If you smell an odor that is not actually present, the experience is called phantosmia. It is a symptom, not a diagnosis: causes can range from a recent infection or allergy to medication effects, nasal or dental problems, injury, or—in less common cases—neurological conditions. If it persists, discuss it with a healthcare professional rather than trying to identify the cause from the smell alone.
What does it mean to smell an odor that is not there?
Phantosmia is the perception of a smell when no odor source is present. It is different from parosmia, in which an odor that does exist smells distorted or unlike its usual smell. A U.S. survey described the experience with the question, “Do you sometimes smell an unpleasant, bad, or burning odor when nothing is there?” That wording was a survey question, not a diagnostic test.
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In an article describing NHANES data, the National Institute on Deafness and Other Communication Disorders (NIDCD) reported that about one in 15 U.S. adults had reported phantom odor perception. This is a survey finding from the United States, not a current global prevalence estimate or a prediction of an individual’s risk. NIDCD’s 2018 summary of the survey gives the question and context.
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Several different conditions and exposures can be associated with phantom smells. The possibilities below are not equally likely in every person, and the odor’s character alone cannot tell you which cause applies.
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Nose, sinus and respiratory causes
Colds, upper respiratory infections, sinus inflammation and allergies are among the commonly discussed causes. Nasal growths, including polyps, can also affect smell. A smell change associated with an infection or allergy may improve as that condition gets better.
Medicines, dental problems and exposures
Some medicines, dental issues, smoking and exposure to chemicals are also listed as possible explanations. NIDCD notes that people who suspect a medication may be affecting their sense of smell should discuss it with their doctor; do not stop or change a prescribed medicine on your own. Chemical exposure is another reason to tell a clinician about relevant work, home or environmental circumstances.
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Injury and neurological conditions
Head injury and aging are among the broader causes considered in smell disorders. Sources also list migraine, temporal-lobe seizures, Parkinson’s disease and brain tumors as possible associations. These are possibilities, not conclusions that can be drawn from phantosmia alone; a clinician considers the full history and examination.
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COVID-19 has also been reported in connection with smell changes, including phantosmia. For broader background on smell-disorder categories and causes, see NIDCD’s overview of smell disorders.
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How is phantosmia evaluated?
A healthcare professional typically starts by understanding the symptom and looking for a possible cause. The visit may include questions about when the smell began, how long it lasts, what it is like, whether it seems to come from one or both nostrils, recent illness, medications, injury and possible chemical exposure. An examination may include the ears, nose and throat.
Depending on the case, a clinician may consider a supervised smell test, nasal endoscopy, CT or MRI imaging, or an electroencephalogram. These are optional diagnostic tools selected for the circumstances—not a set of tests everyone with a phantom smell needs. NIDCD describes the general assessment process in its smell-disorder guidance; Cleveland Clinic also outlines possible questions and tests in its guide to phantosmia.
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What can you do about it?
Care depends on the cause. If the smell change is related to a cold, allergy or infection, it may improve as that problem resolves. Cleveland Clinic lists nasal irrigation with saline as a possible home measure, and the NHS says saltwater rinsing may help when a smell change is associated with infection or allergy. This is a conditional option for relevant nasal symptoms, not an established treatment for every cause of phantosmia. Follow the product instructions and seek advice if you are unsure whether rinsing is appropriate.
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When should you seek medical advice?
Talk with a healthcare professional about phantosmia, especially if it continues. Cleveland Clinic advises contacting a provider when phantom smells last longer than three weeks; Mayo Clinic likewise recommends discussing symptoms with a professional. These sources do not establish a phantosmia-specific emergency warning-sign checklist, so do not use the three-week mark to delay care if you are otherwise concerned or your condition changes.
For an overview of possible causes and advice to discuss symptoms with a clinician, see Mayo Clinic’s phantosmia information.
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