What actually helps when I have a cold?

Two things decide how a cold goes: what is already in the cupboard, and whether you stay off the spray that works. Both are decided before you are ill.

Build the kit while you are well. Build the sick kit while you’re well names the specific misery of being properly ill on your own, standing in an aisle with a fever trying to remember what you came for. Put a small kit together on a good day: fluids with electrolytes, food that needs no cooking, a fever reducer and pain reliever, tissues, a thermometer, a plunger, and check it once a year so nothing has expired. Its shape is decided by two jobs. The first is fluid, because a large part of what turns an ordinary illness dangerous rather than miserable is losing water and salt faster than you replace it, so the drinks come first and the food is chosen for being easy to keep down. The second is effort, because everything in it should be usable by someone dizzy, weak and not thinking clearly, which is why instant noodles and frozen portions of soup you cooked on a good day beat any recipe. Once it is built, the accounts converge on the same two moves at the first symptom, and neither costs anything: drink steadily, and go to bed, not after the errands. One person’s version is that no remedy on any list comes close to sleep.

The spray that works has a three-day limit. The spray that works has a three-day limit corrects the assumption the whole blowing loop runs on: a blocked nose is swollen tissue rather than trapped mucus, because the lining is full of blood vessels and when they fill the airway narrows. That is why blowing does so little and why blowing hard makes it worse, and it is also why your nostrils alternate through the day, which is normal and has a name, the nasal cycle. Then the part people do not find out until they are already in it: the sprays that work spectacularly, usually oxymetazoline, work by squeezing those vessels shut, and past about three days the nose adapts, so when the spray wears off it comes back more blocked than it started. The condition has a name, rhinitis medicamentosa, and the accounts of it there read like accounts of a habit, spare bottles about the house, needing it when not even ill. The way out is known and is not white knuckles: stopping the decongestant and starting an over-the-counter steroid nasal spray at the same time settles the rebound in about two days, where stopping alone can take over a week; take the specifics from a pharmacist. One more thing that page found, which may save you the most: the US regulator reviewed the evidence and concluded that phenylephrine, taken by mouth, does not work as a decongestant, so if you swallowed a tablet marked PE and nothing happened, that was not you. The free things that do work: lie down with the blocked side facing up, move hard, steam, something hot enough to make your eyes water, and a saline rinse. That last one carries the page’s safety rule, and it is not optional: the water has to be distilled, sterile, or boiled for three to five minutes and cooled, never straight from the tap, because tap water can carry an organism that survives in a nose and causes a brain infection that is almost always fatal. It is genuinely rare and entirely avoidable.

The barrier goes on before the paper. Dab the balm on before the tissue does is for the fourth day, when the skin under your nose has gone from red to split and every tissue hurts more than the blocked nose it is for. Twelve separate conversations there say the cause is friction and drying, paper against a wet face many times a day, and that a barrier on the skin before the paper touches it is what prevents it: a thin layer of plain lip balm or petroleum jelly under and around the nose, before you blow and again after. Unscented, no mint, no alcohol, because on skin that has split those burn. The envelope matters: on the outside of the nose, not up inside it. The clinic answer read for that page says jelly inside the nostrils usually drains and is swallowed, but that small amounts can rarely reach the lungs and over months cause lipoid pneumonia, and that for a dry inside-nose the better tools are a humidifier or a saline spray. And if you use supplemental oxygen, no petroleum jelly near your nose at all, because it is combustible in oxygen.

Tissue, then elbow, never the hand. The elbow is for when there is no tissue puts the order in the health bodies’ own words: cover your mouth and nose with a tissue, throw it away, and if you have no tissue, cough or sneeze into your elbow, not your hands. Thirteen separate conversations there say elbow rather than hand, and three say a tissue binned at once is better still. Both sides of the argument, and there is a real one, end at the same place: whatever caught the cough, the hands get washed with soap. Six separate conversations say the technique of the cough is the smaller half and the washing is the larger, and the mechanism is worth knowing, because washing is not killing germs, it is physically carrying them off the skin with the dirt and oil, which is why soap and rubbing matter. Sanitiser is the second choice, at least sixty percent alcohol when soap and water are not available, and two corrections there say it does nothing useful on hands with mucus on them.

And the sneeze you are trying to stop. Press your tongue to the roof of your mouth has a right half and a wrong half, and the wrong half is the one in general circulation. Never stop a sneeze by pinching your nose shut with your mouth closed: a published case describes a healthy man in his thirties who did exactly that, tore the back of his throat, and spent a week in hospital being fed through a tube on intravenous antibiotics, with reported harms from the same manoeuvre including air forced into the chest and a burst eardrum. Before the reflex commits you are interrupting a signal, which is harmless: press the flat of your tongue hard against the roof of your mouth, or press firmly in the groove under your nose. Once it has started, let it out with your mouth open, into your elbow. And driving, the dangerous thing is not the sneeze but the two seconds spent fighting it with one hand off the wheel.

Who this is not for. The kit page’s safety line is the line for all of it, and it is the CDC’s, for flu-like illness. In adults: difficulty breathing or shortness of breath; persistent pain or pressure in the chest or abdomen; persistent dizziness, confusion, or being hard to wake; seizures; not urinating; severe muscle pain, weakness or unsteadiness; a fever or cough that improves and then returns or worsens; and a chronic condition getting worse. Any of those means stop self-treating and get medical care now. In children, add fast breathing or ribs pulling in with each breath, bluish lips or face, chest pain, muscle pain so severe the child refuses to walk, signs of dehydration, no urine for eight hours, a dry mouth, no tears when crying, not alert or interacting when awake, a fever above 104°F that medicine does not bring down, and in a baby under twelve weeks, any fever at all. In the US that is 911 or an emergency department, in the UK 999 or A&E, elsewhere your local emergency number, and the CDC says its lists are not complete, so anything severe or worrying is reason enough to call. That page also names who it does not cover: anyone with a long-term condition, whose clinician’s sick-day plan outranks it, and anyone caring for a baby or small child, for whom the pharmacist is the right first call. And the blocked-nose page names its own reader to send elsewhere: if your nose has been blocked since you can remember, or one side has never opened, the cause is probably structural, and no breath-hold fixes a bone.