From the Guidelines
Treatment for anosmia, or loss of smell, should prioritize smell training, which involves sniffing four distinct scents for 20 seconds each, twice daily for at least 3-6 months, as it has shown promise in improving olfaction in post-viral anosmia, including COVID-19 related smell loss 1. When considering treatment for anosmia, it is essential to determine the underlying cause, as this will guide the most effective management strategy.
- For anosmia caused by nasal congestion from colds, allergies, or sinusitis, decongestants like pseudoephedrine or nasal steroid sprays such as fluticasone may help, along with saline nasal irrigation using a neti pot twice daily.
- For post-viral anosmia, including COVID-19 related smell loss, smell training is recommended, as supported by studies such as Abdelalim et al. (2021) and Mohamad et al. (2021) 1.
- For anosmia due to nasal polyps, oral corticosteroids like prednisone may be prescribed, followed by nasal steroid sprays. Some cases of anosmia, particularly those caused by head trauma or neurological conditions, may be permanent.
- Treatment works best when started early, as prolonged smell loss can lead to nerve damage that becomes irreversible.
- If anosmia persists beyond two weeks or occurs without an obvious cause, medical evaluation is necessary to determine the underlying cause and appropriate treatment, as suggested by the study by Addison et al. (2021) 1. It is crucial to note that the current evidence is limited, and more research is needed to fully understand the effectiveness of different treatments for anosmia, as highlighted in the study by Lechner et al. (2020) 1.
From the Research
Treatment Options for Anosmia
- The treatment for anosmia, or loss of smell, can vary depending on the underlying cause of the condition 2, 3.
- According to a systematic review, treatments with the most robust data for anosmia include:
- Intranasal corticosteroids
- Olfactory training
- Olfactory training is a recommended treatment for post-viral olfactory dysfunction, a common cause of anosmia 3.
- The use of short-term systemic and/or topical steroids may be an option for select patients, but careful consideration of potential risks is necessary 3.
- Other treatment options, such as systemic steroids, topical therapies, and acupuncture, have been studied, but the evidence is limited, and more research is needed to determine their effectiveness 2, 3.
Specific Treatments
- Intranasal corticosteroids have been shown to be effective in improving olfactory function in patients with chronic rhinosinusitis, a common cause of anosmia 4.
- Olfactory training, which involves repeated exposure to different odors, has been shown to improve olfactory function in patients with anosmia 2, 3.
- Short-course oral steroids have been used as an adjunct therapy for chronic rhinosinusitis, but the evidence is limited, and more research is needed to determine their effectiveness 4.