You’re in the middle of dinner at a restaurant and all of a sudden you feel your nose start to tingle. Instead of making the loud “ah-choo” noise of a sneeze, you decide to hold it in. But while you may have saved some fellow diners from turning their heads to look at you, you also put your body at some risk.

What are the dangers?

Dr. Ryan Gossett, a family medicine physician at Marshfield Clinic Health System, says blocking or “silently” sneezing can cause harm, albeit in unlikely circumstances.

“The force of the sneeze has to be directed somewhere, and if not out, then the force stays in,” said Dr. Gossett. “It could be redirected into the eustachian tubes connecting your nose to your ears, pushing bacteria into the middle ear, potentially causing an infection or even rupturing your ear drum.”

From a muscular standpoint, it could cause temporary neck strain as your body tries to restrain the sneeze.  The force could also be directed to your throat, which has in extreme cases led to rupture of the esophagus. Additionally, someone could suffer neurological effects. These range from mild blood vessel injuries to the bursting of vessels deeper in the eye or brain.

By in large if there are injuries they are mild and these will heal on their own resulting in no permanent damage. And Dr. Gossett says most individuals can sneeze silently without sustaining any injuries.

Hold it in or let it out?

There are numerous reasons why people choose to sneeze silently. The most common reasons involve a desire to be quiet or to not spread germs.

“As we have all learned through the COVID-19 pandemic, the best option is to sneeze into your elbow,” said Dr. Gossett. “It not only allows the pressure to be released, but it also muffles the sound and reduces the spread of potential infectious particles.”

If you have no other choice but to try to quiet a sneeze, Dr. Gossett recommends stifling it instead. Try pressing your fingers against your upper lip as you feel it coming. This can stop the sneeze from happening.

However, in general, just let it go and don’t hold back.

“Remember that sneezing actually has benefits for us,” Dr. Gossett said. “It helps clear out our nasal passages, sinuses, eustachian tubes and ears. The pressure and force removes allergens and infectious agents like bacteria and viruses.”

For questions about sneezing, talk to a Marshfield Clinic Health System provider.

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