Understanding your cough: when to seek help

Coughs are something we all deal with, especially when cold and flu season rolls around. Annoying as they are, a cough is actually your body doing its job. It’s a built-in reflex (like blinking or sneezing) that helps clear your lungs and airways of something you don’t want hanging around, like dust, smoke, or mucus.

In most cases, a cough will settle down and go away on its own. However, sometimes it can be your body’s way of warning you that something more serious is going on. 

This article will show you how to tell the difference between a normal cough and one that you should see a doctor about.

Important Note: This article provides general health information and is not a substitute for professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment of any health condition.

Common reasons you might be coughing

A cough is a natural response to a large number of things that could be happening in your body or around you. 

The most common reason for coughing is a viral infection (the common cold, flu, COVID-19, etc) which spreads from person to person through tiny droplets carrying the virus. 

Some other reasons for coughing include:

• Allergies: If you react to things like pollen, dust, or pet hair, a cough can be one of the ways your body shows it.
• Bacterial infections: Infections like pneumonia are caused by bacteria. They can irritate your airways, lead to mucus build-up, and trigger a cough.
• Asthma: For some people with asthma, coughing is a main symptom, especially at night or when exercising.
• Irritants: Breathing in smoke, pollution, or strong fumes can easily irritate your airways and make you cough.
• Acid reflux: Stomach acid coming up into your throat can cause irritation and make you cough, especially at night.

When to see a doctor about a cough

The good news is that most coughs clear up on their own once your body has fought off the infection or the irritation has passed.

However, if you or someone you care about has been coughing for a while or it’s getting worse, it might be time to book a doctor's appointment. Here are some things to consider before booking an appointment.

How long is too long to be coughing?

When it comes to coughs, how long they last can tell you a lot. Doctors often use this scale to understand a cough:

• Acute cough: Lasts less than three weeks. It’s usually linked to a cold or another short-term infection.
• Sub-acute cough: Lasts between three and eight weeks. This can sometimes happen when a cough lingers after a viral infection.
• Chronic cough: Lasts eight weeks or more in adults, or four weeks or more in children. This kind of cough should always be checked by a doctor to find out what’s causing it.

If your cough is lasting longer than three weeks, you might want to book in to see a doctor. You can schedule an online consultation with an AHPRA-Registered Partner Doctor here.

Symptoms that are a sign to see a doctor

If you’re experiencing any of the following symptoms, it’s a sign that you should speak with a doctor.

• Coughing up blood or pink-tinged phlegm: This can be a sign of a serious infection or another condition affecting your lungs, and it should never be ignored.
• Difficulty breathing or shortness of breath: Struggling to catch your breath may mean your airways or lungs are affected and you need urgent attention.
• Chest pain: Pain that is new or getting worse when you cough could point to infection, inflammation, or another underlying issue.
• High fever that does not go away: A temperature that lasts more than a few days, or is very high, may signal a bacterial infection that requires treatment from a doctor.
• Thick, discoloured phlegm: Green or yellow mucus and a cough that lasts longer than three weeks could indicate an infection.
• Wheezing: A whistling sound when you breathe out could be linked to asthma, infection, or narrowing of the airways that you’ll need medical attention for.
• Fainting or feeling confused: These can happen if your body is not getting enough oxygen, which is a medical emergency (in Australia, call 000 for an ambulance).
• Unexplained weight loss: Losing weight over the length of your cough may be linked to a long-term condition that needs checking.
• A cough that gets worse: If, instead of improving in three weeks, your cough becomes stronger or more frequent, it is a sign to see a doctor.
• Other health conditions: People with existing illnesses such as heart disease, asthma, or a weak immune system should seek medical care, as a cough can be exacerbated by these problems.

If you have any of those symptoms or are feeling concerned about your coughing, get care fast with an online doctor's appointment. 

For children and babies, please seek medical advice if a child has a barking cough (possible croup), a whooping sound when breathing in (possible whooping cough), or signs of dehydration like fewer wet nappies, dry lips, or dizziness. This is especially if breathing becomes noisy or laboured, or if the child is under 6 months old.

When to seek emergency care

Sometimes a cough can be a sign of a medical emergency. Call triple zero (000) in Australia for an ambulance straight away if you or someone you’re with is:

• Choking: If coughing turns into choking, and the person cannot clear their airway or catch their breath or speak.
• Severe trouble breathing or swallowing: If breathing feels extremely difficult or painful, or if they cannot swallow safely.
• Lips or face turning blue: This is a clear sign that the body is not getting enough oxygen and needs urgent help.
• Experiencing sudden, severe chest pain: Especially if the pain feels crushing, spreads to the arm or jaw, or comes on out of nowhere.
• Cough linked with sudden dizziness, fainting, or confusion: These can mean the brain is not getting enough oxygen or blood flow.
• Severe allergic reaction (anaphylaxis): If coughing comes with sudden swelling of the lips, tongue, or throat, hives, or collapse.

In any of these situations, do not delay and call emergency services immediately. The Australian emergency number is 000. 

What doctors can do for a cough

If you or a loved one decides to see a doctor about their cough, their first step will be to work out what’s behind it. Once your doctor gets a better idea of the cause, they can suggest the right treatment. 

How does a doctor figure out the cause of a cough?

A doctor will usually begin by asking you some questions, things like when the cough started, how it sounds, and whether anything seems to make it better or worse.

From there, they might need to do a physical check, often listening to your lungs with a stethoscope and looking at your throat and nose.

If they need more information, they may also recommend tests such as:

• Chest X-ray: Gives a clear picture of your lungs to check for infections like pneumonia.
• Blood tests: Show whether your body is fighting off an infection.
• Sputum analysis: If you’re coughing up phlegm, a sample can be sent to a lab to see if bacteria are present.
• Lung function tests: Measure how well your lungs are working, which can help confirm conditions like asthma.

Prescription treatments a doctor might suggest for a cough

When a doctor prescribes something for a cough, the goal is always to treat the underlying cause, not just quiet the cough itself. Depending on the suspected cause of your cough, treatment provided by a doctor might include:

• Antibiotics: These may be prescribed if your doctor confirms that a bacterial infection, such as pneumonia or bacterial bronchitis, is behind your cough. (Please note that antibiotics do not work for viral infections like colds or the flu. Taking them when you don’t need them can do more harm than good by affecting your body’s natural defences.)
• Inhaled asthma medicines: If asthma is the cause, your doctor may prescribe an inhaler. These can contain corticosteroids that reduce inflammation or bronchodilators to open up your airways.
• Acid blockers: If acid reflux (when stomach acid flows back up into your throat) is triggering your cough, medicines that reduce or block acid production may help.
• Allergy medications: If allergies are the issue, treatment might involve antihistamines, corticosteroid nasal sprays, or decongestants.
• Adjusting other medications: Some prescription medicines, such as ACE inhibitors for high blood pressure, can cause a lingering cough. If that’s the case, your doctor may suggest changing your medication.

Medicines to help ease your symptoms

On top of diagnosing and treating the root cause of your coughing, your doctor might be able to provide you with other medications to make you more comfortable while you recover. These could be:

• Cough suppressants: These work on the brain to reduce the cough reflex, so you cough less often. (It’s important to know that cough and cold medicines, including suppressants, are not recommended for children under 12 years old in Australia.)
• Expectorants and mucolytics: These medicines thin and loosen mucus in the airways, making it easier to cough up.
• Pain and fever relief: Paracetamol or ibuprofen may be suggested to reduce fever, ease sore throat pain, or help with the general discomfort.
• Medicines for other symptoms: If your cough is part of a cold, the flu, or another illness, your doctor may recommend additional medicines to help manage those symptoms as well.

If you’re ready to speak with a doctor about your cough, you can book an online consultation here. 

Simple tips for feeling better while you recover

If your cough is mild, or while you’re waiting to see a doctor, there are a few simple things you can do at home to make yourself more comfortable:

• Stay hydrated: Drink plenty of fluids (more than you typically would) such as water, warm tea, or clear broths. This helps thin mucus and soothes your throat.
• Honey: A teaspoon of honey can calm irritation and ease a cough. (Never give honey to children under 12 months.)
• Cough drops or lozenges: Having one can moisten your throat and help settle the cough reflex.
• Moisturise the air: Use a cool-mist humidifier in your room, or take a warm, steamy shower to loosen mucus.
• Avoid irritants: Stay away from cigarette smoke, strong fumes, or anything else that will irritate your airways.
• Rest: Giving your body proper rest is one of the best ways to help it heal. For the common cold, the best thing you can do is rest and let your body fight the virus, even if this means taking a sick day.

FAQs

How long should a cough last?

Most coughs from a cold or flu improve within two to three weeks. If your cough lasts longer than three weeks as an adult, or more than two weeks in a child, it’s a good idea to see a doctor. 

A chronic cough means eight weeks or more in adults, or four weeks or more in children, and should always be checked.

What’s the difference between a dry cough and a wet cough?

A dry cough does not bring up mucus or phlegm. It often feels tickly and irritating. A wet cough, also called a productive cough, brings up mucus from the lungs. The type of cough can sometimes help point to the cause.

Can kids take adult cough medicine?

No. Children should never take adult cough medicine and should only be given medicines made for children. In Australia, cough and cold medicines are not recommended for children under 12 years old. Always read the label carefully and follow professional advice.

Can stress make you cough?

Stress does not cause a cough in the same way an infection does, but it can make you more aware of it. In some cases, anxiety or habit can keep a cough going even after the original cause has gone. If you think stress might be affecting your health, speak with your doctor.