Thermal & cold · graded by use, two uses
Steam Inhalation (for colds and sinus symptoms)
Graded on: common cold symptoms; disability from chronic or recurrent sinus symptoms.
Grade D, tested: a human randomized trial looked for a benefit on the endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score. graded and did not find one. How to read a grade →
At a glance
Steam inhalation means breathing in the steam from a bowl of hot water or a steamer to ease a cold or blocked sinuses. When researchers pooled the studies on colds, steam did not clearly help. In a large study of people with long-lasting sinus trouble, steam did not make daily life easier. Headaches were a little better. Every year, burn units treat people, mostly children, who were scalded by the hot water.
All two uses graded on this record carry a D, each on its own evidence.
As studied, and the trials
Singh et al. (Cochrane Database Syst Rev, 2017; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 28849871): six trials, 387 participants. Whether steam eases cold symptoms was uncertain: the fixed-effect analysis showed a benefit (odds ratio 0.30), the random-effects analysis did not (0.22, 95% CI 0.03 to 1.95), and the share of people reporting that their symptoms resolved was not higher with steam (0.58, 95% CI 0.28 to 1.18). Viral shedding did not differ. The evidence was rated low quality. The review concluded that current evidence shows no benefit or harm. Tested, no benefit.
As studied, and the trials
Little et al. (CMAJ, 2016; PMID 27431306): 871 adults with chronic or recurrent sinus symptoms randomized to usual care, daily saline nasal irrigation, daily steam inhalation or both. Steam inhalation reduced headache but had no significant effect on sinus disability or the other outcomes; nasal irrigation helped modestly. Tested, no benefit.
Read the grade that matches your goal. How EBL grades by use →
A letter describes the human evidence, not the product, the manufacturer, or the intervention's worth.
See the full evidence record →This was not skipped. A human randomized trial has tested it and did not find a benefit on the endpoint below. That is a different statement from an untested intervention, which may still turn out to work. A Route 1 No human randomized trial has been run, so the record rests on animal or mechanistic evidence only. One of the two routes to the lowest letter on EBL's scale. Grade D means nobody has looked. A Route 2 Grade D means somebody looked and the answer was no.
Population Six trials, 387 people
Certainty Low. Random-effects analysis null; review concludes no benefit or harm shown.
PMID 28849871 →
Population 871 adults with chronic or recurrent sinus symptoms
Certainty Moderate. Large pragmatic trial.
PMID 27431306 →
Graded on Common cold symptoms; disability from chronic or recurrent sinus symptoms.
Each use, with its trials
This record carries a separate letter for each thing it has been measured on. The headline grade is the best of them, and it does not transfer to the others.
Singh et al. (Cochrane Database Syst Rev, 2017; PMID 28849871): six trials, 387 participants. Whether steam eases cold symptoms was uncertain: the fixed-effect analysis showed a benefit (odds ratio 0.30), the random-effects analysis did not (0.22, 95% CI 0.03 to 1.95), and the share of people reporting that their symptoms resolved was not higher with steam (0.58, 95% CI 0.28 to 1.18). Viral shedding did not differ. The evidence was rated low quality. The review concluded that current evidence shows no benefit or harm. Tested, no benefit.
Little et al. (CMAJ, 2016; PMID 27431306): 871 adults with chronic or recurrent sinus symptoms randomized to usual care, daily saline nasal irrigation, daily steam inhalation or both. Steam inhalation reduced headache but had no significant effect on sinus disability or the other outcomes; nasal irrigation helped modestly. Tested, no benefit.
Why this letter
Why this gradeGrade D, tested, no benefit. The reasoning, and what the grade does not cover.
Grade D on Route 2: tested, no benefit. The Cochrane review of six trials in the common cold could not show that breathing steam eases symptoms: the result depended on the statistical model chosen, and fewer people reported their symptoms resolving with steam than without, though not significantly (Singh et al., 2017; PMID 28849871). The largest trial, in 871 adults with chronic or recurrent sinus symptoms, found no effect on sinus disability at 3 or 6 months (Little et al., 2016; PMID 27431306). The harm is documented: burn centers report scalds from tipped bowls of hot water every year, most often in children (PMID 22781995; PMID 26917659).
WHAT THIS GRADE DOES NOT COVERsitting in a steam room, which is a different exposure and has its own record; humidified oxygen or nasal high-flow devices used in hospital care.
A grade describes the human evidence for a named use. It is not advice, and it is not a judgment on any individual prescription. How the letters are decided →
Evidence notes: meta-analysis A study that pools the numbers from several trials into one combined estimate., randomized trial
Endpoint graded: Common cold symptoms; disability from chronic or recurrent sinus symptoms (self_report)
Last reviewed: October 2026
The trial that would change this grade.
A positive trial of this shape would move this entry to C.
Why the current trials fall short
The Cochrane review (Singh et al., 2017; PMID 28849871) asked for double-blind trials with standardized delivery. One positive trial of that design would still face the burn risk in any weighing.
Why people believe itOne human source; no published case reports of benefit; two reports of harm.
The case for steam inhalation is that warm, moist air loosens mucus so it drains, and that heat might weaken a cold virus, as it does in the laboratory. It is a home remedy passed down through families, and in one UK survey 17 of 21 family doctors said they recommended it.
What supporters point to, and what each source actually shows. None of it is enough to move this letter higher; the trial described above under Evidence wanted is what would.
- Self-reported survey, not a trialIn a survey of family doctors near Swansea, Wales, 17 of 21 said they recommended steam inhalation, and 8 of 19 recommended it for children under 5. PMID 26917659
A case report describes what happened to one or a few patients. It cannot show the treatment caused the change, and reports of success are published more often than reports of failure.
A PubMed search in October 2026 found no published case report of benefit for this use.
- A radiology report, by its title, of steam inhalation causing airway blockage that appeared after a delay. PMID 8553939
- A 22-month-old scalded by steam and boiling water developed a burned, swollen epiglottis six hours later, could not be intubated normally and needed a tracheostomy. An accidental scald, not therapeutic inhalation, but the same delayed airway injury. PMID 24113478
Searched PubMed, October 2026: 3 case report record(s) returned. Two describe airway injury from steam and are listed; the third is a reconstructive surgery technique. The larger burn literature is in case series from burn centers, cited under cautions.
Dose, form and timing
Nothing validated. Symptom days, if steam is used, against the 7 to 10 days a cold usually lasts.
Safety
Scalds are the documented harm. Dutch burn centers admit about three people a year for burns from steam inhalation, most of them children, who needed skin grafts more often than adults (PMID 22781995). A Welsh burn center treated 16 children over five years, most often for a cold (PMID 26917659), and a London center saw 19 patients aged 2 weeks to 91 years in two years (PMID 32943275).
Grade history
How this letter has changedLatest: October 2026 · First graded.
Breathing steam for a cold or sinus symptoms now has a record. A Cochrane review of six trials could not show a benefit in the common cold (Singh et al., Cochrane Database Syst Rev, 2017; PMID 28849871), and advice to use steam did not reduce sinus disability in 871 adults (Little et al., CMAJ, 2016; PMID 27431306). Burn centers report scalds from it every year, mostly in children (Baartmans et al., Br J Gen Pract, 2012; PMID 22781995). Grade D on Route 2.PMID 28849871 PMID 27431306 PMID 22781995
Every change to a letter on this site is dated and published. The full evidence log →
Sources
The evidence, in fullFive papers, each linked to its PubMed record.
Singh et al. (Cochrane Database Syst Rev, 2017; PMID 28849871): six trials, 387 people with colds; no benefit shown on symptoms, viral shedding or nasal resistance, low-quality evidence. Little et al. (CMAJ, 2016; PMID 27431306): 871 adults with chronic or recurrent sinus symptoms; advice to use steam did not reduce sinus disability, though headache was lower. Baartmans et al. (Br J Gen Pract, 2012; PMID 22781995), Al Himdani et al. (Br J Gen Pract, 2016; PMID 26917659) and Scarborough et al. (Burns, 2021; PMID 32943275): burn center series of scalds from steam inhalation, most in children. Grade D, Route 2.
Primary evidenceFive papers, each linked to its PubMed record.
Singh et al. (Cochrane Database Syst Rev, 2017; PMID 28849871): six trials, 387 people with colds; no benefit shown on symptoms, viral shedding or nasal resistance, low-quality evidence. Little et al. (CMAJ, 2016; PMID 27431306): 871 adults with chronic or recurrent sinus symptoms; advice to use steam did not reduce sinus disability, though headache was lower. Baartmans et al. (Br J Gen Pract, 2012; PMID 22781995), Al Himdani et al. (Br J Gen Pract, 2016; PMID 26917659) and Scarborough et al. (Burns, 2021; PMID 32943275): burn center series of scalds from steam inhalation, most in children. Grade D, Route 2.
Evidence Based Longevity, Inc. is owner-operated and edited by Arnold Sandlow, D.C., a California-licensed chiropractor. Evidence Based Longevity publishes in English only · Machine translations are not produced or reviewed by EBL for accuracy
How EBL searched for the trials (1 search)
The search that was run, what it returned, and what was left out and why, so the absence of evidence can be checked as well as its presence.
("steam inhalation"[tiab] OR "heated humidified air"[tiab] OR "heated, humidified air"[tiab] OR "inhaling heated vapor"[tiab] OR "steam inhalations"[tiab]) AND (randomized controlled trial[pt] OR meta-analysis[pt] OR systematic review[pt])Disclosure
Educational use only · Not medical advice · EBL grades published human evidence and does not recommend treatment. Stopping a prescription is a decision for your physician.
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