Can I fly with a cold?

Is it OK to fly with a cold, or should I rebook?

For most people, the main physical problem with flying while you have a cold is ear pressure. The bigger question is whether you should go, and the CDC's travel advice is plain: postpone your travel and stay home when you are sick, because you can spread illness to other travelers.

In practice, a lot of trips cannot move. A useful test is the CDC's general rule for respiratory viruses: you can go back to normal activities when, for at least 24 hours, your symptoms are getting better overall and you have not had a fever without using fever-reducing medicine. If you are not there yet, especially if you still have a fever, that is the strongest reason to rebook.

Colds usually peak within 2 to 3 days of infection, according to the CDC. If your flight is a few days out, you may be past the worst of it by then.

• Lean toward rebooking: fever, symptoms still getting worse, or a very blocked nose and ears.
• Usually OK to fly with care: no fever for at least 24 hours without fever-reducing medicine, symptoms improving, some congestion left.
• Not sure it is a cold? The CDC suggests getting tested if you think it could be COVID-19 or flu, especially if you are at higher risk.

Why does a cold make your ears hurt on a plane?

Your middle ear connects to the back of your nose and upper throat through the eustachian tube. When the cabin pressure changes, swallowing or yawning opens that tube to even out the pressure on both sides of your eardrum. MedlinePlus explains that nasal congestion from colds, allergies, or other upper respiratory infections makes barotrauma more likely. If the tube is blocked, the pressure on the two sides of the eardrum stays uneven.

Symptoms MedlinePlus lists include ear pain or discomfort, a full or stuffy feeling in the ears, slight hearing loss, and dizziness. More severe cases can cause more hearing loss, a feeling of being underwater, or a nosebleed. Possible complications include a ruptured eardrum, fluid in the middle ear, an ear infection, hearing loss, and vertigo. MedlinePlus also notes that barotrauma usually gets better with self-care and hearing loss is almost always temporary.

If you tend to get airplane ear even when you are well, keep in mind that congestion raises the risk. For the mechanics in more detail, see our page on why airplane ear happens.

How do you protect your ears if you fly with a cold?

MedlinePlus gives a short list of things that help the eustachian tube open. For flying, it also says not to sleep as the plane prepares to land. Descent is when you need to keep equalizing.

• Swallow, yawn, chew gum, or suck on candy especially as the plane descends.
• Try a gentle pressure move: breathe in, then breathe out gently while holding your nostrils closed and your mouth shut. Gentle is the key word.
• Stay awake for landing so you can keep doing the steps above.
• For a baby or toddler, MedlinePlus says nursing or sips of a drink during descent may help.

Should you take a decongestant before flying with a cold?

MedlinePlus lists nasal decongestants, as a spray or pills, used before altitude changes as a way to help prevent ear barotrauma. It does not give an exact timing, and we did not find a primary source that does, so follow the directions on the product you use. Sudafed 12 Hour, for example, is pseudoephedrine 120 mg taken as 1 tablet every 12 hours, no more than 2 in 24 hours, and not for children under 12.

Decongestants are not right for everyone. Check these before you take one:

• High blood pressure or heart disease: the Sudafed label says to ask a doctor before use. The same goes for thyroid disease, diabetes, or trouble urinating from an enlarged prostate.
• MAOI antidepressants: the Sudafed and DayQuil labels both say do not use them if you take a prescription MAOI, or for 2 weeks after stopping one. Both labels also tell you to ask a doctor or pharmacist if you are not sure whether your prescription is an MAOI.
• Do not double up. DayQuil Cold and Flu already contains a decongestant (phenylephrine), plus acetaminophen and dextromethorphan, per its label. Do not add Sudafed or another decongestant on top of it.
• Watch the acetaminophen. DayQuil Cold and Flu contains acetaminophen, the ingredient in Tylenol. Its label warns that severe liver damage may occur if you take it with other drugs that contain acetaminophen, so do not add Tylenol on top of it. The DayQuil label also says to ask a doctor first if you have liver disease, heart disease, or high blood pressure.
• Stop and ask a doctor if you get nervousness, dizziness, or sleeplessness, or if symptoms do not improve within 7 days or come with a fever, per the Sudafed label.

How do you keep from giving your cold to other passengers?

The CDC says most respiratory viruses spread through droplets an infected person releases when they cough or sneeze, and some can spread through close personal contact, such as shaking hands. A plane seat puts you close to strangers for hours, so the CDC's precautions for the days after you start feeling better fit well here.

For the 5 days after you return to normal activities, the CDC advises extra precautions around other people: such as wearing a well-fitted mask, practicing good hygiene, and physical distancing.

• Mask the whole trip, including the gate area and boarding line.
• Keep your hands clean. The CDC suggests packing alcohol-based hand sanitizer in your travel health kit.
• Pack your medicines. The CDC suggests bringing your prescriptions and over-the-counter medicines, enough to last your whole trip, plus a little extra.