Causes and mechanisms of colds

Scientific cold mucus inside nose image

What causes colds?

Colds are usually caused by viral infections. One of the major symptoms of a cold is nasal congestion, which can also be the result of several other causes.1 Here we take a closer look at the causes of colds and their mechanisms.

What are the functions of a healthy nose?

A healthy nose:2,3

  • Warms (just under normal body temperature 31-33oC), moistens (close to 98%), and filters inspired air before it enters the lungs, to ensure that the delicate lung tissue doesn’t become damaged by cold or dry air, or irritated by small particles (e.g. dust)
  • Reduces infections caused by viruses
  • Detects and destroys foreign substances before they enter the rest of the body (nasal membranes bring air in contact with immunoglobin, a protein that detects foreign substances such as viruses, bacteria, and allergens, triggering an immune response to destroy them before they enter the rest of the body)
  • Allows us to smell the air as it flows through the nose, which contributes towards our sense of taste
  • Allows the air resonating in the nose to help give our voice its particular sound
  • Nasal congestion has a variety of causes

    Nasal congestion is caused by swelling of the mucus membrane:6

    • It is not caused by too much mucus, as is often thought, although excessive mucus can exacerbate nasal congestion6
    • It is one of the oldest and most common human complaints7- a ‘stuffy’ nose is among the most troublesome symptoms of viral infections of the nose6
    • It leads to difficulties in breathing, hearing and sleeping; and can also cause voice changes that may be socially embarrassing8
    • It could also lead to impairment in the ability to smell
    Scientific image mucus

    1- Viral infection

    Common cold and influenza

    Woman and dog

    2- Allergies

    Pollens, animal dander, certain foods, insect venom, latex and various medicines.

    Pollutions in nose

    3. Inhaled irritants/pollutants

    Gases, metals, organic chemicals and biological material surrounding a carbon core.

    Glass nose

    4. Structural abnormalities

    Septal deviation, concha bullosa and adenoid hypertrophy

  • Woman inhaling steam

    Colds and influenza are major causes of nasal congestion

    The common cold and influenza are both classed as upper respiratory tract viral infections. They share similar symptoms, but there are some notable differences:

    The common cold is the most prevalent acute illness in the world:1

    • Referred to as a single illness, but caused by numerous viruses from different families1
    • Rhinoviruses are the most common cause, accounting for >80% of cases in the peak season1
    • Usually self-limiting and confined to the upper respiratory tract1
    • Nasal congestion and rhinorrhoea (runny nose) are the main clinical symptoms, with sore throat and cough also common1,9
    • The average adult experiences 2 to 4 colds annually10
    • Children experience 6 to 8 episodes per year10


    • Primarily caused by either of two categories of virus: Influenza A or B11
    • Symptoms vary from person to person
    • Additional symptoms could be non-nasal, including fever, myalgia and fatigue, and can lead to serious complications12,13
  • Woman blowing nose

    How colds and flu cause nasal symptoms14-16

    Colds and flu cause nasal congestion in a similar way, by triggering the immune response and stimulating the inflammatory cascade to release pro-inflammatory mediators such as cytokines, bradykinins and prostaglandins. These dilate the blood vessels in the nasal epithelium, leading to congestion in the nasal passages.

    The body’s natural defences against viral infection cause the familiar symptoms of the common cold and flu:17-19

    • Rhinovirus infection triggers the release of pro-inflammatory and vasoactive mediators (cytokines, bradykinins, prostaglandin) from nasal epithelial cells14-16
    • Vasoactive mediators cause dilation of large capacitance veins resulting in increased vascular permeability and leakage of plasma exudate into the submucosal space14-16

    Excess fluid and inflammatory cells in the submucosal space cause swelling of the nasal mucosa, blocking the nasal passageway.14-16

The Otrivin range – rapid and sustained relief of nasal congestion20

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