Is It Bad To Hold in a Sneeze?

It might be bad to hold in a sneeze. There are some risks of holding in a sneeze, such as a ruptured eardrum, rupture of superficial blood vessels to the eye or nose, throat or neck pain, and less commonly, rupture of a brain aneurysm or rib fractures. Still, experts say those complications are very rare.

"Most people in certain social circumstances have held in a sneeze—in the movies, in restaurants, in a meeting—so it's happening all the time," Erich Voigt, MD, an ear, nose, and throat specialist at NYU Langone Health, told Health. "The risk associated with holding in a sneeze is very low."

Sneezing helps protect your body from allergens, germs, and irritants, so it's best to sneeze if you feel one coming on. Just remember to cover your nose and mouth with a tissue or the crook of your elbow. Read on to read about the risks of halting a sneeze and what to do instead. 

1. Damaged Blood Vessels in the Eyes or Nose

Increased pressure from holding in a sneeze might rupture a superficial blood vessel in your eye or nose. A superficial ruptured blood vessel in your eye may cause a red eye or subconjunctival hemorrhage, a temporary patch of blood on your eye.

2. Ear Infection

Sneezing helps get rid of dust, germs, mold, and other allergens and irritants from your nasal passages. The eustachian tube connects the back of your nose to your middle ear. It's possible that a closed-airway sneeze may push those irritants back to your middle ear, where they cause an infection.

Acute ear infections typically cause ear pain and fullness in the ear. Acute ear infections may go away without treatment. Some ear infections might cause a ruptured eardrum if untreated.

3. Fractures

While unlikely, it is possible to cause a fracture when holding in a sneeze. Our bodies are somewhat flexible and stretchy, like a soccer ball: "It probably won't pop, but rarely it could, if you exert enough pressure. It can stretch and come back to normal form. Just like a soccer ball, enough pressure could cause damage to the body, but it's pretty rare," said Dr. Chang.

You control where that misdirected pressure goes in your body, which could then affect what unsuspecting and undeserving body part ruptures, fractures, or breaks. The stifled sneeze also shifts around your body "depending on where the pressure valve is," said Dr. Voigt.

For example, someone who closes their throat to trap sneeze pressure in their chest is more likely to deal with a rib fracture than if they pinch their nose.

4. Rupture of a Brain Aneurysm

Otolaryngologists call a stifled sneeze a "closed-airway sneeze," Christopher Chang, MD, an ear, nose, and throat specialist based in Virginia, told Health. "When a sneeze is initiated, a lot of pressure builds up in your lungs, and the sneeze is let out all at once forcefully."

Your body retains that pressure if you hold in a sneeze, which might cause an existing brain aneurysm to rupture. Many people do not know that they have a brain aneurysm, which is the widening of an artery due to a weakened section of the blood vessel wall. A ruptured brain aneurysm could be fatal if untreated.

5. Ruptured Eardrum

A ruptured eardrum is a hole in the tissue that divides your outer and middle ear. You force pressure searching for a way out up into your face if you pinch your nose to stifle a sneeze, said Dr. Chang. Pinching your nose might guide that pressure through the eustachian tube and into your middle ear. Changes in pressure might result in a ruptured eardrum.

Although rare, a ruptured eardrum may cause complications like:

• Chronic ear infection
• Hearing loss
• An infection of the bone behind your ear
• Vertigo and dizziness

6. Subcutaneous Emphysema

Subcutaneous emphysema happens if air builds up under your skin. You might notice smooth bulges on your skin that make a crackling sound if you press on it. A facial bone fracture, blunt trauma, and forceful coughing typically cause subcutaneous emphysema.

A case report published in 2022 detailed a person who had subcutaneous emphysema in their right cheek after stifling a sneeze. The authors noted that the person had an unknown facial bone fracture.

7. Throat or Neck Pain

Some evidence suggests that holding in a sneeze might cause severe throat or neck pain. A case report published in 2018 described a 34-year-old man who came to the emergency room with neck pain and an inability to swallow or talk. The man said he had pinched his nose and shut his mouth to stifle a sneeze.

Healthcare providers diagnosed the man with a pharyngeal rupture. This is a serious injury requiring immediate medical attention.

Can Holding in a Sneeze Kill You?

The chance of a halted sneeze killing you is so low experts do not even have enough cases to write up scientific studies. Instead, they resort to what are called case reports, which detail just one particular person's experience with a suppressed sneeze.

"An isolated case report is a rare event," said Dr. Voigt. "Maybe even less likely than one in a million."

You might be slightly at risk for a sneezing-related injury if you have an underlying health issue, such as a small hole at the base of your skull or a weakness in the lining of your lungs. You might develop a complication of those issues if you hold in a sneeze, said Dr. Voigt. Some people may not know they have an issue until a sneeze sends them to the emergency room.

What To Do Instead of Stifling a Sneeze

You might rub or wipe your nose to prevent a sneeze instead of stifling one, said Dr. Voigt. Tickling the roof of your mouth with your tongue may safely stop a sneeze. Still, it's best to sneeze if you feel like you need to.

"The general advice is never to hold a sneeze in because bad things could happen. Nothing bad really happens if you sneeze without trying to hold it in," said Dr. Chang. 

Other ways to help prevent a sneeze instead of holding in one include:

• Avoid air pollution and dry air as much as possible.
• Avoid looking into bright lights.
• Do not eat spicy foods.
• Do not use nose sprays.
• Limit your exposure to allergens, such as dust, mold, pet dander, and pollen.
• Treat underlying environmental or seasonal allergies.

Benefits of Sneezing

Sneezing helps protect your body by removing allergens, germs, and irritants from your nasal passages. Your body expels a forceful burst of air through your nose and mouth, getting rid of foreign invaders. You might sneeze more than usual if you have uncontrolled allergies or infectious illnesses like a cold or the flu. Sneezing helps decongest a stuffy nose.

A Quick Review

Although rare, holding in a sneeze might result in complications, such as a rupture of an aneurysm, ear infection, neck pain, and rib fractures. It's best to sneeze if you feel like you need to. Cover your nose and mouth with a tissue or the crook of your elbow to prevent germs from spreading. You might be able to safely prevent a sneeze by limiting your exposure to allergens and not looking into bright lights.