Smelling an odor when none is present is called phantosmia. It is a symptom, not a diagnosis: possible causes range from a recent infection or sinus problem to medication effects, head injury, or—less commonly—neurological conditions. If the smell persists, talk with a healthcare professional to help identify the cause.
What does it mean to smell something that isn’t there?
Phantosmia is the perception of an odor that is not actually present in the environment. People may describe it as unpleasant, burning, or otherwise unusual, but the odor itself cannot identify the cause.
It is different from parosmia, in which an odor is present but smells different than it normally would. The distinction is whether there is an external odor to perceive, not whether the experience is pleasant or unpleasant. NIDCD explains the difference between phantosmia and other smell disorders.
What can cause phantom smells?
Several types of health conditions or exposures can affect smell. The possibilities below are not a checklist for self-diagnosis; a clinician considers the full history and symptoms.
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Nasal, sinus, and respiratory causes
Colds, upper respiratory infections, sinus inflammation, and allergies are among the possible explanations. Nasal polyps or other growths may also affect smell. Smell changes, including phantosmia, have been reported after COVID-19. These causes are discussed by Cleveland Clinic and the NHS.
Medicines, dental problems, and exposures
Some medicines, dental issues, smoking, and exposure to certain chemicals may be associated with smell changes. NIDCD also includes chemical exposure among possible causes of smell disorders. If you suspect a prescribed medicine is involved, ask your clinician about it; do not stop or change the dose on your own. NIDCD recommends discussing possible medication changes with a doctor.
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Injury and neurological conditions
A head injury can affect smell. Less commonly, phantosmia may be associated with neurological conditions, including temporal-lobe seizures or Parkinson’s disease; Mayo Clinic also lists brain tumors among possible causes. These are possibilities, not conclusions that can be drawn from a phantom smell alone. Mayo Clinic’s overview of phantosmia causes emphasizes discussing symptoms with a healthcare professional.
How common is phantosmia?
In an NIDCD article describing U.S. NHANES survey data, about one in 15 adults reported phantom odor perception. Participants were asked, “Do you sometimes smell an unpleasant, bad, or burning odor when nothing is there?” This is a survey finding from the United States, not a current global prevalence estimate or a prediction of any one person’s risk. NIDCD published the finding in 2018.
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How is the cause evaluated?
A healthcare professional may ask when the smell started, how long it lasts, what it is like, and whether it seems to come through one or both nostrils. They may review medical history, including recent illness, injury, medication use, or possible chemical exposure, and examine the ears, nose, and throat.
Depending on the findings, evaluation may also include a supervised smell test, nasal endoscopy, CT or MRI imaging, or an electroencephalogram. These are possible clinician-selected tools, not tests every person with phantosmia needs. NIDCD describes smell-disorder assessment; Cleveland Clinic outlines questions and additional tests that may be considered.
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What can you do about phantom smells?
Care depends on the cause. If the smell change is related to a cold, allergy, or infection, it may improve as that condition improves. A clinician can advise whether treatment for an underlying condition or a medication review is appropriate.
For smell changes associated with infection or allergy, saltwater rinsing may help some people. Cleveland Clinic mentions nasal irrigation as a possible home measure, and the NHS discusses saltwater rinsing in this context. It is not established as a treatment for every cause of phantosmia, so follow product instructions and seek medical advice if symptoms persist. NHS guidance on changed smell.
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When should you seek medical advice?
Contact a healthcare professional if phantom smells persist. Cleveland Clinic specifically advises seeking care when they last longer than three weeks; Mayo Clinic advises discussing phantosmia symptoms with a healthcare professional. An evaluation can help assess the possible cause rather than relying on the odor’s character to guess at a diagnosis. Cleveland Clinic’s care guidance; Mayo Clinic’s advice.
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