Sneezing in Silence Could Leave You Deaf, Bleeding, or Worse

The Hidden Perils of “Stifling the Achoo”: Why Holding in a Sneeze Isn’t Harmless

Sneezing is one of those bodily reflexes that feels both annoying and embarrassing at times. Many people instinctively try to hold it back in meetings, on crowded buses, or in quiet rooms. Some even press a finger under their nose or pinch their nostrils shut to stop it from happening. On the surface, this seems harmless—after all, it’s just a sneeze. But medicine tells a different story. Suppressing this powerful reflex can lead to consequences that range from irritating to dangerous.

As a doctor, I’ve encountered patients who thought nothing of holding in a sneeze—until they ended up with ear pain, nosebleeds, or even more serious injuries. To appreciate why it’s risky, we need to understand how sneezing works, why the body does it, and what exactly happens when we block it.

Why Do We Sneeze?
Sneezing is a protective reflex designed to clear irritants from the nose and throat. Dust, pollen, smoke, viral particles, or strong odors can all trigger specialized nerve endings in the nasal lining. These nerves send a signal to the brainstem, which activates the “sneeze center.”

What follows is a beautifully coordinated sequence of events:

• The diaphragm and chest muscles contract forcefully.
  
  
• The vocal cords close for a split second to build pressure.
  
  
• The mouth and nose suddenly open, expelling air at tremendous speed.
  

Measurements show that air from a sneeze can travel at over 100 miles per hour, ejecting thousands of tiny droplets. These droplets aren’t just spit—they carry mucus, debris, and sometimes pathogens that your body is trying to eliminate.

In essence, sneezing is the body’s version of hitting the “eject” button on unwanted intruders. Blocking it means stopping your body’s natural defense system in mid-flight.

What Happens When You Hold in a Sneeze?
If you clamp your mouth shut and pinch your nose while the sneeze is building, the force doesn’t magically disappear. Instead, that pressure has to go somewhere. Since the airway is sealed, the energy is redirected into delicate tissues of the head, neck, chest, and even the brain.

The following are the main dangers that come with stifling a sneeze.

Middle Ear Damage
The ears are connected to the back of the nose through narrow channels called Eustachian tubes. These tubes equalize pressure and help drain fluid from the middle ear. When you hold in a sneeze, the sudden buildup of pressure can shoot air backward into these tubes.

Consequences include:

• Ear pain or fullness
  
  
• Ruptured eardrum
  
  
• Fluid accumulation or infection
  
  
• Rarely, inner ear damage leading to hearing loss or vertigo
  

I once had a patient who suppressed a sneeze during a long lecture. Minutes later, he felt a sharp pain in his ear followed by muffled hearing. Examination revealed a small eardrum rupture—caused not by trauma or infection, but by one strong stifled sneeze.

Nose and Sinus Problems
A sneeze’s main job is to expel irritants. If you hold it in, those particles can be forced deeper into the nasal passages or sinuses. This can worsen congestion and increase the risk of sinus infections.

In addition, the sudden reverse pressure can rupture tiny blood vessels inside the nose, triggering nosebleeds. Some patients notice small streaks of blood in their mucus after a stifled sneeze, a direct sign that pressure has damaged delicate nasal capillaries.

Eye and Blood Vessel Injuries
Have you ever seen someone with a red spot in their eye? That’s often a subconjunctival hemorrhage—when a small blood vessel bursts under the eye’s surface. Suppressing a sneeze makes this more likely. The spike in venous pressure during the blocked sneeze can rupture fragile vessels not just in the eyes but in the skin, face, or even brain in rare cases.

Although most broken blood vessels in the eye look worse than they feel and heal on their own, they are a stark reminder that redirecting pressure can harm tissues that were never meant to handle it.

Throat Rupture
This is one of the rare but dramatic complications documented in medical case reports. When both the nose and mouth are sealed during a sneeze, the intense pressure can rupture part of the throat wall. Patients may feel a sudden “pop” in the neck, followed by pain, swelling, and difficulty swallowing or speaking.

Air can then leak into the tissues of the neck, producing a crackling sensation under the skin known as subcutaneous emphysema. This requires urgent medical evaluation. Though rare, it illustrates just how much force a sneeze carries.

Lung and Chest Complications
Suppressed sneezes don’t just affect the head and neck. In unusual cases, the trapped pressure travels downward. This can lead to:

• Collapsed lung (pneumothorax)
  
  
• Air trapped in the chest cavity (pneumomediastinum)
  
  
• Air pockets under the skin of the chest and neck
  

All of these conditions create chest pain, shortness of breath, and require medical care. They are more likely in people with preexisting lung disease but can occur in otherwise healthy individuals as well.

Brain and Vascular Risks
Sneezing momentarily increases intracranial and blood pressure. Normally, this isn’t dangerous. But if you block the sneeze, the pressure may rise even higher. For someone with fragile blood vessels, aneurysms, or vascular disease, there is a theoretical risk of bleeding in the brain.

Such outcomes are extremely rare, but they remind us that sneezing is not a trivial reflex to be trifled with.

Real-World Cases
Medical literature contains case reports of people suffering unusual injuries after suppressing a sneeze. Examples include:

• A man who ruptured his throat and developed swelling of the neck.
  
  
• Patients with ruptured eardrums linked directly to sneeze suppression.
  
  
• Rare cases of spontaneous pneumothorax after stifled sneezing.
  

While these aren’t everyday occurrences, they emphasize that sneezing generates explosive forces. Blocking them is not without risk.

Why People Hold Back Sneezes
Despite these risks, many still stifle sneezes. Reasons include:

• Social embarrassment (sneezing in public feels impolite)
  
  
• Fear of spreading germs
  
  
• Attempting to stay quiet in meetings, libraries, or classrooms
  
  
• Habit—some people were taught from childhood to suppress sneezes
  

Ironically, the fear of spreading germs is counterproductive. A sneeze expelled naturally clears irritants quickly. Suppressing it may force mucus into sinuses or ears, increasing the risk of infection in the person holding it in. Covering the sneeze with a tissue or elbow is far safer.

The Safer Way to Sneeze
You don’t have to choose between politeness and health. The key is learning to sneeze responsibly:

• Use a tissue or handkerchief to cover your mouth and nose.
  
  
• If one isn’t available, sneeze into your elbow rather than your hands.
  
  
• Wash hands afterward to reduce the spread of germs.
  
  
• Let the sneeze out rather than forcing it inward.
  

These simple measures protect both you and those around you without subjecting your body to dangerous internal pressures.

Key Takeaway
Sneezing is more than an annoyance—it’s a vital defense reflex. Suppressing it forces pressure into areas of the body that aren’t designed to handle it, creating risks that range from nosebleeds to ruptured eardrums, and in rare cases, more serious injuries. The safest option is to let your sneeze out while covering it properly.

So, next time you feel that tickle in your nose, resist the urge to pinch it shut. Your ears, sinuses, and throat will thank you.