Plain water gargles cut colds in one trial, while steam bowls have burned children

Key takeaways

• In a 2005 Japanese trial of 387 adults, people who gargled plain water at least three times a day caught about 36% fewer colds than people who kept their usual routine, while an iodine gargle did no better than no gargle.
• Small Scottish trials found that salt-water gargles with nose rinses shortened colds in adults, and that salt-water nose drops shortened colds in young children by about two days.
• A Cochrane review of six steam trials found no clear benefit, and a trial of 871 adults with sinus trouble found that daily steam helped only with headaches.
• A Welsh burn center treated 16 children for steam-inhalation scalds in five years, most often during a cold, and the American Academy of Pediatrics favors cool-mist humidifiers for kids.
• Menthol chest rubs are not for children under 2, and camphor in some rubs can poison babies through the skin or by mouth.

Between 2010 and 2015, doctors at the Welsh Centre for Burns in Swansea treated 16 children who had been scalded while breathing steam¹. The youngest was 1 and the oldest 15, and the most common reason for the steam was an ordinary cold¹.

The burns landed most often on the thighs¹. That pattern fits a bowl of hot water tipping into a child’s lap. One child needed a skin graft, and another was sick enough to need high-dependency care¹.

Steam over a bowl is a remedy many of us learned at home. So is the salt-water gargle. Both are cheap and passed down through families.

Yet when researchers put them to the test, they came out very differently. The humble gargle has a few encouraging trials, while steam has decades of trials with no clear win, and the bowl has a burn record of its own.

This guide sorts the old cold remedies by what the evidence shows, and how to use each one safely.

A gargling tradition got a real trial in Japan

A team of Japanese researchers led by Kazunari Satomura set out to test whether gargling prevents colds²³.

In the winter of 2002–2003, the team randomly assigned 387 healthy adults, ages 18 to 65, to one of three groups². One group gargled plain water at least three times a day. One gargled povidone-iodine, a germ-killing rinse. The third group did nothing new.

Over 60 days, 130 people came down with a cold or another upper respiratory infection, the kind that hits the nose, throat and airways². The water gargle group had the lowest rate: 0.17 infections per 30 person-days, against 0.26 for the do-nothing group². That works out to about 36% fewer colds²³.

The iodine gargle, the germ killer of the group, did no better than doing nothing².

There are real limits. Everyone knew which group they were in, and nobody gargled a fake “placebo” liquid. Peter Muennig of Columbia University’s public health school called the result borderline³. He noted that people in Japan, and in Asia generally, tend to believe gargling prevents illness, so expectations could have shaped what people reported³.

The researchers answered that the public expects iodine to beat water, so any bias should have helped iodine, not water³. That’s a fair point, but one unblinded trial doesn’t settle the question. We found no Cochrane review on gargling to prevent colds.

Salt water and saline rinses have small, early wins

Salt water’s evidence comes from Scottish trials called ELVIS. The idea was to soak the nose and throat in hypertonic saline, which is saltier than body fluids.

In a pilot trial published in 2019, 66 adults were randomly assigned within 48 hours of their first cold symptoms to usual care or to salt-water gargles plus nose rinses⁴. The researchers, led by Sandeep Ramalingam, later summarized the results⁴. The salt-water group’s colds ended 1.9 days sooner. They used 36% less drugstore medicine, and their households had 35% fewer colds passed along⁴.

That was a small, unblinded trial, funded by a local health charity and summarized by its own investigators, so it needs repeating⁴.

In 2024, the same group reported a larger trial in young children, this time with nose drops instead of gargles⁵. They enrolled 407 children aged 6 and under, and 301 of them caught colds⁵. Parents gave salt-water drops at least four times a day, and Scotland’s Chief Scientist Office paid for the study⁵.

With the drops, symptoms lasted 6 days on average, against 8 days with usual care⁵. Another family member caught the cold in 46% of households using drops, compared with 61% of the others⁵.

There’s a catch: these results came from a talk at a European Respiratory Society meeting in September 2024, and at that point they had not been through peer review⁵. Peer review is the check other scientists do before a journal publishes a study.

Saline rinses have also helped with longer-running sinus trouble. In a British trial of 871 adults with chronic or recurring sinus symptoms, daily nose rinsing gave a small improvement over usual care⁶. Fewer rinsers were using drugstore medicines six months later, 59% against 68%⁶.

Steam has been tested for decades without a clear win

The idea behind steam sounds sensible: warm, wet air might help mucus drain, and heat can destroy cold viruses in a lab dish, so perhaps it could in the nose, too⁷.

Cochrane, an international network that pools research, has reviewed heated, humidified air for colds since 2001⁷. Its 2017 update included six trials with 387 people⁷. Its conclusions concern warm, moist air delivered to the nose by a device, not a kitchen bowl⁷.

The results didn’t line up. One way of pooling the data suggested symptom relief, while another found no clear difference⁷. People who breathed the warm air were not significantly more likely to say their symptoms had cleared⁷. One American study found that breathing through the nose got harder, while an Israeli study found it got easier⁷.

The reviewers rated the evidence low certainty, found neither benefit nor harm, and called for better trials⁷. Some studies reported mild nose discomfort or irritation⁷.

The British sinus trial added a home test, in which Paul Little and colleagues at the University of Southampton advised one group of patients to steam daily⁶. Steam didn’t improve their main score for how much sinus trouble disrupted daily life, and the only gain was fewer headaches⁶.

The trial was paid for by the UK’s National Institute for Health Research, a government agency, not a product maker⁶.

Steam bowls send children to burn units

A remedy with weak benefits needs to be very safe, and steam over a bowl isn’t.

Burn doctors in the Netherlands looked at their records and found that steam inhalation sent about three people a year to a Dutch burn center⁸. Most were children, and children needed skin grafts more often than adults⁸. The authors called steam inhalation dangerous and urged that it be dropped from medical guidelines and patient leaflets⁸.

The Welsh team reached the same verdict. Their 16 young patients had burns covering up to 17% of the body, and their care cost more than £37,000¹. The team said steam should no longer be recommended for children¹.

Advice givers haven’t caught up. The Welsh team polled local family doctors, and 17 of the 21 who replied had told patients to try steam¹. Eight of 19 had suggested it for children under 5¹.

If you love the feel of warm, damp air, there’s a gentler way to get it. The American Academy of Pediatrics (AAP) says a warm bath or a steamy shower can help moisten a child’s airways, as long as an adult never leaves a baby or young child alone in the water⁹.

A humidifier is the safer way to add moisture, if you clean it

The AAP prefers cool-mist models for young children because, unlike warm-mist units and steam vaporizers, they can’t scald anyone⁹. Set the unit close to the child’s bed but beyond reach⁹.

The FDA goes further for children with colds. It says not to use warm-mist humidifiers because they can make nasal passages swell and breathing harder¹¹. The AAP’s concern is burns and the FDA’s is swelling, but both point to cool mist.

The catch with cool mist is cleanliness. The Environmental Protection Agency (EPA) says ultrasonic and impeller units, two common cool-mist types, spray out the most germs and minerals from their tanks¹². The minerals can show up as a fine “white dust” on furniture¹².

The EPA’s routine is simple¹²:

• Empty the tank, wipe it dry and refill it every day.
• Scrub off scale and film every third day.
• Use distilled water, which has fewer minerals than tap or bottled spring water.
• Keep indoor humidity at 50% or lower, since damper air feeds mold and dust mites.

The AAP warns that a neglected unit can blow mold, bacteria and mineral deposits into the room⁹. A cool-mist humidifier can ease stuffiness and dry coughs, but only a clean one is worth breathing¹⁰.

Menthol rubs come with a firm age limit, and camphor is why

Chest rubs usually blend menthol, camphor and eucalyptus oil, which give them their strong, cooling smell⁹. The AAP says they may ease congestion and nighttime coughs⁹. Its advice is to rub it on the chest and the front of the neck and leave clothing loose so the vapors reach the nose⁹¹⁰.

The age rule is firm. The AAP says mentholated rubs can be used from age 2 and should never be used on children under 2⁹. Camphor can be toxic if a child swallows it or if it soaks through a baby’s skin⁹.

A few more AAP rules⁹¹⁰:

• Keep rubs away from the face, eyes and nose.
• Store the jar out of children’s reach.
• Follow the directions carefully¹⁰.

If a child swallows a rub, call Poison Help at 1-800-222-1222¹⁵.

Saline rinses, briefly. Salt-water drops and sprays are safe to use several times a day, the AAP says¹⁰. If you make saline at home, the AAP suggests salt and baking soda mixed into sterile, distilled or previously boiled water⁹. Our suggestion: clean rinse bottles and neti pots after each use, following the maker’s directions.

The evidence, rated

Below, we cover how the main claims stack up on our four-level scale.

Claim	Rating	Why
Gargling plain water helps prevent colds	Promising but early	One randomized trial of 387 adults found about 36% fewer colds; no blinding or placebo23
Salt-water gargles and nose rinses shorten colds	Promising but early	A 66-person pilot trial run by the method’s own researchers4
Salt-water nose drops shorten colds in young children	Promising but early	A 301-child trial, reported at a meeting before peer review5
Saline rinses ease long-running sinus symptoms	Promising but early	A small benefit in a trial of 871 adults6
An iodine gargle prevents colds	Evidence says no, or unsafe	Did no better than doing nothing in the Japanese trial2
Steam eases cold symptoms	Not enough evidence	Six trials gave mixed, low-certainty results7
Steam helps chronic sinus symptoms	Evidence says no, or unsafe	No gain beyond fewer headaches in a large trial6
Steam bowls are safe for children	Evidence says no, or unsafe	Burn centers in Wales and the Netherlands report scalds18
Menthol rubs ease night coughs	Not enough evidence	The AAP says they may help; we couldn’t verify the trial data behind that9

Gargling and steam both belong to a tradition many readers value: caring for yourself with what’s already in the kitchen. The trials honor half of that tradition. A glass of water and a pinch of salt cost almost nothing and carry little risk.

The steam bowl’s comfort is real, too. The warmth, the towel over the head and the quiet pause feel like care. You can keep that feeling with a hot shower, a warm drink and a cool-mist humidifier, and leave the boiling water on the stove.

Your throat and nose comfort guide

This chooser is ours, built from the sources above, for ordinary colds and sore throats.

Remedy	How to do it safely	What the evidence shows	Stop and see a clinician if…
Plain water gargle	Three times a day was the trial’s routine2; only for children who can reliably spit (our suggestion)	Promising but early2	Any warning sign in the next section13
Salt-water gargle	CDC lists it for sore throats13; keep it mild and spit it out (our suggestion)	Promising but early4	Pain blocks swallowing, or no improvement after a few days13
Saline drops, sprays or rinses	Sterile, distilled or previously boiled water for homemade mixes9	Promising but early56	Breathing gets hard, or symptoms worsen13
Steamy bathroom	Run a hot shower; never leave young children alone in the water9	Not enough evidence7	Wheezing, harsh breathing sounds or very fast breathing10
Steam bowl	Skip it for children; adults, set the bowl on a stable surface, never in your lap (our suggestion)	Not enough evidence; burn risk178	Any scald that is deep, large or on the face, hands or groin14
Cool-mist humidifier	Out of reach; distilled water; empty daily; humidity at or below 50%912	May ease stuffiness and dry cough, per the AAP10	Symptoms that don’t improve or get worse13
Menthol chest rub	Age 2 and up; chest and front of neck only; store out of reach9	Not enough evidence we could verify9	A child swallows it: call Poison Help, 1-800-222-122215
Warm drinks and honey	Honey only for people age 1 and older13	See our honey articles	Signs of dehydration13

When a sore throat needs a clinician

Most sore throats come from viruses and clear up by themselves within about a week, the CDC says¹³. Strep throat, caused by group A strep bacteria, is different, and a provider may swab the throat to test for it¹³.

The CDC notes that a cough, runny nose, hoarseness or pink eye point toward a virus rather than strep, though only an exam or a test can say for sure¹³.

See a health care provider if you or your child has¹³:

• Trouble breathing or swallowing.
• Blood in saliva or phlegm.
• Heavy drooling, in a young child.
• Signs of dehydration.
• Joint swelling and pain, or a rash.
• Symptoms that worsen, or that haven’t started to improve after a few days.

Call a provider right away if a baby under 3 months old has a fever of 100.4°F or higher¹⁰¹³. Tell your provider if sore throats keep coming back¹³.

The AAP also lists emergency signs for children. A child who can’t stay awake, is too weak to stand, gasps for breath or struggles to cry or speak needs the nearest emergency department¹⁰.

Questions readers ask

The bottom line

The cheapest cold remedies hold up best. Plain water and salt-water gargles, along with saline rinses and drops, have small, early trials suggesting they prevent or shorten some colds. They cost pennies and carry little risk when done with clean water.

Steam is the remedy to retire, at least the bowl-of-boiling-water version. Decades of trials haven’t shown it works, and burn centers have treated children it scalded. Keep the comfort with a steamy bathroom and a clean cool-mist humidifier, keep menthol rubs away from children under 2, and get a sore throat checked when the warning signs appear.

Related reading

• Honey “probably” eases a child’s cough, and that word is a precise rating
• Honey dressings speed burn healing, and home honey remedies need their own rules
• How to tell easing a symptom from treating a disease
• Echinacea came from the prairie and barely touched colds in big trials
• Heat loosens and cold numbs, and either one can injure skin if left on too long

Sources

1. Al Himdani S, Javed MU, Hughes J, et al. “Home remedy or hazard? Management and costs of paediatric steam inhalation therapy burn injuries.” British Journal of General Practice, 2016;66(644):e193-e199. bjgp.org
2. Satomura K, et al. “Prevention of upper respiratory tract infections by gargling: a randomized trial.” American Journal of Preventive Medicine, 2005;29(4):302-307 (PubMed abstract). pubmed.ncbi.nlm.nih.gov
3. Columbia University Mailman School of Public Health, via Newswise. “Gargling May Prevent Colds; Expert Finds Results Hard to Swallow.” Newswise, 2005. newswise.com
4. Ramalingam S, Graham C, Dove J, Morrice L, Sheikh A. “Hypertonic saline nasal irrigation and gargling should be considered as a treatment option for COVID-19.” Journal of Global Health, 2020;10(1):010332. jogh.org
5. European Respiratory Society. “Saline nose drops shorten colds in children” (ELVIS-Kids trial, ERS Congress press release). ERS, September 2024.
6. Little P, Stuart B, Mullee M, et al. “Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trial.” CMAJ, 2016;188(13):940-949. pubmed.ncbi.nlm.nih.gov
7. Singh M, Singh M, Jaiswal N, Chauhan A. “Heated, humidified air for the common cold.” Cochrane Database of Systematic Reviews, 2017, Issue 8, CD001728. pubmed.ncbi.nlm.nih.gov
8. Baartmans M, Kerkhof E, Vloemans J, et al. “Steam inhalation therapy: severe scalds as an adverse side effect.” British Journal of General Practice, 2012;62(600):e473-e477. research.hanze.nl
9. American Academy of Pediatrics. “Cough & Cold Survival Kit: Symptom-Relief Essentials for Families.” HealthyChildren.org, 2024. healthychildren.org
10. Falusi L, American Academy of Pediatrics. “Caring for Kids with Colds & Flu: Simple Remedies to Ease Symptoms.” HealthyChildren.org, 2025. healthychildren.org
11. U.S. Food and Drug Administration. “Should You Give Kids Medicine for Coughs and Colds?” FDA Consumer Update, 2024. fda.gov
12. U.S. Environmental Protection Agency. “Use and Care of Home Humidifiers.” EPA 402-F-22-002, 2022. epa.gov
13. Centers for Disease Control and Prevention. “Sore Throat Basics.” CDC, 2024. cdc.gov
14. Mayo Clinic Staff. “Burns: Diagnosis and treatment.” Mayo Clinic, 2024. mayoclinic.org
15. Health Resources and Services Administration. “General Questions on Poisons.” Poison Help, 2024. poisonhelp.hrsa.gov