Steroids Are Not Effective for the Common Cold
Steroids are not recommended for the treatment of the common cold as there is no evidence to support their use for symptomatic relief.1
Evidence Against Steroid Use in Common Cold
- Current guidelines explicitly state there is no evidence to support the use of intranasal corticosteroids for symptomatic relief from the common cold 1
- A Cochrane systematic review found no benefit of intranasal corticosteroids for duration or severity of common cold symptoms 2
- In placebo-controlled trials, no significant differences were found in symptom duration between intranasal corticosteroids and placebo 2
Recommended Treatments for Common Cold Symptoms
For Adults:
- First-generation antihistamine/decongestant combinations have shown effectiveness for symptom relief 1
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can provide relief for headache, malaise, and myalgia associated with the common cold 1, 3
- Zinc administered as zinc acetate or zinc gluconate lozenges at doses ≥75 mg/day taken within 24 hours of symptom onset can significantly reduce the duration of common cold 1, 4
- Nasal decongestants can reduce symptoms of nasal blockage, though they should only be used short-term 1
For Children:
- Over-the-counter cold medications should not be used in children younger than four years 4
- Safe and effective treatments for children include honey (for children one year and older), nasal saline irrigation, and topical application of ointment containing camphor, menthol, and eucalyptus oils 4
Treatment Considerations and Cautions
- Antibiotics are not effective for the common cold in either children or adults and should not be prescribed 5
- Newer-generation, non-sedating antihistamines should not be used as they are ineffective in treating common cold symptoms 1
- When choosing between NSAIDs and acetaminophen for pain relief, there appears to be no significant difference in effectiveness 6
- The benefits of any symptomatic treatments must be weighed against potential adverse effects 1
Prevention Strategies
- Hand hygiene is the most effective way to prevent transmission of cold viruses 4
- Prophylactic use of zinc may decrease the frequency of colds in adults 5
- Prophylactic vitamin C modestly reduces cold symptom duration in both adults and children 5
The common cold is a self-limiting condition, and patient education about its natural course (typically 7-10 days) is an important aspect of management. While symptomatic treatments may provide relief, there is no evidence that steroids - either intranasal or oral - provide any benefit for common cold symptoms.