Reasons why your cough may not be improving 

Overview

A lingering cough often occurs after experiencing the flu, COVID-19, or seasonal viruses in Australia. Although most coughs tend to resolve on their own, some may continue due to persistent airway irritation or another underlying condition. The positive aspect is that most issues causing a lasting cough can be managed once recognised.

How long is “too long” for a cough?

Doctors classify coughs based on how long they last:

Reasons your cough may not be improving

1. Post-viral cough (the most prevalent cause)

• Can last for up to 8 weeks
• Airways may remain sensitive even after the illness has resolved

2. Asthma or airway hyperreactivity

• Includes cough-variant asthma
• Can be triggered by changes in weather, dust, physical activity, or smoke
• Cough is often more severe at night or in the early morning

3. Allergies or post-nasal drip

• Very common in Australia (due to pollen, dust mites, mould)
• Leads to mucus trickling down the throat, causing irritation and frequent coughing

4. Gastro-oesophageal reflux (GORD)

• Stomach acid irritates the throat
• Cough is exacerbated at night or after eating
• Often accompanied by heartburn or a sour taste in the mouth

5. Smoking or vaping

• Irritates the lining of the airways
• Symptoms may worsen with bushfire smoke or pollution

6. Incorrect or inconsistent medication use

• Missing doses of inhalers
• Incorrect use of inhalers
• Not finishing prescribed treatments

7. Undiagnosed chronic conditions

• COPD
• Bronchiectasis
• Post-COVID syndrome

8. Environmental triggers

• Bushfire smoke
• Seasonal pollen
• Dry winter air
• Exposure to chemicals at work

9. ACE inhibitor medications

• Common blood pressure medications in Australia
• May lead to a persistent dry cough in some individuals

10. Infections requiring treatment

• Whooping cough (pertussis)
• Pneumonia
• Chronic sinus infections

Signs your cough needs urgent care

Seek immediate medical assistance if you notice:

• Coughing up blood
• Chest pain
• Difficulty breathing
• Fever or night sweats
• Unexplained weight loss
• A hoarse voice that persists
• Worsening cough in smokers

These symptoms could indicate a more serious condition.

Note: If you experience severe difficulty breathing, sudden chest pain, or are coughing up significant amounts of blood, call 000 or visit your nearest Emergency Department immediately.

What you can try at home

If your cough is mild and not associated with serious symptoms, you may try the following supportive measures:

• Keep yourself well-hydrated
• Try honey (not suitable for children under 1 year)
• Utilise steam inhalation
• Avoid smoke and other airway irritants
• Use saline nasal sprays
• Elevate your head while sleeping (if related to reflux)

Note: This information is for educational purposes only. Consult a GP before trying home remedies to ensure they are safe for your specific condition.

When it’s time to see a GP

Consider scheduling a medical appointment if:

• Your cough persists for more than 3 weeks
• Your symptoms are worsening
• It interferes with your sleep or daily activities
• You notice any red flag symptoms

What a GP may do

Depending on your symptoms and medical history, a GP may recommend:

• A lung examination
• A lung function test
• A chest X-ray if required
• Allergy assessments
• A review of your medications
• Treatment for asthma, allergies, reflux, or infections
• A referral to a specialist if symptoms persist

Note: While telehealth can be a convenient option for initial assessment and management, a physical examination or diagnostic imaging (such as a chest X-ray) may sometimes be necessary. In these cases, your online GP may provide a referral or recommend an in-person consultation.

How Hola Health can help

• Same-day telehealth appointments with Australian GPs
• Assessment and management of cough symptoms
• Prescriptions or referrals if clinically appropriate
• Medical certificates when required

A persistent cough can be frustrating, but identifying the underlying cause is the first step toward effective management. With appropriate evaluation and care, many chronic coughs can be treated successfully. If symptoms continue, consulting a GP can help you find the right treatment and relief.

Note: The content of this blog is for informational purposes only and does not replace professional medical diagnosis, advice, or treatment.

FAQs

Why does my cough worsen at night?

Night-time coughs are commonly associated with post-nasal drip, gastro-oesophageal reflux, or asthma, which may worsen when lying down.

Can long COVID lead to a persistent cough?

Yes. Some individuals may experience increased airway sensitivity after COVID-19 infection, which can lead to a prolonged cough.

How long should a cough persist following a viral infection?

A post-viral cough may last between 3 and 8 weeks before gradually resolving.

Does steam provide relief for a persistent cough?

Steam inhalation may temporarily soothe irritated airways and help loosen mucus for some individuals.

Can allergies lead to a lasting cough?

Yes. Allergies can cause ongoing throat irritation and post-nasal drip, both of which may trigger a chronic cough.