Here’s a scary lesson about why you shouldn’t hold in your sneezes. In a case report this month, doctors in the UK describe a man in his 30s who tore open his windpipe by holding his nose and mouth closed while sneezing—apparently the first documented instance of such an injury. Though the man did have to spend some time in the hospital, he fortunately made a speedy recovery.
The man’s historically bad sneeze is detailed in a paper published this month in BMJ Case Reports.
According to the report, the man had a history of hay fever. While driving one day, he felt a sneezing episode coming up and decided to pinch his nose and close his mouth to stifle them. Immediately after, he began to experience severe neck pain, which prompted a trip to a local emergency room. Once at the ER, the man was found to have a swollen and stiff neck, and doctors decided to run a CT and MRI scan.
The tests revealed that he had developed a spontaneous tracheal perforation—a hole in his windpipe. This type of injury is usually caused by physical trauma or accidents during surgery or intubation. As far as the report authors know, this is the first case on record of a held-in sneeze causing this injury.
“We suspect the trachea perforated due to a rapid build-up of pressure in the trachea while sneezing with a pinched nose and closed mouth,” the authors wrote.
More serious cases of tracheal perforation can cut off people’s air supply and demand urgent surgery to treat. But since the man seemed to be fine otherwise, the doctors took a more conservative approach. He was given painkillers and allergy medication and kept under close observation in the hospital for two days (he also couldn’t eat or drink for the first night). Afterward, he was given long-term allergy meds and told not to hold in his sneezes anymore. Five weeks later, a check-up revealed that his tear had healed completely.
While this might be the first known case of someone tearing open their windpipe via stifled sneezing, there have been other serious complications tied to it. People have reportedly fractured ribs, ruptured eardrums, and even burst open weakened blood vessels in the brain as a result of holding in a sneeze. These injuries are incredibly rare, but given the lack of any real benefit from keeping your sneezes in, doctors say that you should let them fly free. If you’re worried about spreading snot or germs and are unable to find an isolated corner to duck into, sneezing into your elbow away from others’ faces works fine.
“Everyone should be advised not to stifle sneezes by pinching the nose while keeping the mouth closed as it can result in tracheal perforation, as reported here,” the doctors wrote.
