Updated 07 October 2019

Tired of that nagging cough? Try giving your perfume a miss?

Plus other rare reasons for an ongoing cough...

We all cough at some point or another. Coughing is a physical reflex that helps to clear our airways, and the average cough lasts about 18 days. It's, however, often difficult to pinpoint the cause of a cough, and most people underestimate the time it takes for a cough to clear up.  

Chronic cough is estimated to affect up to 9.6% of the global adult population. The most common cause of a chronic cough worldwide is upper airway cough syndrome (UACS), caused by a post-nasal drip, asthma or gastro-oesophageal reflux disease (GORD). Your persistent cough may, however, be caused by something else entirely, such as scented household sprays and perfumes.

Link between perfumes and coughing

Vickie Harwood, a 61-year-old woman told the Washington Post she had a continuous tickling in her throat, which ultimately led to continuous coughing. It slowly became clear that perfumed lotions and fragrances were responsible for her reaction. It turned out that she'd grown sensitive to fragrances – to the extent that even her husband’s deodorant and cologne would trigger a cough.

After being misdiagnosed with asthma, it was found that she was experiencing vocal cord dysfunction (VCD). The body produces about 1 to 1.5l of mucus per day, but VCD leads to sinus congestion and extra mucus production, which may then trigger airway constriction and breathing difficulties, causing a cough. 

Harwood may have been initially misdiagnosed, but strong perfumes and scents, and even bleaching-based products are a common trigger for asthma sufferers. This is known as an “irritant” response. Coughing is the result of irritation caused by these fragrances and scents when they come into contact with the lining of your nose and lungs, Dr Anna Feldweg explained to Everyday Health. Since avoidance of these strong fragrances in public spaces is almost impossible, medications are prescribed to control the symptoms. 

Other rare causes

As we mentioned, the three most common causes of cough are post-nasal drip, asthma and gastro-oesophageal reflux disease, but in up to 20% of patients, the cough remains unexplained even after extensive diagnostic investigations. 

Psychogenic cough: Also called "habit cough", this term describes a cough without obvious medical aetiology, which has a psychiatric or psychological basis. It is typically persistent and causes long-term morbidity. A study examined the case of a 45-year-old woman who experienced a violent coughing fit every couple of minutes, and found work-related stress to be the cause. The cough had disrupted her speech, work and daily activities, but interestingly disappeared at night. When weekly cognitive psychotherapy and antidepressant therapy were introduced, the cough disappeared after a few weeks and no relapses were reported. 

Atelectasis is a common respiratory (breathing) complication that usually happens after major surgery. It involves a complete or partial lung collapse due to a blockage or pressure on the lung, which may be caused by an accumulation of mucus in the airways. Coughing typically brings about some relief. However, if the coughing is severe, the patient should see a doctor.   

When a cough lingers on

If a cough doesn’t clear up by itself within a reasonable amount of time, and produces blood or is associated with intense chest pain, a healthcare practitioner should be consulted as soon as possible.

Image credit: iStock


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Cough Expert

Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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