How to Clear Out Congestion

Nonallergic rhinitis, an inflammation of the nasal mucous membranes not caused by allergies, is another common cause of congestion that can lead to sneezing, post-nasal drip and a stuffy or runny nose.

Chest congestion, which can be caused by allergies or respiratory bugs, can feel like pressure in your chest and can come with either a productive cough, where mucus comes out, or a dry cough. Chest congestion can also result from other health issues, such as bronchitis, asthma, heart failure and lung disease.

2. Pick the right treatment

Once you know why you’re congested, it’s time to choose the appropriate treatment. The goal of treating congestion is to bring up the phlegm (or bring it out), so it doesn’t lead to infection. Antihistamines are ideal for allergies that cause sneezing and a runny nose, Monteleone says. Intranasal steroids — like fluticasone propionate (Flonase) and triamcinolone acetonide (Nasacort) — reduce inflammation in the nasal passages and can also be used for congestion caused by allergies.

Nasal decongestant sprays containing phenylephrine (Sinex Nasal or Neo-Synephrine) or oxymetazoline (Afrin) can be used for colds or allergies.

It’s important to note that antibiotics are not a quick fix the minute you get stuffed up. They’re only effective for bacterial infections — not viral infections like the common cold, says Dr. Daniel Merenstein, a professor of family medicine at Georgetown University in Washington, D.C. They also can’t help with allergies.

If you’re uncomfortable, Merenstein says, there’s nothing wrong with reaching for an over-the-counter pain reliever, as long as your doctor approves. It’s not going to clear the congestion, but it can help relieve pain from the pressure or from blowing your nose, he adds.

3. Pay attention to timing

Don’t use nasal decongestant sprays for more than three days, Monteleone warns. Rebound congestion, also known as rhinitis medicamentosa, occurs when blood vessels become enlarged again and can cause even more severe congestion.

If you know you have allergies that cause nasal congestion, starting a nasal steroid (like Flonase) before symptoms set in can help prevent them, Merenstein says. Oral allergy medications can help relieve symptoms after exposure to an allergen, but nasal steroids work a little better for prevention, Merenstein adds.

4. Know which meds to skip

Oral phenylephrine. While nasal phenylephrine is effective at relieving congestion, phenylephrine pills are not effective decongestants, according to a 2023 committee report from the U.S. Food and Drug Administration (FDA).

Oral steroids. People often use oral steroids a little too quickly for congestion relief, and side effects can be a concern for some. So don’t take them if you don’t need them, Merenstein says.

First-generation antihistamines. Medications like diphenhydramine hydrochloride (Benadryl) can be problematic for many older adults, including those with an enlarged prostate. Instead, many experts recommend second-generation antihistamines, such as loratadine (Claritin) or fexofenadine hydrochloride (Allegra), Monteleone says. “You don’t want to take something very sedating,” Monteleone says, adding that the medication can be even more problematic if you’re already at a higher fall risk. Long-term antihistamines, including Benadryl, have been linked to a higher risk of dementia, too.

A few other considerations: Guaifenesin, the active ingredient in many mucus-loosening medications, including Mucinex, can thin gunk and phlegm in the chest. But older adults should talk to their doctors before taking it, especially if they’re taking other medications that may interact with the drug, Merenstein says. Ask your doctor about taking a steroid or other decongestants, especially if you have glaucoma. Some of these medications can be linked to different types of glaucoma.

One tip ahead of cold and flu season is to talk to your doctor about congestion treatments before you get sick, so you know what works best the next time you get stuffed up — especially if you have a chronic condition or are on other medications, Monteleone says. Oral decongestants can affect blood pressure and blood sugar in some people. 

5. Opt for natural fixes

You may not need to hit the drugstore at all for congestion relief. Saline sprays and nasal rinses with a neti pot can help relieve head congestion. When using a neti pot, just be sure to use sterile water, not tap water, public health experts stress.

A steamy shower is another natural option that can help ease head or chest congestion; so is sitting or sleeping upright.

Drinking lots of fluids can help to water down mucus so it clears out, and the extra fluid can keep you from becoming dehydrated, Monteleone says. Indoor air filtration systems and humidifiers can be hugely helpful, too.

6. Know when congestion requires medical care

Pay attention to the possible causes of congestion — and its duration.

If your mucus or phlegm is green or yellow and thick, you may have a secondary infection, such as pneumonia or bronchitis, and should check in with your doctor. Similarly, a thick, yellow nasal discharge that seems worse on one side could indicate sinusitis and may require prescription treatment, Merenstein says.

If you’re getting over a cold, know that a cough can take several weeks to go away. But if it lingers and you have a fever, you’ll want to see your doctor.

A runny nose or sneezing that seems like a cold but doesn’t go away may actually be allergies, Monteleone says. And while allergy-related congestion doesn’t usually require antibiotics, it can sometimes lead to a sinus infection that does.

If the congestion and other symptoms, like a fever or aches, hit quickly, ask your doctor if your illness is due to a viral infection, like flu or COVID-19. If it turns out to be viral, an antiviral medication could help keep your infection from turning severe. It’s especially important to see a doctor for these symptoms if you have lung-related ailments, such as chronic obstructive pulmonary disorder (COPD), Merenstein says.

If you have chronic congestion, it may not be due to a specific allergy or illness, but you may benefit from seeing an ear, nose and throat specialist. Anatomical changes in your nasal cavity — like weakened cartilage that can come with age — may be to blame.

7. Steer clear of quick cold aids

Having a quick fix for a cold would be great, but there aren’t any. The virus that causes the common cold has to run its course.

Some research claims zinc may be able to lower inflammation and block a cold virus from multiplying, thus reducing nasal congestion, but results are mixed.

“If you start right away, it might be worth it,” says Merenstein, who adds that there’s also some mixed evidence that echinacea may reduce the time you experience cold symptoms.