing. Towelettes are flat, sealed foil packets containing a small cloth or pad saturated with an ammonium carbonate solution. You tear them open and the ammonia begins to off-gas from the wet pad. Capsules, sometimes called ampules or poppers, are small glass vials encased in a fabric or plastic sleeve. You snap the capsule to break the glass inside, which mixes the chemicals and releases ammonia gas.
Both deliver the same active ingredient, but the experience differs. Capsules tend to release a more concentrated burst of ammonia in a shorter period, which is why they are preferred by athletes who want a sharp, intense hit. Towelettes release ammonia more gradually and at a somewhat lower concentration, which makes them better suited for first aid applications where you want a gentler stimulus on someone who may be disoriented. First aid kits almost always contain towelettes rather than capsules for this reason. They are also flatter and easier to store, and they have a longer shelf life because the sealed foil packet protects the solution from degradation better than the glass-capsule format.
In practice, many athletes have migrated from towelettes to capsules because of the stronger effect, and some powerlifting gyms keep bottles of pure ammonia solution that athletes pour onto rags. That homemade approach carries higher risk because there is no standardization of concentration, and holding a rag soaked in ammonia directly against your face is a good way to burn sensitive tissue. If you are going to use ammonia inhalants for athletic arousal, the commercial single-use products are the safer choice because their concentration is controlled and their exposure is brief.
How Long They Last and How to Store Them
Sealed ammonia towelettes have a shelf life of roughly two to five years depending on the manufacturer and storage conditions. The main enemy of shelf life is heat: storing them in a hot car or in direct sunlight accelerates the breakdown of ammonium carbonate and can leave you with a packet that barely produces any ammonia when opened. If you keep a few in a first aid kit, check them periodically. An expired or degraded towelette will have a noticeably weaker smell when opened, and one that has lost its seal entirely will have dried out and become useless.
Once opened, the ammonia dissipates within minutes. A torn towelette left on a counter will stop producing any noticeable gas within about ten to fifteen minutes as the ammonium carbonate finishes volatilizing. There is no way to reseal and reuse them, which is part of their design as a single-use product. If you need another dose, you open another packet. For first aid purposes, one towelette per episode is usually sufficient. If a person does not respond to one, the problem is likely not a simple faint, and additional ammonia is not the answer.